9 October 2020
New research from Tommy’s National Centre for Miscarriage Research, published in the journal Ultrasound in Obstetrics and Gynaecology, shines a light on the psychological effects of loss in both parents and calls for more specialist mental health support.
Earlier this year, our team at Imperial College London found that around 1 in 5 women experienced long-term symptoms of post-traumatic stress (PTS) following an early miscarriage or ectopic pregnancy, and this latest research shows that 1 in 12 partners did so too. With our focus on isolation during Baby Loss Awareness Week, it's vital we remember that both parents can struggle to cope with their grief, and we must break the silence so that anyone who needs help feels able to ask for it.
What our scientists found
Our researchers surveyed more than 100 couples who had experienced early miscarriage or ectopic pregnancy, asking them about their emotions and behaviour. (They used a questionnaire for screening for PTS, but formal diagnosis of PTSD would require a clinical interview.) 102 partners took the survey a month after loss, but this dropped to 70 by the end of the study, which highlights the challenge of ensuring that both parents can open up about their experiences.
A month after loss, 7% of partners met the criteria for PTS - rising to 8% at 3 months - and 4% were still having symptoms 9 months later. Responses from the mothers were similar to those we reported earlier this year: a third (34%) suffered PTS a month after loss, dropping to a quarter (26%) by 3 months, with a fifth (21%) still experiencing symptoms at 9 months.
Although more mothers met PTS criteria than partners, many partners experienced the individual symptoms even if they didn't meet full criteria for the condition. For example, more than 80% of the partners reported feeling helpless at all stages of the study, and around a third felt terrified. Around 70% of partners said they had re-experienced the event, and 20% said their symptoms had affected their relationships.
Bereaved parents in the study who met the criteria for PTS reported regularly re-experiencing the feelings associated with the loss, and suffering intrusive or unwanted thoughts about it. Both women and partners also reported having nightmares or flashbacks, while others avoided anything that might remind them of their loss.
Why this research matters
Professor Tom Bourne, who led this work at our National Centre for Miscarriage Research, said: “Our previous research suggested women can be left deeply traumatised after a pregnancy loss, and this new study suggests partners also experience post-traumatic stress. Partners are often ignored when a woman experiences pregnancy loss. Yet this research suggests that although partners do not suffer PTS as often as women, there still could be many thousands of partners living with post-traumatic stress, which is a serious condition that requires treatment.
“We have made significant progress in recent years in breaking the silence around mental health issues in pregnancy and post-natally, but early pregnancy losses are still shrouded in secrecy, with very little acknowledgement of how distressing and profound an event they are. This research suggests psychological support should be offered to both the woman and her partner, with couples given the option of attending therapy together.”
Dr Jessica Farren, first author of the research, added: “Post-traumatic stress can have a toxic effect on all elements of a person’s life – affecting work, home and relationships. Evidence suggests the risk of relationship breakdown increases after pregnancy loss, and our research shows the loss of a pregnancy can leave have a significant and lasting psychological impact on both a woman and her partner. Hopefully, an awareness of the results of this study will help couples navigate their different responses to these losses and show each other the understanding that is needed to navigate a tricky period in their relationship.”
Tommy’s chief executive Jane Brewin commented: “Baby loss can have a deep and lasting impact on both parents, and this study gives a voice to many who have suffered in silence, highlighting the profound consequences that can have for their mental health and well-being. The message is clear; partners are vulnerable to the same psychological problems as mothers, and specialist support must be made available to either or both bereaved parents.
“It’s fitting that Tommy’s National Centre for Miscarriage Research has raised this issue in Baby Loss Awareness Week, which this year focuses on the isolation that grieving families too often face – an issue that can be exacerbated for partners who feel they have to be strong and supportive, hiding their own heartbreak. Attitudes to baby loss must change so that anyone who wants to open up or ask for help feels able to do so.”
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