Pregnancy loss is mentally and physically traumatizing, especially for patients who have a history of infertility. The stressors of miscarriage can have both short- and long-term effects. Short-term effects can include a sense of loss of personal agency, symptoms of depression and anxiety, and struggles with sexual and marital relationships. It’s important to know that you’re not alone if you experience difficulty with your mental health after pregnancy loss.
According to a 2016 study conducted by British and Belgian researchers, about a third of women meet the diagnosis for probable post-traumatic stress disorder (PTSD) following a miscarriage, and symptoms of PTSD can persist for at least three months. A 2022 study from Australia found that women who have a history of miscarriage or stillbirth were at higher risk for stroke, suggesting longer-term effects of the stressors related with this traumatic event. In addition, a 2011 study found that some women can continue to feel symptoms of depression and anxiety during a successful pregnancy that follows a miscarriage or stillbirth.
It is normal to feel emotional pain and distress after a miscarriage. I recommend patients try to be open with their feelings and allow time to grieve. It is important to also recognize that both people in a couple will process their grief differently. For example, one person may want to be surrounded by friends while the other may want to withdraw socially.
While it’s normal to feel despair immediately after a miscarriage, persistent symptoms of anxiety and depression beyond two months after a miscarriage warrant further evaluation.
Anxiety symptoms can include:
Depression symptoms can include:
You should talk to your physician if you continue to experience anxiety or depression symptoms in the months following your pregnancy loss.
As difficult as it can be, remember that a miscarriage or pregnancy loss is not your fault. Chromosomal abnormality is the most common reason for a miscarriage, and may account for up to 70% of all miscarriages. Other causes include uterine factors, infections, thyroid, immune disorders, medication, drug use, and concurrent medical comorbidities that can have an impact on the pregnancy.
Meanwhile, medical researchers and clinicians are doing all they can to better understand why miscarriages occur and explore paths to potential therapies that can reduce their occurrence. For IVF patients with recurrent pregnancy loss, evidence suggests that preimplantation genetic testing of embryos for aneuploid (abnormal) chromosomes (PGT-A) improves the chance of a successful pregnancy in patients with recurrent pregnancy loss. Furthermore, recent studies have identified a range of specific genes that appear to play a role in miscarriages after IVF transfer of a euploid (chromosomally normal) embryo. Studies to determine clinical applications for treatment and testing that can help patients avoid miscarriage are ongoing.
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Thanh Ha Luu, MD, earned her medical degree from the Rush University Medical College in Chicago. She completed her residency in Obstetrics and Gynecology at the Cleveland Clinic and her fellowship in Reproductive Endocrinology and Infertility at the University of Colorado. She is passionate about fertility preservation in patients at risk of infertility and improving access to care for all patients needing infertility services. She practices at InVia Fertility Specialists in Hoffman Estates, Illinois.
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