Too many women do not receive support for anxiety and post-traumatic stress disorder (PTSD) after a miscarriage, according to campaigners who urged the government to completely overhaul medical services to better accommodate those with pregnancy loss.
Tommy’s charity said that although one in four pregnancies end in miscarriage, it is still not fully understood due to a lack of NHS data collection. NHS support is also limited to those who experience three consecutive miscarriages, although many women experience lifelong physical and psychological consequences.
“We’re trying to debunk the myths about miscarriage,” said Jane Brewin, Tommy’s CEO. “One of them is that it is something short-term rather than a serious long-term condition that has no lasting effects on people.
“There are people who are really not well psychologically, who receive no intervention other than going to the family doctor, who cannot refer them for support unless they have three in a row. That’s really not enough.”
Tommy’s urges the government to prominently highlight investments in mental health support as well as miscarriage prevention and treatment in its women’s health strategy, which will be published later this year. His research estimates that abortions cost the NHS £430m annually, before factoring in wider costs to the economy such as taking time off from work.
Research by the charity has shown that 20% of women who miscarry will continue to experience clinical PTSD, 16-18% will suffer from anxiety and depression, and their risk of suicide quadruples.
These symptoms can persist even after they have a healthy pregnancy later, which some refer to as a “rainbow baby” to reflect a positive outcome after a stormy experience. However, women and their partners report that they have trouble rejoicing about their new pregnancy and are constantly worried that they will have another miscarriage.
The issue came to public attention after media coverage of Carrie Johnson’s reported pregnancy, in which she said she was hoping for a “rainbow baby.” In a private Instagram post, she wrote: “At the beginning of the year, I had a miscarriage that broke my heart. I feel incredibly lucky to be pregnant again, but it also felt like a bag of nerves.”
Professor Siobhan Quenby, a researcher at the University of Warwick and head of Tommy’s National Center for Miscarriage, said societal attitudes need to change to ensure adequate support for miscarriages, including the taboo about disclosing pregnancy before 12 weeks, could exacerbate anxiety.
“Society says that if you just lost a baby a few months later, it somehow doesn’t exist and that you shouldn’t be upset because of that, and that doesn’t require support. This is not entirely true,” he said.
This was the experience of Gina Notarianni, who had had three miscarriages. “After the first miscarriage, the excitement goes beyond the pregnancy,” she said. “Just because you have other kids, you never lose that space. I’m so lucky to have three healthy kids, but that doesn’t replace them. You always wonder about the things you don’t have.”
Ruth Bender Atik, CEO of the Miscarriage Association, said employers need to educate themselves about the different ways abortion offers, because it’s complex and personal.
“You may have an employee who doesn’t want to come back directly and talk about it. It could be because he doesn’t have deep feelings about his loss or because this structure gives him a sense of control. But there may also be someone who has to take six weeks off because he is depressed and cannot concentrate.”