Women May Experience Long-Term Post-Traumatic Stress Following Miscarriage

One month after pregnancy, nearly one-third of women suffered what they described as post-traumatic stress disorder. Travelerpix/Shutterstock

Women who experience an early pregnancy loss may struggle with post-traumatic stress, anxiety, and severe depression. For many, a miscarriage or ectopic pregnancy loss can impact their mental well-being for months to come, new research suggests.

An early pregnancy loss “represents not only the loss of a much-desired child but also may challenge an individual’s sense of control over life and pose a threat to plans of parenthood,” write the authors in the American Journal of Obstetrics and Gynecology. Early pregnancy loss is one of the most common reasons women of reproductive age see primary and secondary care doctors – about 250,000 miscarriages and 10,000 ectopic pregnancies occur in the UK every year.

“Both miscarriage and ectopic pregnancy may involve significant pain or bleeding and hospital admission or emergency procedures. They may also lead to prolonged periods of uncertainty while awaiting diagnosis or resolution,” added the researchers.

An estimated half of all women will experience a pregnancy loss throughout the course of their childbearing years – and with that loss, the feelings of sadness, grief, and frustration. To study the psychological impact of early-stage pregnancy loss, researchers at the Imperial College London and KU Leuven in Belgium assessed 650 women from three London hospitals after they had experienced a pregnancy loss before 12 weeks, more than 500 of whom had miscarried and another 116 who had been diagnosed with an ectopic pregnancy, whereby a nonviable embryo grows outside of the womb. Women were asked to complete questionnaires about their emotions and behavior one month after their pregnancy loss, and again three and nine months later.  

An ectopic pregnancy occurs when an embryo implants outside of the womb, making the pregnancy nonviable. VectorMine/Shutterstock

One month after pregnancy, nearly one-third of women suffered what they described as post-traumatic stress disorder. These women reported regularly re-experiencing the feelings associated with their loss, as well as suffered from intrusive thoughts. Some also reported having nightmares or flashbacks, while others avoided anything that reminded them of the experience. However, the researchers add that this is not a formal diagnosis of PTSD, which would require a clinical review. Furthermore, self-reported results may result in a selection bias; women already experiencing psychological symptoms may have been more likely to respond. When compared against women who had a healthy pregnancy, one-quarter of women who had a pregnancy loss experienced moderate to severe anxiety with one-in-10 reporting moderate to severe depression.

Distress declined over time but remained at “clinically important levels” at nine months. At this time, nearly one-in-five women who had suffered an early-loss pregnancy reported feelings of post-traumatic stress or severe anxiety and 6 percent had moderate to severe depression.

The authors say their findings highlight the need for improvements in the care of women and their partners in the months following the loss of a pregnancy.

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