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The psychological consequences of miscarriage

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    Abigail Ringer considers recent research showing an increased risk of post traumatic stress disorder following miscarriage and ectopic pregnancy, and whether there is sufficient psychological support for those affected.

    By Abigail Ringer

I have just read about new research which links post-traumatic stress and anxiety with miscarriage and ectopic pregnancy. The research was published in the British Medical Journal and compared stress and anxiety levels among women who had been affected by pregnancy loss against women who experienced an uncomplicated pregnancy. The research revealed that a high level of women suffer from stress and anxiety after a miscarriage and suggests that women should routinely receive psychological support following pregnancy loss.

Miscarriage and Ectopic Pregnancy

According to the Miscarriage Association, miscarriage is defined as the loss of a baby before 24 weeks gestation and I was surprised to read that miscarriage affects a quarter of all pregnancies.

Ectopic pregnancy arises when the fertilised egg implants in the fallopian tubes rather than in the womb itself and because there is not enough room to grow, the pregnancy is not successful. Ectopic pregnancy affects around 1 in 90 pregnancies.

The study & results

The recent study was carried out by a team from Imperial College London and involved gathering information from 89 women who attended the Early Pregnancy Assessment Unit at Queen Charlotte’s and Chelsea Hospital in London over an 18 month period. The women were asked to complete a range of questionnaires asking them about their thoughts and feelings at 1 month and 3 months following their attendance.

The results of the study revealed that at 1 month, whilst none of the women who had normal pregnancies met the criteria for post traumatic stress disorder (PTSD), 28% of women who had suffered early pregnancy loss met the criteria for PTSD. The symptoms were likely to persist at least three months following pregnancy loss.

Similarly, the women who had experienced early pregnancy loss were more than 3 times as likely to report symptoms of anxiety than those with normal pregnancies and much more likely to suffer from depression.

Response of the research authors

Dr Jessica Farren, lead author of the research, commented: “We were surprised at the high number of women who experience symptoms of PTSD after early pregnancy loss…There is an assumption in our society that you don’t tell anyone you are pregnant until after 12 weeks. But this means that if couples experience a miscarriage in this time, they don’t tell people. This may result in profound psychological effects of early pregnancy loss being brushed under the carpet and not openly discussed.”

It has also been recognised that there are not sufficient opportunities for such psychological trauma to be diagnosed and therefore women affected will often not receive appropriate support at an early stage, which can compound their psychological suffering.

Our experience

Many of us will have read the account of Nicole Martin on BBC News who describes the affect that her three miscarriages had on her life: “I often say the miscarriages robbed me of my personality. I couldn’t find joy in anything and hated the jealousy I felt towards other pregnant women.”

As part of a team of clinical negligence lawyers who represent women affected by miscarriage and other pregnancy and childbirth complications, the results of this study mirror what we are being told by our clients, including that there is often a lack of support offered.  It is also often the case that such psychological effects can persist long after physical injuries have resolved.  Psychological injuries can be extremely debilitating, affecting the woman’s ability to work, care for herself and others and generally all aspects of every day life.  I hope that this study will lead to patients receiving greater psychological support following miscarriage and other pregnancy and childbirth complications.

 

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