Pregnancy Loss & Depression: The Untold Story

Setting the scene:

Last week, I gave a public lecture at our local women’s hospital. I love the opportunity to interact with the community because I hear about what’s really on women’s minds and hearts.

After the talk, several women approached me for follow-up discussion and comments. Two of these women shared the same experience: pregnancy loss. They had received some help early after their losses, but the help had ended and they still felt the pain of their loss. What was making things very difficult for these women was that they were pregnant again. They struggled with feelings of anxiety and worry over another loss, guilt for not enjoying their pregnancy, re-living their grief for their lost child, and fear of the future.

I was taken back by the depth of these ladies’ struggles, and how little help was available for them. The physicians and nurses who were giving them prenatal care hadn’t offered help, or checked-in with about how they were managing their current pregnancy. It just wasn’t on their radar. As a result, these women were struggling through their pregnancy with their partners – largely in silence.

The untold story:

Pregnancy loss is not openly discussed in our society. In the early days after a loss, people express their condolences and support. But, that fades all too quickly. We’ve learned that most women who suffer a pregnancy loss experience intense grief for 4 to 6 months, and for some it can last up to 2 years. So, while women may receive some support in the early days after their loss, it falls far short of the length of time they feel their grief.

Many women who have suffered loss don’t know that it is normal for grief to last 6 months or longer. They’re confused. They feel that they should be moving on with their lives, but are unable to do so. They feel immobilized by their distress – and don’t recognize that it is normal.

What we know so far:

Let me share a few things we know so far about pregnancy loss, depression and anxiety.

1. Pregnancy loss is more common than you think.
   
   Up to 1 in every 5 women has experienced pregnancy loss at some point in their lives. That means that many women have experiences that they’re not talking about. And women that I speak with tell me that when they start talking about their experience, other women join in. The result? Everyone gets to see how common pregnancy loss is. Everyone gets support for the experience they’ve been silently keeping.
    

2. Only 2-3% of women experience a recurring pregnancy loss. 
   
   This means that after a woman has experienced a pregnancy loss, there is a very low risk of having another. This is a good fact to know because it is the main concern when women with a history of loss become pregnant again.
    

3. Depression and anxiety are higher in women who’ve experienced a loss compared to other new mothers. 
   
   In fact, it’s 4-times higher. That means that it’s important for women to talk to their doctors, not just during the initial time after the loss, but also if they aren’t starting to get better after the 6-month mark when they should start to be feeling better. We know that only 1 in 4 women with anxiety after a loss actually accesses help. The other 3 in 4 suffer in silence, on their own.
    

4. Some women are more at risk for depression and anxiety than others. 
   
   Not every woman who has experienced a pregnancy loss is prone to depression or anxiety. Women who are most at risk are those who: a) have been through infertility treatments; b) have had a previous loss; c) have a prior history of depression; and d) have had a very high level of distress right after the loss. If you fall into this category, please be sure to be sharing this with your doctor or nurse.
    

5. Men grieve differently. 
   
   Women who have experienced loss have shared with me that their partners manage the loss differently. We’re learning this, too. Men prefer to talk less, tend to be more irritable, and may increase their alcohol consumption. They also tend to resolve their feelings about the loss a bit earlier than women – somewhere around 3 to 5 months after the loss.

Key Messages

Whether you are a woman (or partner) who’s had a pregnancy loss, a friend or family member of someone who’s suffered, or a clinician helping women with loss, here are some key messages for women and their partners:
 

1. Grieving can feel intense for 4 to 6 months, but then usually starts to decline for most people.
    

2. If you don’t notice an improvement in how you feel within that time, do talk to your doctor or nurse because this normal grief can evolve into depression/anxiety for 1 in 5 women.
    

3. Talk about your experiences with other couples. Pregnancy loss is common, and people find support in talking with one another about it.
    

4. While another pregnancy loss is top of the list in terms of fears of getting pregnant again, it is rare (2-3%).

This is but the tip of the iceberg. Please feel free to share comments. I’d love to hear your thoughts.

Further Information

Key Takeaway:
 

• Pregnancy loss is not openly discussed in our society. Many women who have suffered loss don’t know that it is normal for grief to last 6 months or longer. They feel that they should be moving on with their lives, but are unable to do so. They feel immobilized by their distress – and don’t recognize that it is normal.