Miscarriage and ectopic pregnancy may trigger long-term post-traumatic stress, anxiety and depression

The largest ever study into the psychological impact of miscarriage and ectopic pregnancy has shown that early-stage pregnancy loss can have a serious impact on mental health. The research was led by Professor Tom Bourne at the Tommy’s National Centre for Miscarriage Research at Imperial College London.

A close up of two people holding hands

January 15 2020

According to a study published by Tommy’s National Centre for Miscarriage Research, 1 in 6 women experience long-term post-traumatic stress following miscarriage or ectopic pregnancy.

This is the finding of the largest ever study into the psychological impact of early-stage pregnancy loss, from scientists at Imperial College London and KU Leuven in Belgium.

Post-traumatic stress disorder (PTSD) after early pregnancy loss

The research, published in the American Journal of Obstetrics and Gynaecology, studied 737 women who had experienced an early pregnancy loss, with the majority having an early miscarriage or an ectopic pregnancy.

The study revealed that 1 month following pregnancy loss, nearly a third of women suffered post-traumatic stress while 1 in 4 experienced moderate to severe anxiety.

The team behind the research, funded by the Imperial Health Charity and the Imperial NIHR Biomedical Research Centre, call for immediate improvements in the care women receive following an early-stage pregnancy loss. 

“Pregnancy loss affects up to 1 in 4 women, and for many women it will be the most traumatic event in their life. 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.

“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. Whilst general support and counselling will help many women, those with significant post-traumatic stress symptoms require specific treatment if they are going to recover fully. This is not widely available, and we need to consider screening women following an early pregnancy loss so we can identify.”

Professor Tom Bourne, lead author of the research from Tommy’s National Centre for Miscarriage Research at Imperial College London

More about the study 

The research follows an earlier pilot study in 2016, which investigated the psychological impact of early-stage pregnancy loss in 128 women 1 and 3 months after miscarriage or ectopic pregnancy. Estimates suggest there are 250,000 miscarriages every year in the UK, and around 11,000 emergency admissions for ectopic pregnancies. Ectopic pregnancies always result in pregnancy loss, as an embryo grows in an area outside of the womb and is unable to develop.

The women in the study attended the Early Pregnancy Assessment Units at 3 London hospitals - Queen Charlottes and Chelsea, St Mary’s, and Chelsea and Westminster. All were asked to complete questionnaires about their emotions and behaviour 1 month after pregnancy loss, then again 3 and 9 months later

Their responses were compared to 171 women who had healthy pregnancies. The results revealed that women who had suffered early pregnancy loss experienced increased psychological symptoms, compared to those who had healthy pregnancies.

The women in the study who met the criteria for post-traumatic stress reported regularly re-experiencing the feelings associated with the pregnancy loss and suffering intrusive or unwanted thoughts about their miscarriage. Some women also reported having nightmares or flashbacks, while others avoided anything that might remind them of their loss.

The authors note that the study used a questionnaire to screen for post-traumatic stress, but formal diagnosis of post-traumatic stress disorder would require a clinical interview. The team also explain that women who were already experiencing symptoms of post-traumatic stress and depression may have been more likely to respond to the questionnaire, which could mean the number of women suffering psychological symptoms may appear higher.

The long-lasting effects of PTSD

 “The effects of post-traumatic stress can have a toxic effect on all elements of a person’s life – affecting work, home and relationships. We have made significant progress in recent years in breaking the silence around mental health issues in pregnancy and postnatally, but early pregnancy losses are still shrouded in secrecy, with very little acknowledgement of how distressing and profound an event they are.

“Many women don’t tell colleagues, friends or family they are pregnant before the 12-week scan, leaving them feeling unable to discuss their emotions if they suffer a pregnancy loss. We also know partners can suffer psychological distress following miscarriage or ectopic pregnancy and are investigating this in ongoing research.”

Dr Jessica Farren, author of the research from Imperial College and Obstetrician and Gynaecologist

The team’s research will also now focus on identifying which women are at risk of developing psychological symptoms after pregnancy loss, and also the best type of treatments and how to deliver these.

“For too long women have not received the care they need following a miscarriage and this research shows the scale of the problem. Miscarriage services need to be changed to ensure they are available to everyone and women are followed up to assess their mental wellbeing with support being offered to those who need it and advice is routinely given to prepare for a subsequent pregnancy.”

Jane Brewin, Chief Executive of Tommy’s

Read more about Tommy's research into miscarriage 

 

Make a donation to Tommy's

Learn more about Tommy's pioneering reasearch

  • Predicting and preventing premature birth

    Premature birth is the biggest killer of newborn babies in the UK and much of Tommy's research is devoted to predicting and preventing this. One discovery has made a huge difference to our ability to treat women in time.

  • Finding the reasons for stillbirth

    In more than half of stillbirths parents are not given a reason for their babies' death. Doctors simply do not know why it happens. This animation looks at how Tommy's researchers are finding out the causes of stillbirth and how this leads to treatments and saved lives.

  • Finding the reasons for miscarriage

    Too many miscarriages are unexplained. Our research is entirely dedicated to finding out why miscarriages happen and how to prevent it in the future.

Read more Tommy's News

  • A nurse taking a patients blood pressure in a hospital room

    News

    Pregnancy is a unique chance to predict health risks to mums

    A recently published article, co-authored by Professor Catherine Williamson from Tommy’s Research Centre at King’s College London, suggests that certain pregnancy complications can indicate future health issues for women.

  • Rising demand for Tommy's midwives in coronavirus lockdown

    News

    Tommy’s awarded grant to help meet rising demand for support during coronavirus lockdown

    Tommy’s has received a grant from the UK Government’s Department for Health and Social Care to support the costs of its PregnancyHub information and support services throughout the summer, due to rising demand in the wake of coronavirus.

  • Tommy's researchers latest findings

    News

    Tommy’s Research Centres continue vital work on pregnancy complications

    Although recruitment to some clinical trials had to be paused when coronavirus hit the UK, scientists at Tommy’s Research Centres across the UK are still hard at work, supporting women and families in our specialist clinics and sharing their latest studies with academic journals.

  • Blog

    Miscarriage during lockdown

    The day before Mother’s Day, and two days before the UK officially went into coronavirus lockdown, Zara Dawson found out she was having a miscarriage. Her third consecutive miscarriage in less than a year, and fourth consecutive loss, after losing her second son Jesse in 2018 to termination for medical reasons.

    Was this information useful?

    Yes No