Having a miscarriage can cause depression and PTSD, so why is no one talking about it?
Trigger warning: This article discusses miscarriages and depression.
Yolanda Dodson, 32, living in Alexandria, VA, was nine weeks pregnant when she found out she had a miscarriage. Three days later she had a dilation and curettage (also known as a D&C), which is a procedure to remove the no-longer-viable pregnancy from her body—something she never imagined she’d have to endure. “After my loss, I was lost,” Dodson tells HelloGiggles. “I was so angry at my body for what happened. Trying to be a mom to my 6-year-old while having these feelings was the hardest. People told me to be happy I had him, and I was, but [I was] longing for my child that I lost. It made me feel like I wasn’t enough. I was very depressed and had many dark thoughts.”
Dodson is not alone in her experience. As a psychologist who specializes in reproductive and maternal mental health, I frequently treat patients who describe the same anger and frustration with their body post-pregnancy loss. A reported 10-20% of confirmed pregnancies end in miscarriage, a number that’s believed to be higher as many people miscarry before they know they’re pregnant. These miscarriages can have very real and lasting mental health impacts on the people who experience them. For instance, a 2003 study found that women who had miscarried experienced depressive symptoms six to eight weeks after their loss, and a 1995 study found that depression following a pregnancy loss can last upwards of a year.
Mental health symptoms that are often markers of postpartum depression—like severe anxiety—can also follow a miscarriage. In fact, a 2007 study found that anxiety is actually more likely to occur post-pregnancy loss than depression, due in part to “disaster thinking,” when you’ve already experienced the worst outcome and fear it could happen again. In addition, the hormonal changes that accompany a pregnancy loss are similar to postpartum hormone changes and, as is the case with postpartum mood and anxiety disorders, can contribute to mental health issues. While only 9% of postpartum women will experience PTSD following a non-traumatic birth, a 2020 study found that as many as one in six women who’ve had miscarriages will experience symptoms of PTSD for as long as nine months following a loss, meaning PTSD is actually more common post-miscarriage than it is post-birth.
Christiana, 36, from St. Louis, MO, tells HelloGiggles how her post-miscarriage symptoms were similar to those of women who experience mental health issues postpartum. “I was diagnosed with anxiety,” she says. “When I was released from the hospital after my 16-week pregnancy loss, I was sent home with Xanax, which did help take the edge off. I also went to a therapist for counseling, and that helped me deal with the constant feeling of fight or flight. During my subsequent pregnancy, the anxiety intensified.”
Christiana says the anxiety that accompanied her second-trimester miscarriage robbed her of a “happy, peaceful pregnancy experience” when she got pregnant once again. Even though she continued to see a psychologist for the duration of that pregnancy, which resulted in the birth of her son, her anxiety didn’t cease and, in fact, morphed into postpartum anxiety.
“I did my research and, due to how I felt before and during my pregnancy, I had a feeling that the anxiety may get worse,” she says. “But I guess I hoped that the happiness of finally having a baby would override that. It didn’t.”
Christiana’s experience is a common one. A 2011 study found that the subsequent birth of a healthy child doesn’t diminish the mental health impact of miscarriage or stillbirth from a prior pregnancy. In fact, studies have shown that experiencing a miscarriage could contribute to prenatal and postnatal mood disorders like depression during a complication-free pregnancy and birth.
For those women who experience postpartum depression but have no baby to show for it, trying to navigate feelings of grief, guilt, and self-blame can be particularly challenging.
The commonality of miscarriage can downplay the psychological toll it can take. When doctors, family members, or friends dismiss miscarriages as something that “just happens,” it can reinforce ideas that people should simply “get over it” and “try again” or, if they’ve suffered multiple miscarriages, to just stop trying to get pregnant altogether.
“I don’t think people know what to say, and they can come off as insensitive,” Tara Anders, 24, who has had three miscarriages, tells HelloGiggles. “I have been told by others to ‘just stop trying,’ and ‘as soon as you stop trying it will happen for you,’ and ‘don’t stress; that’s why you can’t hold on to the pregnancy,’ or ‘just adopt.’”
Like moms who blame themselves for experiencing depression after having a baby, women who lose pregnancies often blame themselves for not carrying to term even if there was nothing that they could have done differently.
“I wish I had known that it wasn’t my fault,” Christiana says. “There are so many unknowns and [you] won’t always have answers, and you have to learn to live with that.”
Women who have lost a pregnancy also feel loneliness in a similar way to mothers experiencing postpartum depression. “I felt so lonely for months,” Dodson says. “No one around me ever had a miscarriage, and my best friend was having a healthy pregnancy at the time of my loss.”
I often see women in my practice navigating the aftermath of miscarriage by themselves because cisgender male partners do not understand the depth of their loss. And while studies have shown that pregnancy and infant loss also negatively impact the mental health of male partners, men also process the loss differently, experiencing less acute and prolonged feelings of sadness or pain, which can make women who’ve miscarried feel isolated and alone in their grief.
Just like how we encourage new moms to navigate mental health issues postpartum by reaching out for help, we should be advising moms who’ve experienced pregnancy loss to seek out communities and support networks to better understand and treat the mental health implications of miscarriages. For instance, Through the Heart, an online resource, offers those who are struggling post-miscarriage information on how to deal with loss, support forums, and comfort kits. My online community, #IHadAMiscarriage, is another resource for grieving parents to connect with others who can offer support, comfort, and solidarity. One 2017 study found that both psychological and support interventions can help reduce the level of stress, depression, and anxiety in women who go on to be pregnant after experiencing a loss—so reaching out to an online community or mental health provider can help mitigate the mental health impact of miscarriage.
Women shouldn’t have to live with the depression, anxiety, and PTSD that can follow a pregnancy loss. The commonality of miscarriage doesn’t lessen the pain it can bring or the impact it can have on a person’s mental health. It does, however, offer those women who have suffered a pregnancy loss one small but significant comfort: You are not alone.