Many people are already aware of the emotional consequences of miscarriage — either through personal experience, or from reading published research that has found significant symptoms of depression and anxiety in people who experience early pregnancy loss (EPL).
But now, a new U.K. study published in the American Journal of Obstetrics and Gynaecology has further illuminated the link between EPL (defined as a loss before 12 weeks) and mental health: losing a baby early through miscarriage or an ectopic pregnancy can lead directly to symptoms of post-traumatic stress disorder (PTSD).
Researchers from Imperial College London and KU Leuven in Belgium studied a group of 650 women who had experienced EPL, and had them complete questionnaires documenting their feelings over the course of a year, according to a news release.
It was the largest study ever to examine the psychological impact of early-stage pregnancy loss.
The researchers found that nearly one-third of those women (29 per cent) showed symptoms of post-traumatic stress. One in four experienced moderate to severe anxiety, while another 11 per cent — one in ten — had moderate to severe symptoms of depression.
It is estimated that between 15 and 20 per cent of all pregnancies end in miscarriage, according to the Society of Obstetricians and Gynaecologists of Canada.
Women don’t get adequate mental health care after pregnancy loss
“These can be profound events which stay with you,” Dr. Jessica Farren, specialist registrar and clinical fellow at Imperial College London, told BBC. For some women, she said, pregnancy loss is “the first time they have experienced anything beyond their control.”
Also beyond their control are the initiatives of the medical system itself, which, the study found, often fails to provide adequate care to women following pregnancy loss.
“The treatment women receive following early pregnancy loss must change to reflect its psychological impact.”
The study’s researchers recommended psychological assessment for women who have miscarried.
“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,” professor Tom Bourne, lead author of the study, said in the study’s accompanying news release.
“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.”
The challenges for women in Canada following EPL
Though the study in question was conducted in the UK, women in Canada face similar challenges when it comes to mental health care and support after pregnancy loss — a phenomenon that two Canadian researchers elucidated with a study they published in 2016.
Lynn Rempel and Joyce Engel, who are both researchers at Brock University, told HuffPost Canada in 2018 that even though healthcare professionals do genuinely seem to care about how their patients will fare after pregnancy loss, most emergency nurses lack the appropriate training to support those women.
“Women can experience complicated grief and depression following a miscarriage,” Rempel told HuffPost Canada. “Women in Canada are not properly screened, assessed and treated for mental health issues following a miscarriage.”
As a corrective, the two researchers used the findings from their study to build a screening tool that might help emergency nurses better gauge whether women might be at risk of complicated grieving. It also suggests next steps those nurses might take to refer their patients for follow-ups.
How miscarriages might affect a person’s ability to work
One consequence of this problem turned up last year, when a Canadian woman appeared before the Human Rights Tribunal of Ontario and claimed she’d been dismissed from her job as a result of severe depression she had developed following the loss of her pregnancy.
The case yielded an unprecedented ruling that classified miscarriage as a “disability” that could significantly impact a person’s ability to function in society
“I think it would behoove employers and human resource managers to put together a focus group of people who have experienced this,” Deborah Davidson, a sociology professor at York University who works with women grieving from miscarriages and stillbirths, told the Toronto Star after the ruling.
She hopes that, in the future, employers will be more cognizant of the consequences pregnancy loss has on women and families, and says companies should consider the prospect of offering compassionate leave for those who experience it.
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