One in four pregnancies ends in miscarriage, but despite this, we shy away from talking about the topic.
This crushing silence only makes things worse for the women affected and can go as far as damaging their mental health.
New research has found women who experience miscarriage or ectopic pregnancy may be at risk of Post Traumatic Stress Disorder (PTSD), which is triggered by particularly distressing life events.
Katy Evans began experiencing symptoms following her miscarriage nine months ago.
“I naively didn’t think I would suffer from PTSD, but then my husband and I were watching a film when a couple went for a scan and there was a really long scene focusing on the scan image and the happy couple,” she told The Huffington Post UK.
“This really shocked us both as we were so unprepared to see a scan again and definitely gave me flashbacks to our scan and all of the emotions we felt at the time.”
The researchers, from Imperial College London, found that four in 10 women experience symptoms of PTSD three months after pregnancy loss.
Miscarriage is defined as the loss of a baby before 24 weeks - although most miscarriages occur before 12 weeks.
Ectopic pregnancies are much rarer, affecting around one in 90 pregnancies. The fertilised egg usually implants in the fallopian tubes connected to the womb, where it cannot grow, and so the pregnancy either miscarries or must be ended surgically or with medicine.
The new research found that 45% of women who’d experienced miscarriage and 18% of women who’d suffered an ectopic pregnancy reported PTSD symptoms after three months.
However, symptoms of PTSD, such as flashbacks, sleeping problems, anger and depression, can start weeks, months or even years after a traumatic event.
Evans began experiencing symptoms after discovering she’d suffered a missed miscarriage at her 12-week scan.
A missed miscarriage is when a woman only finds out her baby has died when she has a routine scan - she usually will have not experienced pain or bleeding.
“I found that I didn’t want to be around friends and family who had babies as more often then not they’d be complaining about sleepless nights and how hard it was and all I wanted was to be able to moan about how little sleep I’d had or how exhausted I was,” Evans said.
“Friends and family have definitely told me that I haven’t been my normal carefree self and for a long time I felt utterly consumed with grief and then completely empty inside.”
Although she feels “lighter now”, she still fears what will happen if she gets pregnant again and has found it hard to articulate these fears out loud to friends and family.
“I still find it hard to talk about with certain people and I can still get teary about the miscarriage,” she said.
“I still haven’t had a proper period since my miscarriage nine months ago and have had to go to the hospital for some internal scans. These scans happen in the same ward as the antenatal scans so sitting in a room full of happy, expectant mums with their proud bumps is also very hard to deal with.
“In the short time you know you are pregnant - whether that’s a week or three months - you are not only emotionally tied to your baby but also the life that you are going to have when that baby is born. To have all of those hopes and expectations taken away from you is the hardest thing I’ve had to deal with.”
Angela Brightwell, who runs the blog Funny Matters, has experienced five miscarriages, including one ectopic pregnancy, in the space of two years.
She’s also found the ordeal traumatic and she isn’t surprised many women show symptoms of PTSD.
“Women often blame themselves for what happened and pore over and over in their mind what they did and didn’t do that might have caused the miscarriage, sparking off obsessional and unhealthy thinking,” she said
“There is also the sense that your body has let you down and that somehow you are inferior to other women who don’t seem to have trouble getting and staying pregnant.
“This then causes negative thought patterns about yourself, leading to self-esteem issues and worse.”
Like Evans, she’s found it hard to be around friends with children.
“Despite wanting the best for other people around you, it can be incredibly difficult to come to terms with your own loss and it can be difficult to cope with other people around you being pregnant,” she said.
“I remember being shocked at myself that I could feel so bitter towards other people with successful pregnancies when that’s not the sort of person I normally am - this in turn again makes you feel bad about yourself, exacerbating the self-esteem and self-blame.
“You often also become less sociable and withdraw into yourself, I certainly did. And sleep becomes disrupted on an ongoing basis, again exacerbating the cycle of negative thought patterns.”
Kate Pinney, a midwife from baby loss charity Tommy’s, told HuffPost UK it’s not uncommon for women to feel isolated following a miscarriage or ectopic pregnancy.
“The silence that surrounds miscarriage makes it difficult for women to be open about the wide range of reactions that they might be experiencing,” she said.
“Currently, our societal norms mean many couples won’t tell friends or family they are pregnant before 12 weeks. This silence compounds the impact that a loss can cause as they suffer in silence.
“Silence creates an implicit assumption that all women feel the same - but there might a wide range of subtle feelings and experiences that depend on the circumstances.
“Many women who have lost babies harbour unexpressed feelings of failure, isolation, guilt, anxiety and depression.”
Evans added that our reluctance to talk about fertility issues makes life harder for women who experience pregnancy loss.
“Because we don’t speak about how hard it is to get pregnant (and this goes back to school - we’re taught how to put a condom on a test tube and told how to not get pregnant) we often feel like we’re the only ones struggling to get pregnant, whereas everyone else around us just needs to look at their partners co*k and they get pregnant,” she said.
“One thing that helped me deal with seeing mums with newborns and pregnant women everywhere was that I didn’t know their story - maybe they’d also had miscarriages and IVF and had tried for several years.”
Tommy’s is currently investing in research to better emotionally support women and their families following pregnancy loss and it runs a helpline for those in need.
But according to Brightwell, to really help couples after pregnancy loss we need to break the silence around the topic.
“I have been open about my miscarriages from the first one as I think it’s incredibly important that we talk about everything to do with the human experience - we all go through the same things and it’s vital for society that we share these experiences and help others,” she said.
“We really need to recognise the impact of miscarriages on women and increase awareness of the fact that it’s perfectly normal to struggle emotionally and psychologically after a loss, otherwise more and more women will be diagnosed with PTSD and be unable to recover from such a cycle of negativity.”
Useful Links And Helplines
PTSD UK offers a website with more information on the condition.
Mind, offers a phone service on mental health conditions open Monday to Friday, 9am-6pm on 0300 123 3393.
Tommy’soffers information on baby loss, with a helpline open Monday to Friday, 9am-5pm on 0800 0147 800.