As miscarriage is considered the spontaneous, involuntary reproductive loss that happens prior to 20 or 28 weeks and results in fatal death. Although it is fairly common, occurring in 10-20% of clinical recognized pregnancies, women experience a range of psychological reactions. There is a range of risk factors associated with miscarriage. These could be:
- Woman’s age. The older the potential mother, the more are the chances of a miscarriage to occur.
- Biological factors, like chromosomal abnormalities, endocrinologic, anatomic, immunologic or microbiologic diseases, like diabetes, polycystic ovaries.
- Environmental factors, like drug abuse, exposure to toxins, stressful life events.
- History of multiple induced abortions.
Miscarriage is considered as an important loss and as a sum of shorter, minor losses. It is not only about the unborn child but also about the expectations, desires and thoughts about it. Moreover, it is an unexpected event that changes radically the personal and family schedule. The physical pain or the view of blood, stimuli directly linked to the event of miscarriage, are difficult to forget and make any effort to recover even harder.
Miscarriage is an event that cannot be reversed or altered. It is natural for a woman to feel restricted due to the lack of options available and the fact that she cannot change it. It, also, fills her with stress and anxiety about any future pregnancy. This fact, in addition to the social demand of a woman being a mother may affect her self-esteem, especially on the part that she cannot fulfill society’s or family’s expectations on her. In cases of social prejudice, married women having no babies are treated in a similar way to those who are single.
Her reaction to miscarriage depends on a variety of factors and is different interpersonally.
- Her perceptions about pregnancy and loss.
- The level of attachment to the unborn baby.
- Family or social support.
- Ethnic culture (in some countries there is some kind of racism or prejudice towards childless women).
The most common psychological responses to the event are.
- Denial.
- Anger and frustration with self or medical care
- Feeling of losing control and instability
- Self-blame
- Guilt and remorse
- Fear for her health and the future
These responses may become risk factors for the development of mental disorders. For the first six months after miscarriage women are at elevated risk to experience symptoms of depressive disorders. The chances are double for childless women. Furthermore, there is a risk for the occurrence of anxiety disorders. For the postpartum period there is a possibility of 8 times more then the average to develop symptoms of OCD (Obsessive-Compulsive Disorder) and a little less for PTSD (Post-Traumatic Stress Disorder). In several occasions, there is commorbidity between depressive and anxiety psychological consequences.
References
Swanson K. Predicting depressive symptoms after miscarriage. A path analysis based on the Lazarus paradigm. J Womens Health Gend Based Med. 2000;9:191-206.
Zelkowitz P, Milet T. The course of postpartum psychiatric disorders
in women and their partners. J Nerv Ment Dis 2001;189:575– 82.
Disclaimer: The information contained in this article should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
Chrysi Miliordou - Chrysi Miliordou is a psychologist, holding a Master's Degree. She is a member of the accredited body of psychologists in Britain.
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