Emotional Weight of Miscarriage
Authored by:
Anna Glezer, M.D.
You might be one of the millions of women who have been through a miscarriage, also known as a spontaneous abortion. Yet, while common, the grief many women go through following a miscarriage is unique.
This loss is challenging because it differs in many ways from the loss of a loved one.
Unlike the loss of a loved one, there is nothing tangible to grieve. Instead, you are grieving for the loss of future, expectations, and dreams.
Even though common, many women do not share their experiences, and this leads to feeling alone
Because the loss is early on, you might not have even shared that you are pregnant with others, so there is not a support system to provide you with comfort after the loss
Many might tell you it is common and encourage you to move on quickly
Many early miscarriages are due to some kind of abnormality in the baby, and so others might say “it’s for the best,” which can diminish the significant of your loss
For all these reasons, a miscarriage is sometimes referred to as a “silent loss.”
Many of my patients also describe feeling guilt, shame, and worthlessness following a miscarriage. Thoughts like “There must be something wrong with me” or “I’m a failure as a woman,” fill their heads.
Psychological consequences of a miscarriage
For some, the miscarriage leads to clinically significant symptoms of depression, anxiety, or posttraumatic stress. Studies show that 20-55% of women report elevated symptoms of depression after miscarriage, with 10-50% meeting diagnostic criteria for a depressive disorder. Similarly, 20-40% of women describe anxiety symptoms. There is also a heightened risk of OCD symptoms recurring and posttraumatic stress.
This psychological distress can be severe. One international study noted a higher rate of suicide in women who have had a miscarriage in the year prior compared to those of similar reproductive age.
How long will these symptoms last? This is a question many women ask after a miscarriage. There is not one answer. However, the research shows that women can experience symptoms of depression or anxiety as much as a year or longer after a miscarriage. A time of particular vulnerability is around the anniversary of the loss and of the originally estimated due date. Even when otherwise feeling well, those two times can bring back feelings of grief.
It is also important that the majority of women are pregnant within 18 months of having experienced a miscarriage. That means these feelings of depression and anxiety can carry into that pregnancy, making it more difficult to enjoy the experience and develop a healthy attachment with the baby. This is why recognition of these symptoms is important and treatment essential.
High risk women
What about repeat miscarriages? Research shows that women who have had more than one miscarriage have worse psychological well-being and higher rates of depression. Similarly, there is a correlation between higher anxiety and grief levels in women whose pregnancy was made possible with reproductive technology like IVF.
What about the dad?
Men also suffer following miscarriage. Often, though, there is a pressure to be strong and supportive, and feelings of loss and grief are unrecognized and unexplored. There is a misconception also that because the man is not carrying the child, he has not developed a bond with the baby. There have not been any studies looking at specific rates of depression or other illness in men following pregnancy loss. However, it is important to recognize that the father has also suffered a loss and that seeking professional help and support is a healthy choice.
Treatment options for mental wellness after a miscarriage
There are ways to decrease the emotional after-effects of a miscarriage.
The first is ensuring a support network. This means potentially reaching out to family, friends, or organizations with online support for processing and moving forward after the loss, such as Tommy’s.
It could also mean working with a professional therapist who specializes in grief, loss, and fertility.
If the symptoms of depression, anxiety, and mental distress are severe and impact functioning, seeing a physician for medication management is an important step.
Selected References:
Toffol, E., Koponen, P. Partonen, T. (2013) Miscarriage and mental health: Results of two population-based studies. Psychiatry Research 205: 151-158.
McCreight, B.S. (2004) A grief ignored: narratives of pregnancy loss from a male perspective. Sociology of Health & Illness 26(3): 326-350.
Nynas, J. et. al. (2015) Depression and anxiety following early pregnancy loss: Recommendations for primary care providers. Prim Care Companion CNS Disord. 17(1).
