Content warning: This article discusses miscarriage, ectopic pregnancies and post-traumatic stress disorder. Some readers may find this topic disturbing and may want to skip this one.
Though as a society we’re getting a little better at talking about miscarriage and ectopic pregnancies, that doesn’t make them any less traumatic for the people who experience them. In fact, a new study found that one in six women who have a miscarriage or ectopic pregnancy face long-term post-traumatic stress.
This comes as no surprise to women like Toni Giddley, who experienced five pregnancy losses because of miscarriages and ectopic pregnancies. “After each of my losses, I would dream of the babies,” she tells Scary Mommy. “I’d see other mothers pregnant or with their children and I would cry. I was always a happy person and now I was resentful. What made those women better than me? I snapped at my friends.”
Eventually, she started using drugs as a way of escaping. “I didn’t want to confront the loss,” Giddley explains. “Society doesn’t look at ectopic pregnancies and miscarriages as a loss of life, because it typically happens during the first trimester. So no one mourned with me.”
Unfortunately, her experience is fairly common. Here’s what we learned from the new research, and what we should know about the long-term impact of miscarriages and ectopic pregnancies on mental health.
The Psychological Impact of Early Pregnancy Loss
When a pregnancy ends too soon and the person goes to the doctor, chances are the medical team will focus on their physical recovery. Of course, that’s incredibly important, but once the bleeding stops, many women are left with lasting feelings of anxiety, depression, and post-traumatic stress.
New research out of Imperial College London and KU Leuven in Belgium and published in the American Journal of Obstetrics and Gynecology was the largest ever study into the psychological impact of early-stage pregnancy loss, featuring more than 650 participants. The researchers found that one month following pregnancy loss, nearly a third of women (29 percent) suffered post-traumatic stress while one in four (24 percent) experienced moderate to severe anxiety, and one in 10 (11 percent) had moderate to severe depression. Nine months later, many were still struggling significantly, with 18 percent reporting having post-traumatic stress, 17 percent with moderate to severe anxiety, and six percent reporting moderate to severe depression.
One of the primary aims of this research is to improve the care women receive after a pregnancy loss. “Pregnancy loss affects up to one in two women, and for many women it will be the most traumatic event in their life,” Professor Tom Bourne, lead author of the research from Tommy’s National Centre for Miscarriage Research at Imperial College London said in a statement. “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.”
And while everyone who experiences a pregnancy loss is deserving of mental health care, Bourne says that women with post-traumatic stress disorder (PTSD) require specialized treatment in order to even attempt a full recovery. “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,” he added in the statement.
Though we have a long way to go, this topic has been increasingly on medical and mental health professionals’ radar. Scary Mommy spoke with a few — as well as with some women who’ve experienced early pregnancy loss — to find out more about this type of grief.
Why It Hurts So Much and For So Long
No matter how many times a doctor reassures you that miscarriage is common and an unfortunate, but normal, part of the reproductive process, it doesn’t make the loss feel any less painful. “When a pregnant person experiences the loss of a pregnancy it can feel to them as if a child has died, regardless of how far along they were in the pregnancy,” Haley Neidich, a licensed psychotherapist specializing in perinatal mood and anxiety disorders, who also experienced a miscarriage, tells Scary Mommy. “The moment a woman becomes pregnant, she typically begins fantasizing about her child and the baby becomes very real for them. I often hear from clients that they had no idea how painful the loss of a pregnancy could be emotionally.”
As far as the PTSD, the lack of control over the situation — in this case, a pregnancy — can have lasting effects on a person’s mental health, according to Venka de Rooij, a psychotherapist and trauma specialist. “I find the more helpless and overwhelmed a person feels, the more likely you are to be traumatized,” she tells Scary Mommy. “In the case of a miscarriage or ectopic pregnancy, there is nothing a woman can do to either prevent or correct it, so feeling very helpless is a very normal response.”
Along the same lines, trauma may also stem from the fact that miscarriage and ectopic pregnancy both involve a combination of mental, emotional, and physical stress. “What folks on the outside don’t often understand about pregnancy loss is that beyond the emotional pain, women are often undergoing physical procedures to remove the excess tissue from the pregnancy, and these medical interventions can and often do compound the trauma,” Neidich says. “PTSD occurs when the brain becomes overwhelmed and cannot process an upsetting life event. Many things can cause trauma, but those events which result in the loss of a child or pregnancy or involve fear of bodily harm are most likely to trigger mental health symptoms in women.”
And for many women, this trauma sticks around for years. Melanie Musson has experienced four pregnancy losses and also has four living children with another on the way, and is still processing a miscarriage more than a decade later. “To this day, 11 years later, if I go to the hospital waiting room where I waited for my ultrasound that showed my baby had no heartbeat, I have terrible anxiety,” she tells Scary Mommy. “I have gotten through it by focusing on science and statistics.”
Another source of the trauma is what Keisha M. Wells — a licensed counselor who specializes in maternal mental health services — calls an “out-of-order” loss. “Issues in pregnancy and childbirth are common; however, the loss of a pregnancy or a baby is still so stigmatized, in which mothers, and fathers or partners, feel great shame and guilt,” she tells Scary Mommy. “Individuals who have endured this type of out-of-order loss — as most parents never expect to experience the disruption of a pregnancy or death of their baby — are faced with distress and a wide-range of emotions including shock, despair, anger, and confusion.”
And this anger and sadness isn’t limited to things related to motherhood or babies. “Experiencing a miscarriage is not only a true loss that requires real grieving, it also strips you of any excitement or joy someone would normally feel when something positive happens, trying-to- conceive-related or not,” Arielle Spiegel, who experienced four pregnancy losses tells Scary Mommy. “Anything good — whether it’s an opportunity at work, a budding new friendship, or a new house or apartment — feels too good to be true, or not something to get excited about. Because you’re used to experiencing that excitement and having it stripped away from you, and also because your mind and body are still numb from the pain you’ve experienced.”
When and How to Get Help
If you or someone you know is experiencing post-traumatic stress as a result of a pregnancy loss (or anything else for that matter), it’s a good idea to talk to a professional about it. “If someone has symptoms such as anxiety, intrusive thoughts about the experience, difficulty sleeping, or avoiding triggers related to the [miscarriage or] ectopic pregnancy, I suggest they seek out therapy immediately,” Rachel Del Dosso, a licensed marriage and family therapist who specializes in PTSD tells Scary Mommy. “Trauma is stored in our bodies and unless it is effectively resolved, it can continue to cause symptoms and distress.”
Given how isolating miscarriage and ectopic pregnancy can be, Wells recommends getting as much support as possible. “Navigating trauma and the path of grief is a singular and uncertain journey; however, the pain of loss can be eased with education and adequate support from caring individuals, including family members and friends, as well as individual counseling and grief support groups,” she explains. In addition, therapists specializing in trauma and perinatal loss can help people normalize their symptoms, work with them on identifying and understanding their emotions and reactions, and provide education on coping skills.
Lastly, know that your grief is completely warranted and valid. If your healthcare provider doesn’t see it that way — or tries to minimize what happened to you — it may be time to find someone else, if that’s a possibility. Dr. Eduardo Hariton, an OB-GYN and fertility specialist says that he makes an effort to be compassionate with his patients while they are in mourning. “I tell my patients that feeling grief is normal as they have had a loss. I try to comfort them and support them through this difficult time,” he tells Scary Mommy. “A loss can have a tremendous impact on a woman or a couple, and making sure patients feel supported and have access to mental health providers is essential for their wellbeing and overall health.”