Having a miscarriage can take quite the toll on parents, especially for mothers who experience both the emotional and physical trauma of losing a pregnancy.
Miscarriage is, unfortunately, not uncommon – the chance of miscarriage within the first 20 weeks of pregnancy is around 15 to 20 percent, according to Ontario Prenatal Education. With these probabilities, it is even more important for expectant mothers to have easy access to proper education, resources, and treatment options for a post-miscarriage scenario.
This article will discuss miscarriage and its effects on mental health, as well as how proper training for patient care after a miscarriage is essential for healthcare professionals.
What is miscarriage?
A miscarriage generally refers to the loss of a baby at or before 20 weeks of pregnancy. Miscarriages generally occur due to issues with the embryo or fetus that make it unviable and/or pose a potential threat to the mother’s body, resulting in the body instinctively terminating the pregnancy.
According to HealthLink BC:
“Most miscarriages happen because the fertilized egg in the uterus does not develop normally. A miscarriage is not caused by stress, exercise, or sex. In many cases, doctors don't know what caused the miscarriage.”
It is important for parents experiencing this kind of loss to understand what factors contribute to a miscarriage, as understanding why they occur can help to lessen the feeling of guilt that parents commonly experience after a miscarriage.
How does miscarriage affect mental health?
It is undeniable that the loss of a pregnancy due to miscarriage generally has a significant impact on the overall mental health of the parent. Understanding how these impacts are likely to manifest is key to coping with the grief of miscarriage.
A January 2020 study found that in the month following pregnancy loss, around 29% of women experienced post-traumatic stress (PTS). The study further reports that 24% of women experience moderate to severe anxiety, and a further 11% experience moderate to severe depression.
It is equally important to consider how miscarriage may impact the partner (a spouse or significant other). Another 2020 study found around 7-8% of partners also met the criteria for post-traumatic stress (PTS) in the immediate one to three month period following the loss of the pregnancy.
Here is a breakdown of some of the most common ways miscarriages impact mental health after the fact:
- Anxiety: The unexpected loss of a pregnancy can lead mothers and their partners experiencing heightened anxiety, especially concerning future pregnancies.
- Depression: Being one of the stages of grief, depression is very commonly seen in women after a miscarriage. Despite happening in the early stages, miscarriages can still hold the same emotional weight of losing a well-known and older loved one, and the grief that follows can serve some heavy doses of depression as a result.
- Guilt: Guilt is likely to be a prominent emotion felt after a miscarriage. There are a lot of considerations for a baby’s health as it grows in a woman’s body, and the loss of the pregnancy can result in the mother feeling as though it was in some way her own fault. Guilt can be a very intense emotion that ultimately feeds back into the anxiety and depression.
- PTSD: A miscarriage can be a highly traumatic event for many parents. This can lead to the development of Post Traumatic Stress Disorder, or PTSD. PTSD has many symptoms including disturbing or intrusive thoughts, flashbacks, and nightmares.
Stigmatization experienced by parents from healthcare professionals
Although there is state of the art equipment and procedures to ensure the physical recovery of a woman following a miscarriage, there tends to be a gap when it comes to post-miscarriage mental health recovery and treatment.
According to a 2019 survey of people in Ontario who have experienced miscarriage, 49% reported they had experienced stigmatization from healthcare professionals. Stigmatization was defined in the study as ‘insensitive comments about how you should feel, grieve, or experience the loss that you did not agree with, or care that did not recognize the significance of your loss or your need for support’
The general public conversation surrounding miscarriage is, unfortunately, a rather quiet one. Despite being a fairly prevalent issue, miscarriage has a tendency to be avoided during discussions and is thus cloaked in a social stigmatization that can inhibit those experiencing it from seeking out or receiving the proper mental health help they require.
According to a 2019 survey of people in Ontario who have experienced miscarriage, 49% reported they had experienced stigmatization from healthcare professionals.
Providing appropriate miscarriage grief training for healthcare professionals
According to a 2016 study entitled “Health Professionals’ Practices and Attitudes About Miscarriage”, the main barriers to care identified in regards to miscarriages were the availability of affordable specialized services and the general knowledge and awareness of health professionals and the health system.
The study aimed to examine the attitude, beliefs, and practices of healthcare professionals who work with women and families currently experiencing the loss of a pregnancy in order to identify gaps in the care currently being offered and provided for miscarriage. There are several actions that can be taken to reduce the stigma surrounding miscarriage, including:
- Addressing misconceptions and stigmas surrounding miscarriage so that there is no spreading of misinformation or misunderstanding
- Providing healthcare professionals with the proper resources and training to feel highly confident in their ability to provide support
- Utilizing effective care that is focused on recovery and rehabilitation
The study further states:
“Women and families experiencing miscarriage need privacy and timeliness in care. Interventions such as funded midwifery loss care or a routine telephone follow-up call could improve access to care and help healthcare professionals ensure that families obtain the type and amount of support that they need.”
Finding support after a miscarriage
For those experiencing the after effects of a miscarriage, finding quality and adequate support is key to overcoming the hardship of losing a pregnancy. If there are two parents involved, it is important for both partners to recognize the impacts their own personal mental health has taken, as self-care can be key to recovery.
Here are some tips for finding the best support following a miscarriage:
Immediate support may be most effective: It is estimated that a grief period will generally be at its most intense within the immediate six months following the miscarriage. This means that finding support as soon as possible after the loss of pregnancy occurs is crucial, as the next half year following the event will likely be the most intense emotional period.
Peer support and connections are crucial: The Canadian Paediatric Society suggests connecting with families who have experienced a similar loss can be beneficial to individuals or couples experiencing miscarriage. Miscarriage comes with unique emotional impacts, such as the feeling of biological failure, and being able to relate to others about that feeling can make those experiencing it feel less alone.
Friends and family play a key role: In the event of a loved one passing, connecting with family and friends can provide much more intimate support than can be provided in a professional setting. Spending time with family can help to ward off feelings of hopelessness and pessimism following the loss of a pregnancy.
Professional counseling: Going through a miscarriage is hard, and no one going through it should be expected to have all the answers or know how to perfectly cope. Therapists and counselors, especially those specialized in grief counseling, prenatal, or fertility issues, can be incredibly helpful for the emotional recovery of a mother and family following the loss of a pregnancy.
Resources available in Ontario:
Pregnancy and Infant Loss Network https://pailnetwork.sunnybrook.ca/
KFL&A Public Health: https://www.kflaph.ca/en/healthy-living/pregnancy-and-infant-loss-and-support.aspx