Women who suffer a miscarriage are at risk for depression, anxiety, and even post-traumatic stress disorder symptoms — and these problems shouldn’t be ignored.
Expecting a first child or an addition to the family is usually a happy time of life as plans are made for the baby’s arrival. But unforeseen, and often unexplained, problems can result in the sad reality of the loss of a baby. It’s understandable and expected for women and their partners to grieve when a child is stillborn or dies soon after birth.
However, friends and even family members may think the loss of a pregnancy in its early stages isn’t a very serious or traumatic event, and they can assume women will quickly move on and even happily look forward to expecting again soon. However, that’s an unfortunate and just plain wrong assumption. Miscarriages and ectopic pregnancies frequently have a profound psychological and emotional impact on women, according to a new study.
What causes a miscarriage?
The March of Dimes notes about 10 to 15 percent of pregnancies end in miscarriages, most often in the first 13 weeks (the first trimester). While genetic defects, maternal health, and exposure to toxins and drugs can play a role in miscarriages, often the exact cause is never known. Ectopic pregnancies occur when a fertilized egg attaches somewhere outside of the uterus (most often, inside a fallopian tube). The fetus doesn’t have the space or needed tissue to develop, resulting in the inevitable early loss of pregnancy.
Research by investigators from Imperial College in London and the University of Leuven in Belgium found that after either of these types of early pregnancy losses, women may suffer from depression, anxiety, and even post-traumatic stress disorder (PTSD).
For the study, published in the BMJ Open journal, the research team studied 113 women who had recently suffered a pregnancy loss in the first three months of pregnancy. About 80 percent had experienced a miscarriage, while the rest had ectopic pregnancies. The researchers also questioned a control group of 50 women with ongoing pregnancies.
The findings revealed women who suffered an early pregnancy loss were at significant risk for emotional and psychological problems, compared to women with normal pregnancies.
Post-traumatic stress disorder symptoms
Three months after their miscarriage or ectopic pregnancy, one in five of the women experienced anxiety, and one in 20 developed depression. In addition, almost half of the women who suffered a miscarriage and about 20 percent of the women who had ectopic pregnancies developed post-traumatic stress disorder symptoms, including reliving the trauma of losing their unborn baby through flashbacks, nightmares, and intrusive memories.
In fact, the symptoms impacted the women’s lives on multiple levels. Almost a third told the researchers their PTSD had interfered with their work life, and 40 percent said their relationships with family and friends had suffered, too. Some reported they avoided anything that reminded them of their pregnancy, and they made a point to stay away from family members and friends who were expecting.
"We were surprised at the high number of women who experienced symptoms of PTSD after early pregnancy loss,” said lead researcher Jessica Farren, MD, of the Imperial College department of surgery and cancer.
"There is an assumption in our society that you don't tell anyone you are pregnant until after 12 weeks. But this also means that if couples experience a miscarriage in this time, they don't tell people. This may result in the profound psychological effects of early pregnancy loss being brushed under the carpet, and not openly discussed."
The researchers concluded that after an early pregnancy loss, women should be routinely screened for depression, anxiety, and PTSD and receive psychological support if needed. Farren and colleagues are planning larger follow-up studies and hope to find ways to identify women most at risk for mental health problems after a miscarriage or ectopic pregnancy.
The National Institute of Child Health and Human Development offers extensive information on pregnancy loss.
February 22, 2017
Janet O’Dell, RN