Miscarriage can trigger PTSD just like surviving a terrorist attack or domestic violence
- Women who have miscarriages are more likely to experience long-term post-traumatic stress disorder, anxiety, and depression than those who carry their pregnancies to term.
- PTSD symptoms can include reliving the traumatic event through flashbacks or nightmares, feeling emotionally numb, or avoiding places that serve as memories of the trauma
- Treatment for PTSD can include therapy and medication, and future studies seek to understand what treatments work best for women who've experienced pregnancy loss.
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Women who have miscarriages are more likely to experience long-term post-traumatic stress disorder, anxiety, and depression, according to a study published Tuesday in the American Journal of Obstetrics and Gynecology.
Researchers at Imperial College London and KU Leuven in Belgium looked at 737 women who experienced early pregnancy loss, or a nonviable pregnancy that occurs in the first 12 weeks, and compared them to 171 women who carried their pregnancies to term and delivered healthy babies.
They found that 29% of women who experienced a pregnancy loss, either from a miscarriage or ectopic pregnancy, had PTSD symptoms one month after that loss. (An ectopic pregnancy happens when a fertilized egg attaches itself outside of the uterus rather than in the uterus where it's supposed to grow.) Additionally, 24% of these women had anxiety, and 11% had moderate to severe depression one month after pregnancy loss.
Comparatively, of the women who delivered healthy babies, 13% reported having moderate to severe anxiety and 2% reported having moderate to severe depression one month after giving birth.
The study also found the women who had PTSD, depression, or anxiety after pregnancy loss said their symptoms continued for long periods of time, ranging from three months to nine months after the loss.
"We had noticed the level of psychological distress amongst our patients in clinical practice and wanted to have evidence to quantify this," Dr. Tom Bourne, the lead author of the study, told Insider of his team's idea to launch the research.
Every year an estimated 123 million women around the world become pregnant, and 10% will experience an early loss of that pregnancy, which is by far the most common type of pregnancy loss. "It is immediately clear that each year a very large number of women are at risk of developing significant psychological illness including PTSD," Bourne said.
Post-traumatic stress disorder can cause painful flashbacks, insomnia, and isolation
A person develops PTSD after going through a physically or emotionally horrific experience, like a terrorist attack, serving in the military in active combat, being a victim of domestic violence, or losing a loved one, according to the Anxiety and Depression Association of America. An estimated 8 million Americans who are 18 or older have PTSD.
A miscarriage can also be a traumatic loss that fits the Diagnostic Statistical Manual's PTSD definition since "for many women, miscarriage or ectopic pregnancy will be the most traumatic event that has happened in their lives up to that point," Bourne said.
Symptoms of PTSD include reliving the traumatic event through flashbacks or nightmares, feeling emotionally numb or avoiding places that serve as memories of the trauma, being unable to sleep or concentrate, and feeling skittish or irritable, the Anxiety and Depression Association of America website noted.
A person must experience these symptoms for more than one month to be diagnosed with acute PTSD, and more than three months to be diagnosed with chronic or long-term PTSD, Bourne said.
Long-term PTSD can lead to depression, anxiety, or developing phobias, as well as acting in a self-destructive manner through alcohol or drug abuse. Additionally, someone who deals with PTSD for more than three months could experience chronic pain and the breakdown of their career and personal relationships, including relationships with future children.
The study suggests many women suffer in silence
There were caveats to the study. Bourne's team had the women in the study fill out questionnaires about their symptoms rather than being interviewed by a psychologist, which could have skewed results. Also, some initial participants dropped out of the study, which could have led to a less representative sample of women, Bourne said.
Nonetheless, Bourne said quantifying the fact that women do indeed experience psychological distress after pregnancy loss could empower "colleagues in the workplace, employers, and family members to better support women and their partners going through a pregnancy loss, and also maybe spot some of the symptoms associated with post-traumatic stress and help women seek help."
The study also demonstrates that losing a baby early, rather than later into pregnancy, doesn't necessarily protect women against negative mental health effects, and in some ways could make them feel more isolated.
"If we consider the '12-week rule,' whereby women often don't inform people that that they are pregnant until they are around 12 weeks, this means that many women suffer a loss without their friends or family knowing anything about it," Bourne said. "The result is a lack of support for the individual and a lack of understanding of the impact of the loss in general."
PTSD treatment can include therapy and medication
There are treatment options for people who have PTSD including therapy and medication.
There are various therapy options, like behavioral therapy where a therapist helps a person recognize negative thinking patterns so they can avoid them in the future, and exposure therapy where a person is exposed to triggering memories in a safe and controlled setting so they can better cope with future flashbacks, according to the Mayo Clinic.
Medications like antidepressants and anti-anxiety drugs can help people with PTSD manage symptoms that would otherwise affect their day-to-day lives.
Discussing pregnancy loss more openly could also help manage women's expectations and destigmatize it, Bourne said. His team is also gearing up for a new study on the best treatment options for women dealing with PTSD after pregnancy loss.
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