A Call For Better Support After Pregnancy Loss
As many as one in four women who find out theyre pregnant will have a miscarriage, according to the U.S. National Library of Medicine. By contrast, ectopic pregnancies are less common, occurring in up to 2 percent of the general population and up to 5 percent of women who used assisted reproductive technology.
Some women stay silent about these losses when what they really need is support. If youre not getting support for your feelings, there are support groups for pregnancy loss that can validate your feelings, Monk says.
In addition, Domar says, cognitive behavioral therapy can be helpful. By identifying and reframing unhelpful thoughts, accepting your feelings of loss, and finding ways to reengage in activities that bring you joy and a sense of meaning, you can use CBT to come to terms with the emotional pain of losing a pregnancy.
Potential Next Steps For Couples
- Be sensitive to each other. Talking about other pregnancies may be the non-birthing partners way of trying to fix things, however what the birthing partner usually needs is someone to listen and be there.
- Support your partner. Taking the time to sit with each other, talk, and engage in activities together will help both partners heal faster.
- Ask for support. Support groups, counselors, and even therapists can be of great help to both partners.
- Get busy. Keeping yourself busy through this process is important, to decrease the constant thoughts that you have about the miscarriage. One or two new projects are adequate to keep busy while handling this change.
- Give it time. Give yourself and your partner enough time to fully experience this and come out the other side.
Feeling Bad After Pregnancy Loss Is Normal Research Suggests
Making matters worse, someone can have post-traumatic stress symptoms and be depressed or have anxiety after a miscarriage or ectopic pregnancy, Dr. Domar notes. This is one of the first studies to show that its pretty normal to feel psychologically lousy for a long time after a pregnancy loss, she says. The take-home message is that feeling anxious, depressed, or having post-traumatic stress symptoms is a normal reaction to a pregnancy loss, whether its a miscarriage or an ectopic pregnancy.
Men need to recognize their feelings about early pregnancy loss, too, Domar says. You just dont see men acknowledge this part of it is that theyre very intent on supporting their wives, she explains. And early pregnancy loss is a very abstract experience for men. It happens to her body, not his. He may not have even seen the baby on ultrasound.
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Psychological Trauma After Miscarriage
Post Traumatic Stress Disorder is often associated with combat or war zone exposure, natural disasters or serious vehicle accidents. But symptoms of PTSD can arise from a variety of traumatic experiences, such as a miscarriage.
In December 2019, a study of 650 women, by Imperial College London and KU Leuven in Belgium, has found that one in six women suffer from long-term symptoms of PTSD after a miscarriage.
For some women it may be the first time they experience anything beyond their control and for many women it will be the most traumatic event in their life.
Early Miscarriage And Ectopic Pregnancy May Trigger Post
Women may be at risk of post-traumatic stress disorder following an early miscarriage or ectopic pregnancy, suggests a new study.
The team behind the research, at the Tommys National Centre for Miscarriage Research at Imperial College London, say the findings suggest women should be routinely screened for the condition, and receive specific psychological support following pregnancy loss.
In the study, published in the journal BMJ Open, the team surveyed 113 women who had recently experienced an early pregnancy loss .
Most had suffered a miscarriage, while around 20 per cent had suffered an ectopic pregnancy, where the baby starts to grow outside of the womb.
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The Study Suggests Many Women Suffer In Silence
There were caveats to the study. Bourne’s team had the women in the study fill out questionnaires about their symptoms rather than being interviewed by a psychologist, which could have skewed results. Also, some initial participants dropped out of the study, which could have led to a less representative sample of women, Bourne said.
Nonetheless, Bourne said quantifying the fact that women do indeed experience psychological distress after pregnancy loss could empower “colleagues in the workplace, employers, and family members to better support women and their partners going through a pregnancy loss, and also maybe spot some of the symptoms associated with post-traumatic stress and help women seek help.”
The study also demonstrates that losing a baby early, rather than later into pregnancy, doesn’t necessarily protect women against negative mental health effects, and in some ways could make them feel more isolated.
“If we consider the ’12-week rule,’ whereby women often don’t inform people that that they are pregnant until they are around 12 weeks, this means that many women suffer a loss without their friends or family knowing anything about it,” Bourne said. “The result is a lack of support for the individual and a lack of understanding of the impact of the loss in general.”
More Than A Small Loss Miscarriage Can Be A Deep Source Of Distress
After all, pregnancy loss involves not only the loss of a desired child, as the researchers noted, but it also may challenge an individuals sense of control over life, and pose a threat to plans of parenthood. Whats more, miscarriage and ectopic pregnancy may involve symptoms of physical discomfort, including pain or bleeding, as well as medical interventions. A prolonged period of uncertainty may follow, as the woman waits for diagnosis, resolution, or the green light to try for another pregnancy.
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What Does Dr Jessica Farren Make Of These Results
Dr Jessica Farren, a Parla expert advisor, led the research from Imperial College London. She was astounded at how prominent and long-lasting PTSD like symptoms were amongst the women in the study. We were surprised at the high number of women who experienced symptoms of PTSD after early pregnancy loss particularly the number of women who were still experiencing symptoms three months after their miscarriage. She points out that miscarriage and ectopic pregnancy are incredibly common and that this therefore points to an important public health concern.
The fact that this study focused on women who have experienced loss early on in their pregnancy was really important to Jess, as its a bereavement that often gets forgotten. There is an assumption in our society that you dont tell anyone you are pregnant until after 12 weeks. But this also means that if couples experience a miscarriage in this time, they dont tell people. Jess says. This may result in the profound psychological effects of early pregnancy loss being brushed under the carpet, and not openly discussed.
Jessica hopes that this research will bolster the case for having more robust mental health checks for women that have experienced loss.
The Toll Of Early Pregnancy Loss
One in four pregnancies ends in miscarriage most often before or around 12 weeks. Estimates suggest there are 250,000 miscarriages every year in the UK, and around 11,000 emergency admissions for ectopic pregnancies. The latter always result in pregnancy loss, as an embryo grows in an area outside of the womb and is unable to develop.
In the study 537 women had suffered a miscarriage before 12 weeks of pregnancy, while 116 had suffered an ectopic pregnancy.
All were asked to complete questionnaires about their emotions and behaviour one month after pregnancy loss, then again three and nine months later.
Their responses were compared to 171 women who had healthy pregnancies. The results revealed the latter womens levels of psychological symptoms were significantly lower than those found in women who had suffered early pregnancy loss.
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How Can I Help Myself
- Talk to your partner, family or a friend about what happened and how you are feeling, if you can.
- Try not to feel guilty or embarrassed. These thoughts and feelings are not your fault.
- Dont use alcohol or smoke to try to cope with your feelings. This may harm you or your baby.
- Accept that recovering takes time dont be hard on yourself.
- Accept the help that is offered to you.
Like Moms Who Blame Themselves For Experiencing Depression After Having A Baby Women Who Lose Pregnancies Often Blame Themselves For Not Carrying To Term Even If There Was Nothing That They Could Have Done Differently
I wish I had known that it wasnt my fault, Christiana says. There are so many unknowns and wont always have answers, and you have to learn to live with that.
Women who have lost a pregnancy also feel loneliness in a similar way to mothers experiencing postpartum depression. I felt so lonely for months, Dodson says. No one around me ever had a miscarriage, and my best friend was having a healthy pregnancy at the time of my loss.
I often see women in my practice navigating the aftermath of miscarriage by themselves because cisgender male partners do not understand the depth of their loss. And while studies have shown that pregnancy and infant loss also negatively impact the mental health of male partners, men also process the loss differently, experiencing less acute and prolonged feelings of sadness or pain, which can make women whove miscarried feel isolated and alone in their grief.
Women shouldnt have to live with the depression, anxiety, and PTSD that can follow a pregnancy loss. The commonality of miscarriage doesnt lessen the pain it can bring or the impact it can have on a persons mental health. It does, however, offer those women who have suffered a pregnancy loss one small but significant comfort: You are not alone.
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Can You Suffer From Ptsd After A Miscarriage
This recent study, led by Adia expert and gynaecologist, Dr Jesscia Farren, revealed that women who experience early miscarriage and ectopic pregnancy are at risk of developing PTSD.
Thestudy, which was published the American Journal of Obstetrics and Gynaecology surveyed 650 women who had lost their baby at 20 weeks or less, or had experienced an ectopic pregnancy where the baby develops outside the womb. This was thelargest ever study into the psychological impact of early-stage pregnancy loss. The women were sent questionnaires, asking them about their feelings, one month, three months and nine months after their loss. The results were concerning. One month following pregnancy loss, nearly a third of women suffered post-traumatic stress. In addition, nearly a quarter experienced moderate to severe anxiety and 11% had moderate to severe depression. Nine months later, 18% of the women involved in the study still reported symptoms of PTSD.
Can You Have Ptsd And Depression At The Same Time
PTSD and depression share many similar symptoms, but they are separate mental health issues and should be treated as such. That said, its very common to suffer from both PTSD and depression simultaneously.
Importantly, if you have depression you are more likely to experience PTSD and vice versa. That means you can be suffering from depression after loss and PTSD. This might sound overwhelming, but pinpointing the unique symptoms will allow your doctor to find the most effective treatment plan for you.
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Kellie’s Story: ‘i Felt So Alone After My Baby Died’
Kellie Cunningham lost her baby boy five months into her pregnancy in 2017. She named him Henry.
“It changed my life,” she says.
“I went into hospital one person and came out a totally different person.”
Kellie said she did not get any NHS follow-up or mental health support after she left hospital, and went on to develop PTSD, only picked up by a support group led by the baby loss charity, Sands.
She began to pay for her own therapy.
“I was just left to pack up my things in hospital that day, take the little memory box they gave me, and leave the building. I felt so alone.
“People think because your baby never lived, you cannot feel a close bond with them.
“But as soon as you find out you are pregnant, you are planning your futures. For that to be taken away from you in a second has a big impact,” she said.
Kellie now raises money for Sands, and is a befriender for the charity, helping other women who have lost babies.
She continues to suffer with PTSD and anxiety five years after the loss of Henry.
“I strongly believe if I had been given support when I left the hospital I would not have ended up with PTSD, or still be in therapy, years later.”
Estimates suggest there are about 250,000 miscarriages in the UK each year, with most occurring in the first three months of pregnancy.
Prof Bourne, who works at Tommy’s National Centre for Miscarriage Research at Imperial College London, has studied this for many years.
Symptoms of PTSD are wide-ranging and can include:
How Common Is Ptsd
About one or two in every 100 women have post-traumatic stress after giving birth.
It’s possible for birth partners to experience PTSD symptoms too. Seeing someone you care about in distress or pain can be very upsetting and many partners have told us that seeing a traumatic birth made them feel helpless, out of control or scared. This can cause birth trauma.
PTSD UK states that research is limited, but it is thought that 5% of partners develop trauma symptoms after being present during the birth.
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Miscarriage Perceived Ostracism And Trauma: A Preliminary Investigation
- 1Department of Psychology, Illinois State University, Normal, IL, United States
- 2College of William & Mary, Williamsburg, VA, United States
Miscarriage often is a traumatic experience with serious mental health implications. Friends and family members are often uncomfortable with and avoid discussing the topic with bereaved individuals, potentially making them feel ostracized , contributing to their mental health concerns. We investigated the correlation between posttraumatic stress symptoms, perceived ostracism, and recalled grief intensity measures in a sample of cisgender women who have had a miscarriage. These participants were recruited using Qualtricss Panel Recruitment Services. Womens perceived ostracism correlated positively with posttraumatic stress symptoms and negatively with grief congruence . Perceived ostracism also explained additional variance in posttraumatic stress symptoms when considered alongside grief intensity measures .
For Those Women Who Experience Postpartum Depression But Have No Baby To Show For It Trying To Navigate Feelings Of Grief Guilt And Self
The commonality of miscarriage can downplay the psychological toll it can take. When doctors, family members, or friends dismiss miscarriages as something that just happens, it can reinforce ideas that people should simply get over it and try again or, if theyve suffered multiple miscarriages, to just stop trying to get pregnant altogether.
I dont think people know what to say, and they can come off as insensitive, Tara Anders, 24, who has had three miscarriages, tells HelloGiggles. I have been told by others to just stop trying, and as soon as you stop trying it will happen for you, and dont stress thats why you cant hold on to the pregnancy, or just adopt.
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The Results Revealed That One Month After The Pregnancy Loss More Than One In Four Women Met Official Criteria For Probable Ptsd
Among the women who suffered a miscarriage 25 per cent reported PTSD symptoms, compared to 38 per cent of the women who suffered an ectopic pregnancy.
Post-traumatic stress disorder is caused by stressful, frightening or distressing events, and causes people to relive the event though nightmares, flashbacks, or intrusive thoughts or images that appear at unwanted moments. The symptoms can start weeks, months or even years after a traumatic event and can cause sleeping problems, anger, and depression.
The women in the study who met the criteria for PTSD reported regularly re-experiencing the feelings associated with the pregnancy loss, and suffering intrusive or unwanted thoughts about their miscarriage. Some women also reported having nightmares or flashbacks, while others avoided anything that may remind them of their loss, or friends and family who are pregnant.
Miscarriage And Mental Illness
Mental illness can be a consequence of miscarriage or early pregnancy loss. Even though women can develop long-term psychiatric symptoms after a miscarriage, acknowledging the potential of mental illness is not usually considered. A mental illness can develop in women who have experienced one or more miscarriages after the event or even years later. Some data suggest that men and women can be affected up to 15 years after the loss. Though recognized as a public health problem, studies investigating the mental health status of women following miscarriage are still lacking.Posttraumatic stress disorder can develop in women who have experienced a miscarriage. Risks for developing PTSD after miscarriage include emotional pain, expressions of emotion, and low levels of social support. Even if relatively low levels of stress occur after the miscarriage, symptoms of PTSD including flashbacks, intrusive thoughts, dissociation and hyperarousal can later develop.Clinical depression also is associated with miscarriage. Past responses by clinicians have been to prescribe sedatives.
Recurring miscarriage may increase the incidence of intrusive thoughts in women and their partners.
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