Written by: Vivette Glover, Professor of Perinatal Psychobiology
In the UK, 1 in 4 pregnancies end in loss during pregnancy or birth, with 684 babies miscarried and 9 babies stillborn each day in 2016. These statistics are shocking, and the effects of these losses are not merely physical. Depression and anxiety may follow a pregnancy loss, and can be a particular problem during a subsequent pregnancy.
My colleagues and I have investigated the effects of previous pregnancy loss on maternal depression and anxiety using data from over 13,000 pregnant women who took part in a study called ‘Children of the 90s’.1 In this study, around 20% of women had experienced at least one previous miscarriage or stillbirth, with 6% of women suffering four or more losses. The likelihood of a woman experiencing depression and anxiety was highest among the women who had experienced the greatest number of previous losses, even when other factors that are associated with mental health problems were taken into account. In fact, 35% of women who had experienced four or more losses had depression during the later stages of their next pregnancy, while this figure was only 15% among women who had not suffered a loss. We also showed that depression and anxiety following pregnancy loss often persisted beyond the birth of a healthy baby.
We believe that more attention needs to be given to the psychological state of women with a history of repeated miscarriage or stillbirth. Depression and anxiety can be very distressing for women and their families, and in a minority of cases can even cause children to have behavioural problems, learning difficulties or physical disorders such as asthma. Sadly, mental health problems frequently go undetected by the professionals who care for pregnant women. The good news is that both anxiety and depression can be treated – talking therapies can be effective in milder cases, while more severe cases might benefit from medications that are known to be safe in pregnancy. It is therefore important that those caring for pregnant women give mental health the same priority as physical health, and ask women who have experienced previous pregnancy losses appropriate questions so that they can get all the help that they require.