TOP TAKE-AWAYS: POSTRAUMATIC STRESS DISORDER AND PREGNANCY LOSS

Posttraumatic Stress Disorder (PTSD) is often associated with experiencing events like combat or a natural disaster. However, PTSD can occur after any traumatic event, and pregnancy loss can be very traumatic for many women.

A study published in 2016 examined the psychological symptoms faced by women who experience an early pregnancy loss before 20 weeks.
Posttraumatic Stress Disorder (PTSD)
At 1 month and at 3 months, approximately 40% of women who had experienced an early pregnancy loss reported most or all of the symptoms consistent with moderate or severe PTSD.

• Re-experiencing the loss (flashbacks, dreams, feeling as if the event was happening again) was the most commonly reported PTSD symptom following an early pregnancy loss. At 1 month, 93% reported re-experiencing, and 89% reported at 3 months.
• At 1 month “feeling emotionally upset when you were reminded of the loss of your pregnancy” was the most commonly reported experience. Fifty-eight percent of women reported that they experienced this feeling at least 2 to 4 times a week.
• The second most commonly reported experience at 1 month was “having upsetting thoughts or images about the loss of your pregnancy that came into your head when you did not want them”. Forty-three percent of women reported that they experienced this feeling at least 2 to 4 times per week.

Anxiety and Depression

Anxiety and depression tend to decrease from 1 to 3 months.

• At 1 month, 32% of women who had experienced an early pregnancy loss met criteria for moderate to severe anxiety. At 3 months, the rate of anxiety decreased to 20% for women who experienced an early pregnancy loss.
• At 1 month, 16% of women who had experienced an early pregnancy loss met criteria for moderate to severe depression. At 3 months, the rate of depression decreased to 5% for women who experienced an early pregnancy loss.

Trying again

At 3 months, 50% of women who experienced an early pregnancy loss reported trying to conceive but not yet being pregnant. 

PTSD symptoms remained relatively high, regardless of current pregnancy status.

• Forty-one percent of women who were trying to conceive reported all of the symptoms consistent with moderate to severe PTSD, compared to 33% who were pregnant again, and 38% who had not tried to conceive. 

Anxiety decreased for women who became pregnant again. 

• Twenty-three percent of those who were trying to conceive reported moderate to severe anxiety, compared to none of the women who were pregnant, and 25% of those who were not trying to conceive. 

Depression symptoms decreased from one to three months, regardless of current pregnancy status. 

• Two of 11 women who reported moderate to severe depression at one month reported moderate to severe depression at three months.  One woman was trying to conceive again and one woman was already pregnant.

We believe the main take-away from this study is that symptoms of anxiety and depression decreased between one and three months, but the symptoms associated with PTSD persisted. PTSD is a real and serious condition that may follow pregnancy loss. If you experience symptoms of PTSD, we encourage you to contact your healthcare provider. 

Farren, J., Jalmbrant, M., Ameye, L., Joash, K., Mitchell-Jones, N., Tapp, S., Timmerman, D., & Bourne, T. (2016). Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: A prospective cohort study. BMJ Open, 6, 1-9. doi: 10.1136/bmjopen-2016011864