An empirical study of anxiety, depression & post-traumatic stress after miscarriage and the implications for counselling

Abstract

This research was designed to investigate the effect of miscarriage on the psychological health of women. Two hypotheses are tested. First, that miscarriage produces anxiety, depression, post-traumatic stress, and symptoms of post-traumatic stress disorder at rates significantly higher than those found in the general population. Second, that certain life experiences or predisposing factors, when preceding a miscarriage, produce anxiety, depression, post-traumatic stress, and symptoms of post-traumatic stress disorder at significantly higher rates than found in women who have not had such an experience. Data was gathered using two standardised and one purpose designed questionnaire. Women who suffered miscarriage were sent the questionnaires one month post miscarriage. A control group of women attending gynaecology outpatient clinics also completed the questionnaires where appropriate. The findings of the research are that there is significant evidence supporting both hypotheses. Miscarriage has a significant impact on the psychological state of women, here looking at anxiety, depression, intrusion and avoidance. Women certainly suffer from post-traumatic distress, and as this is a subset of post-traumatic stress disorder (PTSD), further work may show PTSD to be of significance. There is a complex of predisposing factors which can point to vulnerability to such response, as well as factors which although unrelated might have been expected to be significant. Miscarriage should therefore be taken seriously as a psychological issue by counsellors, health professionals and society in general. Counselling should be offered and note taken of predictors of response, as well as of the individual's context and understanding of their situation. Cognitive concepts may well be important in understanding these psychological responses and in structuring counselling responses.