- Researchers say 1 in 6 women experience post-traumatic stress after a miscarriage or ectopic pregnancy.
- Experts say many women suffer in silence either because they hadn’t told people about the pregnancy or because friends and family downplay the event.
- Advocates say more help needs to be made available to women who are experiencing post-traumatic stress after an early pregnancy loss.
It was an unplanned pregnancy and one that she wasn’t thrilled about.
But as the weeks clicked by and Kristina moved closer to the point of telling friends and family, she grew more adjusted to the notion of bringing a third child into her home.
That’s why, when she miscarried at 10-and-a-half weeks, she was stunned not just by the grief that overcame her, but the long battle with anxiety, panic attacks, and depression that stemmed from it.
“The emotional talks in your own head after that — it’s crazy,” Kristina told Healthline.
It was so crushing, overwhelming, and frightening, Kristina said it took her more than 4 years to build up the courage to try again.
Her story — and countless others — drive home the research from a study released this week by scientists at Imperial College London and KU Leuven in Belgium.
The study reported that 1 in 6 women experience long-term post-traumatic stress following miscarriage or ectopic pregnancy.
The researchers studied more than 650 women who had experienced an early pregnancy loss.
The majority had an early miscarriage (defined as pregnancy loss before 12 weeks) or an ectopic pregnancy (where an embryo starts to grow outside the womb).
The study revealed that a month following pregnancy loss, nearly a third of the women (29 percent) reported post-traumatic stress while 1 in 4 (24 percent) experienced moderate to severe anxiety and 1 in 10 (11 percent) had moderate to severe depression.
Nine months later, 18 percent of the women had post-traumatic stress, 17 percent moderate to severe anxiety, and 6 percent moderate to severe depression.
Tom Bourne, PhD, FRCOG, FAIUM, a study author and a consultant gynecologist at Queen Charlotte’s and Chelsea Hospital, told Healthline the motivation for the study came from women who had experienced early pregnancy loss.
“We had noticed the level of psychological distress among our patients in clinical practice and wanted to have evidence to quantify this,” he said.
Taking note of this, he said, led to a small pilot study that was published in BMJ Open in 2016 that showed high levels of post-traumatic stress.
“From this we planned this larger study,” he said.
His team previously published criteria used to diagnose miscarriage, which now form the basis of guidelines worldwide.
Bourne said the old practice of not sharing the news of a pregnancy until 3 months in, a practice he calls the “12 week rule,” might contribute to the anguish.
“In general, people do not talk about miscarriage and ectopic pregnancy,” he said. “For example if we consider the 12 week rule whereby women in general often do not inform people that that they are pregnant until they are around 12 weeks has also meant that many women suffer a loss without their friends or family knowing anything about it, the result being there is a lack of support for the individual and a lack of understanding of the impact of the loss more generally”
Kristina found that to be true.
Left with just her spouse to talk about the experience, she felt alone and struggled with chronic panic attacks and depression.
She realized, she said, that the old “12 week rule” made no sense.
“As soon as you see those lines on the pregnancy test, you’re as pregnant as you are at 39 weeks,” she said. “It’s fallacy to suggest that losing a child before 12 weeks isn’t a true loss.”
Jamie Zahlaway Belsito agrees.
During Christmas 2008 she announced to her family that she was expecting her first child.
“I was just so happy,” she told Healthline.
Then, five days later, she lost the child she’d just shared that news about.
The response she got from those around her?
“I am so sorry, but you’ll get over it,” one friend shared.
“It’s not as bad as my friend: She lost her baby at 5 months,” another person crowed.
Zahlaway Belsito said from the start that did not match up to what she was experiencing.
“I felt like my entire body had failed me,” she said. “I wanted to get as far away from myself as I could, and all I could do was sit there in my own human mess. I was a straight-up nervous wreck. I’d been successful at just about everything I’d taken on in life, and here I was: unable to do this one thing that is supposed to just be so natural.”
Zahlaway Belsito realized she was sinking into a bad place, so she reached out for help and found little.
“There I was, a white, educated, privately insured woman in Boston, and I couldn’t find help,” she said. “Imagine how hard it is for others.”
From that, she went on to create and oversee the Maternal Mental Health Leadership Alliance, a group pushing policy to support and help women after miscarriage.
To her, the study findings provide proof of what she has long known: that women struggle greatly after pregnancy loss and that more help is needed.
Which, Bourne said, was a big reason for the study.
“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,” he said.
So how does one know they need help?
Bourne says there are indicators.
“Women that experience [post-traumatic stress] may be suffering from symptoms that (by definition) impact their ability to carry out day-to-day activities, and their quality of life,” he said.
Bourne points to sleep difficulties, irritability, outbursts of anger, a feeling of disconnection, decreased trust, and decreased intimacy as just a few.
“People often become withdrawn and give up previous interests,” he said. “In the extreme there is an increased incidence of alcohol and substance abuse as well as suicidal ideation. Many find it hard to cope in the workplace. “
Zahlaway Belsito says anyone experiencing these symptoms or who knows someone who exhibits these signs should contact Postpartum Support International, a group that will connect them to in-person help in their area.
Kristina suggests finding people to talk to — in person or online — who have been through the loss and understand it.
Bourne plans to conduct a clinical trial to determine the optimal treatment for post-traumatic stress specifically associated with pregnancy loss.
Zahlaway Belsito is also working toward that goal with a firsthand understanding of why.
After reaching out to a mental health provider she was told they could see her in 6 to 8 weeks.
“I told them they’ll see me at my funeral first,” she said.
She did find help eventually — and looks forward to the day all women are treated more compassionately and proactively for pregnancy loss.
“It’s one of the most devastating experiences a woman can have,” she said. “It’s time to start treating it that way.”