Research published in BMJ Open explored the emotional impact of miscarriage and ectopic pregnancy, including symptoms of post-traumatic stress disorder (PTSD), anxiety and depression.
The study found that some women experienced symptoms of PTSD following pregnancy loss, underlining the need for emotional support after miscarriage and ectopic pregnancy.
About the study
Researchers from Imperial College London surveyed 113 women who had recently experienced a miscarriage or ectopic pregnancy.
Most of the women in the study had experienced miscarriage in the first three months of pregnancy, while around 20% had experienced an ectopic pregnancy, where the pregnancy develops outside the womb.
In the study, funded by the Imperial College Healthcare Charity, the scientists sent the women questionnaires asking them about their thoughts and feelings after their pregnancy loss.
All of the women had attended the Early Pregnancy Assessment Unit at Queen Charlotte’s and Chelsea hospital, West London. A comparison group of 50 women with ongoing pregnancies was also included.
Key findings
Three months after pregnancy loss:
- 38% of women met the criteria for probable post-traumatic stress disorder (PTSD)
- 45% of women who had experienced miscarriage reported PTSD symptoms
- 18% on women who had experienced ectopic pregnancy reported PTSD symptoms
- Around 1 in 5 women experienced symptoms of moderate anxiety
- One in 20 women experienced symptoms of depression
Our Trustee, Dr Jessica Farren, lead author of the research from the Department of Surgery and Cancer at Imperial, said this research suggests women should have an opportunity to discuss their emotions with a medical professional.
“We were surprised at the high number of women who experienced symptoms of PTSD after early pregnancy loss. At the moment there is no routine follow-up appointment for women who have suffered a miscarriage or ectopic pregnancy. We have checks in place for postnatal depression, but we don’t have anything in place for the trauma and depression following pregnancy loss.
“Yet the symptoms that may be triggered can have a profound effect on all aspects of a woman’s everyday life, from her work to her relationships with friends and family.”
Understanding PTSD after pregnancy loss
Post-traumatic stress disorder is caused by stressful, frightening or distressing events. Symptoms can include nightmares, flashbacks, intrusive thoughts or images, and can cause sleeping problems, anger and depression.
Symptoms may begin weeks, months or even years after a traumatic event.
Women who met the criteria for PTSD described regularly re-experiencing the feelings associated with their pregnancy loss. Some reported nightmares or flashbacks, while others avoided reminders of their loss or found it difficult to be around pregnant friends and family members.
Nearly a third of women said their symptoms had affected their work life, while around 40% reported an impact on relationships with friends and family.
Why these findings matter
The study highlighted the importance of giving women the opportunity to discuss the emotional impact of pregnancy loss with a healthcare professional.
Women who experience miscarriage or ectopic pregnancy do not routinely receive follow-up care focused on their emotional wellbeing, despite the impact these experiences can have on everyday life.
Earlier studies had shown that women who experience stillbirth may develop post-traumatic stress disorder, but this was the first study to focus specifically on early pregnancy loss.
The authors also noted that the silence which often surrounds miscarriage can mean the psychological effects of pregnancy loss are not openly discussed or fully recognised.
Further research
Not everyone who experiences miscarriage or ectopic pregnancy will go on to develop PTSD, anxiety or depression.
The authors called for further research to understand why some people are more affected than others and how best to identify those who may benefit from additional support.
They also highlighted the need to explore which treatments and forms of support are most effective following pregnancy loss.