Grief, trauma and your mental health after miscarriage

On this page:

Grief and your mental health

Mental health problems after miscarriage

Miscarriage as trauma

Asking for help after a miscarriage

Mental health medication and future pregnancies

 

Grief and your mental health

Grief

Going through miscarriage can be heartbreaking and even traumatic. 

You may feel a complicated mix of emotions including sadness, shock, grief, depression, guilt, anger or resentment. For those who were pregnant, the changes in hormone levels can also cause mood changes and difficult emotions.  

Some people may seem to come to terms with what happened within a few weeks. For others, it can take longer. You may also find that you and your partner (if you have one) grieve in different ways.  

Some people want to talk about their feelings, while others find it too painful. Some find that planning for their next pregnancy helps them move on. For others, the thought of trying to get pregnant again is too traumatic, at least for now.

Although it is really difficult to go through, grief is a normal, human response after a loss.  Grieving your baby can help you process your emotions and find a way to live with what has happened.  

There is support available to help you grieve. You may find it helpful to find some peer support on our Facebook groups.  

You can also talk to a Tommy’s midwife free of charge from 9am–5pm, Monday to Friday on 0800 0147 800 or you can email them at [email protected].  

If you are Black or Black Mixed Heritage there is a dedicated helpline for you. You can book a call on that line here.

 

Your mental health

You may already be managing a mental health problem and worry that your loss has made things worse or bought back difficult feelings and behaviours. Or you may be concerned that what you or your partner are going through is something more than grief.

It can be hard to work out what is part of the natural process of grieving and what might be a mental health problem, especially without specialist support. There is no clear way of separating the two.

You may want to look for extra support for your mental health if:

• you have difficult symptoms that are very intense or last a long time after your loss  
• the way you feel is making daily life difficult to cope with.

If you have relied on unhelpful ways of coping in the past (for example, alcohol, drugs, self-harm restricting food or overeating) and you are noticing that these are creeping back in, you may want to seek support sooner. 

 

Mental health problems after miscarriage

In this section we have more information on specific types of mental health problem that research has shown can develop after a miscarriage.

Anxiety after a miscarriage

Anxiety is a feeling of unease, worry or fear, that can be mild or severe. Everyone feels anxious sometimes, but it can become a problem when it feels very strong and is there a lot of the time.  

Some people with anxiety also have panic attacks, which can be very frightening.  If you find it hard to control your worries, or you’re having panic attacks, it’s important to ask for support from your doctor. 

Symptoms of anxiety can include:

• feeling anxious all or most of the time and not feeling able to control it
• restlessness
• feeling very worried (for example, in pregnancy you may feel constantly worried about your baby)
• feeling a sense of dread
• being unable to concentrate, or feeling like your mind goes blank
• feeling irritable
• feeling constantly on edge
• difficulty falling or staying asleep.

Panic attacks can come on very quickly and for no apparent reason. Symptoms can include:

• a racing heartbeat
• a feeling of dread or fear of dying
• chest pain
• shortness of breath
• dizziness
• sweating
• feeling faint
• shaky limbs
• tingling
• a churning stomach. 

Most panic attacks last for between 5 and 20 minutes. They can be very frightening, but they are not dangerous.

If you are reminded of a difficult or traumatic experience (for example, returning to a scan room where you were given bad news) your body can release hormones that make you feel more anxious or panicked (fight or flight hormones).  Understanding this and preparing for it may help you manage these situations in the future. Some people find deep breathing or mindfulness helps.

You may find it helpful to have a look at Mind’s information on coping with anxiety and panic attacks.

We often hear from people who are bombarded with ads promoting maternity and baby products after loss, which can be really distressing. Find out how to stop pregnancy ads.

The main treatments for anxiety are guided self-help, talking therapies and medication.

 

Depression after a miscarriage

Everyone has times in their lives where they feel sad, upset or miserable. People sometimes use the word ‘depressed’ to refer to these feelings.  

Depression as a diagnosis is when you feel sad or in a low mood all the time for weeks or months, not just a few days. The condition can vary from mild to severe and can affect people in different ways. 

Signs of depression include:

• feeling generally down most of the time
• losing interest in things you used to enjoy
• not being able to concentrate or make decisions
• feeling like you don’t enjoy life
• feeling tearful
• feeling irritable and not wanting to be with other people
• feeling restless and agitated
• losing your self-confidence
• feeling worthless
• feeling guilty
• losing your appetite or not being able to stop eating
• having trouble sleeping
• losing or gaining a lot of weight
• thinking about suicide.

You may not have all these symptoms and they may come on gradually or you may suddenly start to feel very low. If you are worried that you or your partner might have depression, talk to your GP. You may be offered talking therapies such as CBT and/or medication. You may find it helpful to look at this page on self-care for depression.

If you feel like you want to harm yourself or feel like you want to die, it’s important to tell someone. This could be a family member, a friend, your GP or your midwife. Help is available now if you need it. You can call the Samaritans on 116 123.

 

Post traumatic stress disorder (PTSD) after a miscarriage

 

Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by events or circumstances that feel physically or emotionally harmful or life threatening and have lasting effects on how well you function in daily life.

PTSD can develop immediately after an event or it can happen weeks, months or even years later. It can be very difficult to come to terms with a traumatic event, but PTSD is treatable even if it’s been years since the event happened. 

Symptoms of PTSD include:

• flashbacks to the experience
• nightmares about the experience
• repetitive and distressing images or sensations
• physical sensations such as pain, sweating, feeling sick (nausea) or trembling
• constant negative thoughts about the experience
• trying to feel nothing at all (emotional numbing) and trying to distract yourself to avoid thinking about what happened
• avoiding places, people or other things that remind you of the traumatic event
• watching out for danger or threats and being easily startled
• anxiety
• irritability
• difficulty concentrating
• angry outbursts
• sleeping problems
• headaches
• stomach pain.

Tell your GP if you are having upsetting thoughts. It may be very difficult to talk about your thoughts and feelings, especially after a distressing experience. Remember that healthcare professionals won’t judge you.

“I suffered with nightmares after my miscarriages and had great difficulty sleeping. It wasn’t until after my 5th miscarriage that I realised these factors were symptoms of PTSD. I want other women to be diagnosed earlier than I was, as it makes a massive difference in the healing process.”  

Rianne

 

Your GP may carry out an assessment of your symptoms before you’re referred to a mental health specialist for more assessments. You may be referred to a clinic that specialises in treating PTSD if there is one in your area. The main treatments for PTSD are therapy and medication.

 

Miscarriage as trauma

You may not have, or want, a diagnosis of a mental health problem.  

You may find it more helpful to understand your experiences as a natural reaction to going through a difficult or traumatic experience. We often think of trauma as a response to experiences like natural disasters, but going through any very stressful, frightening or distressing events can be traumatic.  

Trauma by itself is not a mental health diagnosis. It is a way of understanding your experiences and your reactions to them.    

Trauma is an emotional response to an event (or set of events). Experiences where you feel frightened, humiliated, invalidated, unsafe, unsupported and powerless can cause trauma.  Different events and experiences will be traumatic to different people.

Traumatic events can be difficult to cope with because:

• they don’t fit with our sense of how the world should be and we can’t make sense of them
• they seem random, and have no clear cause or ‘meaning’ behind them
• they show us that bad things can happen to us and the people we care about, which can make us feel unsafe and threatened.

Effects of trauma are similar to the effects PTSD, but they are less severe and do not last as long.  If the effects of trauma go on longer than 3 months, or are still very intense after a month, it may be a sign you are developing PTSD. 

Common effects of trauma are:

• flashbacks
• nightmares
• avoiding people, places or things that remind you of what happened
• feeling anxious, irritable and/or angry
• having difficulty sleeping and concentrating
• constant negative thoughts about what happened
• feeling on the lookout for other things that might go wrong
• You are more likely to be affected in a negative way if:
• you were not helped and supported during the traumatic event (for example by healthcare professionals or your employer)
• have had previous trauma (for example previous loss or losses)
• you felt stigma and isolation related to trauma.

Everyone has different reactions to trauma, so if you have gone through this you might notice effects quickly, or a long time afterwards.  

There are things you can do to take care of yourself after a difficult or traumatic experience.  

• Get to know what helps you, what ‘triggers’ difficult feelings and where to get more support. This may help you feel more able to cope in the future.  
• Talk to people you know well and others who have gone through similar things. You may find it helpful to join our Baby Loss Support group on Facebook. This is a very supportive community of people who have been through loss.
• Avoid spending too much time alone and stick to your routines where possible.
• Take care of yourself and try to avoid alcohol or drugs to help you cope.

There is some more information on coping with trauma here.    

We know it can sometimes be really hard to avoid things that trigger difficult experiences if you want to get pregnant again and have to go back to the same hospital, for example. It can be very difficult to live with constant reminders of past trauma. We have more support on trying again and being pregnant after a loss.

We often hear from people who are bombarded with ads promoting maternity and baby products after loss, which can be really distressing. Find out how to stop pregnancy ads.

 

Asking for help after miscarriage

Your feelings and experiences are yours alone. Other people can’t know how you feel about your own experiences or how difficult or traumatic they were to you. You may have had similar experiences to someone else but be affected differently.  

There is support available, however you feel.  

You may find it helpful to find some peer support on our Facebook groups.  You can also talk to a Tommy’s midwife free of charge from 9am–5pm, Monday to Friday on 0800 0147 800 or you can email them at [email protected]. Our midwives are also trained in bereavement support.  

It’s a good idea to talk to your or GP if you:

• have depression or anxiety symptoms that are long lasting and affecting your daily life
• feel you can’t cope with daily life
• have intense emotions that are not getting better or are getting worse  
• aren’t sleeping well
• think your relationships are suffering
• are caring for someone who's not coping well
• have panic attacks
• have unpleasant thoughts that keep coming back and you can’t control them.

Tell your GP how you feel. Some people find it helpful to write things down before their appointment to make sure they remember everything they want to say. They will want to ask you some questions to understand a bit more about your symptoms before talking about your treatment options. 

Mind has a useful film on talking to your GP about your mental health.

There are also lots of organisations who may be able to help you access free or low-cost counselling, depending on your needs.  

 

Mental health medication and future pregnancies

You may already be on medication for your mental health and worry that it caused your loss (this is very unlikely, although more research is needed). Or you may have been offered it since. 

If you want to get pregnant again you may have questions and concerns about the impact of mental health medication on your ability to get pregnant, or on your baby.  

Talk to your doctor when making any decisions about medication. Do not stop taking any medication suddenly.

As well as your doctor, you might find it helpful to talk things through with other people who are close to you and/ or others who have been through similar experiences.  

Here are some useful things to think about when making this decision.

• BUMPS (Best Use of Medicines in Pregnancy) has lots of information about different types of medication and the research that has been done into the risks and benefits.
• Making this kind of decision is about balancing the risks and benefits of different options. Ask your doctor to explain the risks of an untreated mental health problem for you and any future pregnancy as well as the risks of any medication.  Ask them to tell you the absolute risk (rather than the risk compared to anything else) of any possible problems. 
• Some anti-sickness medication suitable in pregnancy cannot be taken with some types of anti-depressants. Ask your doctor to explain more about your options if you think you might need anti-sickness medication in the future.
• You may find it helpful to get a second opinion to ensure you get balanced advice. Many surgeries will have one or more GPs who specialise in mental health. You can ask the receptionist if you are unsure.