A three‐month follow‐up of psychological morbidity after early miscarriage

Prettyman, Richard; Cordle, Christine; Cook, Georgia

doi:10.1111/j.2044-8341.1993.tb01762.x

Cited by 115 publications

(36 citation statements)

References 7 publications

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“…This is also reflected in the perception of women with regard to the health care system (32). Other women have described gaps in the information provided by the health care system and the lack of empathy for those who have experienced miscarriage (18,28). The typical reaction among health professionals is to think of a miscarriage occurring in the first trimester as a rather common incident.…”

Section: Discussionmentioning

confidence: 99%

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Applicability of general grief theory to Swedish women's experience after early miscarriage, with factor analysis of Bonanno's taxonomy, using the Perinatal Grief Scale

Adolfsson¹,

Larsson²

2010

Upsala Journal of Medical Sciences

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BackgroundGrief is a normal phenomenon but showing great variation depending on cultural and personal features. Bonanno and Kaltman have nonetheless proposed five aspects of normal grief. The aim of this study was to investigate if women with miscarriage experience normal grief.Material and methodsContent analyses of 25 transcribed conversations with women 4 weeks after their early miscarriages were classified depending on the meaning-bearing units according to Bonanno and Kaltman's categories. In the factor analyses, these categories were compared with the Perinatal Grief Scale and women's age, number of children and number of miscarriages, and gestational weeks.ResultsWomen with miscarriage fulfill the criteria for having normal grief according to Bonanno and Kaltman. All of the 25 women had meaning-bearing units that were classified as cognitive disorganization, dysphoria, and health deficits, whereas disrupted social and occupational functioning and positive aspects of bereavement were represented in 22 of 25 women. From the factor analysis, there are no differences in the expression of the intensity of the grief, irrespective of whether or not the women were primiparous, younger, or had suffered a first miscarriage.ConclusionWomen's experience of grief after miscarriage is similar to general grief after death. After her loss, the woman must have the possibility of expressing and working through her grief before she can finish her pregnancy emotionally. The care-giver must facilitate this process and accept that the intensity of the grief is not dependent on the woman's age, or her number of earlier miscarriages.

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Section: Discussionmentioning

confidence: 99%

“…Symptoms of depression in post-miscarriage are found in between 45%–50% of the women during the first few weeks after the loss (15,16). Anxiety has been measured and identified after miscarriage (17,18), and even post-traumatic stress has been identified (19). …”

Section: Introductionmentioning

confidence: 99%

Applicability of general grief theory to Swedish women's experience after early miscarriage, with factor analysis of Bonanno's taxonomy, using the Perinatal Grief Scale

Adolfsson¹,

Larsson²

2010

Upsala Journal of Medical Sciences

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“…Approximately 14% and 0.5% of all clinically-recognized pregnancies in the United States result in miscarriage and stillbirth, respectively (Saraiya, Berg, Shulman, Green, & Atrash, 1999). Since the 1980s, research has shown that women (and to a lesser extent, their partners) experience a variety of psychological distress outcomes following pregnancy loss, including grief, anxiety, depression, and guilt (Friedman & Gath, 1989; Greil, 1991; Leppert & Pahlka, 1984; Prettyman, Cordle, & Cook, 1993), and that these outcomes are often sustained over time (Lee, Slade, & Lygo, 1996; Neugebauer et al, 1997; Robinson, Stritzinger, Stewart, & Ralevski, 1994). These issues associated with pregnancy loss are far-reaching, and result in extensive stress and even marital conflict (Goodwin, 2002).…”

Section: Pregnancy Lossmentioning

confidence: 99%

“…Previous studies have found variables affecting distress following early pregnancy loss (EPL) such as gestational age (Toedter, Lasker, & Alhadeff, 1988), planned versus unplanned pregnancy (Tharpar & Tharpar, 1992), other “loss” experiences (Garel et al, 1992), and pre-loss psychiatric symptoms (Janssen, Cuisinier, de Graauw, & Hoogduin, 1997; Prettyman et al, 1993). Childlessness has also been reported to be a specific risk factor associated with increased levels of grief among women following pregnancy loss (Janssen et al, 1997).…”

Section: Pregnancy Lossmentioning

confidence: 99%

Trauma of Pregnancy Loss and Infertility Among Mothers and Involuntarily Childless Women in the United States

Schwerdtfeger

Shreffler

2009

Journal of Loss and Trauma

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Recent studies have repeatedly associated posttraumatic symptoms with women's experience of pregnancy loss. Using a nationally representative sample of American women (N = 2,894) from the National Survey of Fertility Barriers, the current study examines long-term psychological outcomes and reactions to pregnancy loss and infertility among mothers and involuntary childless women. In general, childless women who have experienced pregnancy loss or failure to conceive report the lowest life satisfaction and highest levels of depression despite a considerable period of time (seven years) since the loss or first year without a conception. However, women with the dual experience of pregnancy loss and involuntary childlessness report the most fertility-related distress. Results of the current study suggest that the “non-event” of involuntary childlessness may serve as an additional stressor in the traumatic experience of pregnancy loss.

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“…[3][4][5] Such symptoms decline over time, to levels equivalent to the non-pregnant population at 1 year. 6 In general, anxiety is more marked than depression.…”

Section: Introductionmentioning

confidence: 99%

Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study

et al. 2016

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ObjectivesThis is a pilot study to investigate the type and severity of emotional distress in women after early pregnancy loss (EPL), compared with a control group with ongoing pregnancies. The secondary aim was to assess whether miscarriage or ectopic pregnancy impacted differently on the type and severity of psychological morbidity.DesignThis was a prospective survey study. Consecutive women were recruited between January 2012 and July 2013. We emailed women a link to a survey 1, 3 and 9 months after a diagnosis of EPL, and 1 month after the diagnosis of a viable ongoing pregnancy.SettingThe Early Pregnancy Assessment Unit (EPAU) of a central London teaching hospital.ParticipantsWe recruited 186 women. 128 had a diagnosis of EPL, and 58 of ongoing pregnancies. 11 withdrew consent, and 11 provided an illegible or invalid email address.Main outcome measuresPost-traumatic stress disorder (PTSD) was measured using the Post-traumatic Diagnostic Scale (PDS), and anxiety and depression using the Hospital Anxiety and Depression Scale (HADS).ResultsResponse rates were 69/114 at 1 month and 44/68 at 3 months in the EPL group, and 20/50 in controls. Psychological morbidity was higher in the EPL group with 28% meeting the criteria for probable PTSD, 32% for anxiety and 16% for depression at 1 month and 38%, 20% and 5%, respectively, at 3 months. In the control group, no women met criteria for PTSD and 10% met criteria for anxiety and depression. There was little difference in type or severity of distress following ectopic pregnancy or miscarriage.ConclusionsWe have shown a large number of women having experienced a miscarriage or ectopic pregnancy fulfil the diagnostic criteria for probable PTSD. Many suffer from moderate-to-severe anxiety, and a lesser number depression. Psychological morbidity, and in particular PTSD symptoms, persists at least 3 months following pregnancy loss.

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A three‐month follow‐up of psychological morbidity after early miscarriage

Cited by 115 publications

References 7 publications

Applicability of general grief theory to Swedish women's experience after early miscarriage, with factor analysis of Bonanno's taxonomy, using the Perinatal Grief Scale

Applicability of general grief theory to Swedish women's experience after early miscarriage, with factor analysis of Bonanno's taxonomy, using the Perinatal Grief Scale

Trauma of Pregnancy Loss and Infertility Among Mothers and Involuntarily Childless Women in the United States

Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study

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