One in six women suffer from long-term PTSD symptoms following a miscarriage or ectopic pregnancy, research suggests.
Scientists quizzed 650 women who lost their baby about their psychological state following the heartbreaking news.
Almost a third of women suffered from post-traumatic stress a month later. Others were plagued with anxiety and depression, as well as feelings of guilt and shame.
And 18 per cent of women studied still had PTSD nine months later, reliving their devastating loss through nightmares and flashbacks.
It has long been known that miscarrying has a devastating toll on expecting mothers’ mental health.
But the new study, the largest ever into the psychological effects of a lost pregnancy, lays bare its long-term impact.
Experts have now called for mental health services to reach out to women in the year after their loss.
One in six women suffer long-term post-traumatic stress almost a year after miscarrying, research suggests (stock)
As it currently stands, women are offered a follow-up appointment with their GP where they can ask to be put in touch with charities and therapists.
But for some women they may refuse help because they believe their grief will subside. For many it doesn’t, and they are left to their own devices to seek help.
One in six pregnancies ends in miscarriage – most often before or around 12 weeks.
They most commonly occur because the fetus isn’t developing normally. Half are associated with extra or missing chromosomes.
Estimates suggest there are 250,000 miscarriages every year in the UK, around 11,000 of which are ectopic pregnancies. There are almost a million in the US.
How at least one in six pregnancies ends in a miscarriage
One in six pregnancies in women who know they are pregnant become miscarriages.
But even more happen among women who don’t know they have conceived.
Miscarriage occurs when a pregnancy is lost within the first 23 weeks after conception.
The main symptoms are bleeding from the vagina, which may be accompanied by lower abdominal pain.
There are various reasons women may have a miscarriage – it is common and is not usually caused by something they have done.
If a miscarriage happens in the second trimester – between weeks 14 and 26 – it may be a sign of an underlying problem.
Often, miscarriages are isolated events and women will go on to have successful pregnancies.
The majority of miscarriages can’t be prevented, although being generally healthy will help reduce the risk.
Losing three or more pregnancies in a row – known as recurrent miscarriages – is uncommon but still affects around one in 100 women.
Ectopic pregnancies always result in loss, as an embryo grows in an area outside of the womb and is unable to develop.
Scientists from Imperial College London and KU Leuven in Belgium studied over 650 women who had experienced an early pregnancy loss.
Of them, 537 had suffered a miscarriage before 12 weeks of pregnancy, while 116 had suffered an ectopic pregnancy.
One month after miscarrying, nearly a third of women (29 per cent) suffered post-traumatic stress.
One in four (24 per cent) experienced moderate to severe anxiety, and one in ten (11 per cent) had moderate to severe depression.
Nine months later, 18 per cent of women had PTSD, while 17 per cent had moderate to severe anxiety, and 6 per cent moderate to severe depression.
Lead study author Professor Tom Bourne said: ‘For many women it [miscarrying] will be the most traumatic event in their life.
‘This research suggests the loss of a longed-for child can leave a lasting legacy, and result in a woman still suffering post-traumatic stress nearly a year after her pregnancy loss.
‘The treatment women receive following early pregnancy loss must change to reflect its psychological impact, and recent efforts to encourage people to talk more openly about this very common issue are a step in the right direction.
‘Whilst general support and counselling will help many women, those with significant post-traumatic stress symptoms require specific treatment if they are going to recover fully.
‘This is not widely available, and we need to consider screening women following an early pregnancy loss so we can identify those who most need help.’
The women in the study attended the Early Pregnancy Assessment Units at three London hospitals – Queen Charlottes and Chelsea, St Mary’s, and Chelsea and Westminster.
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 women in the study who met the criteria for post-traumatic stress reported regularly having flashbacks about their miscarriage.
Some women also reported having nightmares, while others avoided anything that might remind them of their loss.
The authors caution the study used a questionnaire for screening for post-traumatic stress, but formal diagnosis of post-traumatic stress disorder (PTSD) would require a clinical interview.
The team said the results could have been skewed because women who were already experiencing symptoms of post-traumatic stress may have been more likely to respond to the questionnaire.
But they add that the fact that such a large proportion were experiencing symptoms suggests many women could be suffering in silence.
Jane Brewin, chief executive of the charity Tommy’s comments, said: ‘For too long women have not received the care they need following a miscarriage and this research shows the scale of the problem.
‘Miscarriage services need to be changed to ensure they are available to everyone, and women are followed up to assess their mental wellbeing with support being offered to those who need it, and advice is routinely given to prepare for a subsequent pregnancy.’
‘AFTER MY FIRST MISCARRIAGE I WAS NUMB. THE SECOND TIME I COULDN’T BEAR THE GUILT OF LETTING DOWN MY FAMILY’
Kate Rawson, an actor and playwright, experienced two miscarriages in 2014 and 2015, one at eight weeks and one at 11 weeks.
She has written a radio play about recurrent miscarriage called Little Blue Lines. Here she discusses her experience:
After my first miscarriage I was numb. I did not know how to react or who to approach. I did not know if it was grief that I was feeling, or if that was even a valid response to have about losing something so ‘small’.
So I tried to believe reassuring words, ‘It’s not your fault; you can try again; you’ve got time; it’s just one of those things.’
The second time it happened I knew something was wrong immediately, just a faint pink patch in my pants, a slight cramping feeling.
Then dread and anxiety at what was to come, and guilt at what I could have done to cause it – sadness for myself, but also my husband, my family, my friends who would have to do all those sad faces and texts and calls again.
The physical miscarriage was a huge shock, one I was absolutely not prepared for and I will never forget it.
I tried to ‘move on’ as advised. ‘Trying again’ was full of anxiety that got worse when I fell pregnant for the third time.
Happily that resulted in a healthy full term birth, but the first trimester was extremely stressful, for both myself and my husband.
I struggled to keep perspective and flitted between wanting this baby more than anything else to wishing I would just bleed and get the awful thing over with and my life back.
It was only after my son was born I realized the enormity of what I had been through, and the need to process it – there are support groups at my hospital now but there was nothing available to me at the time – so I wrote about it.
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