Miscarriage and loss: The long-standing mental health impact

5 September 2022
Neha Jain Written by Neha Jain
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Neha Jain

Neha is a freelance writer passionate about providing well-researched and empathetic mental...

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Nilom Shah Reviewed by Nilom Shah
Nilom Shah

Nilom Shah

Nilom Shah, Counseling Psychologist Nilom B Shah is a Mental Health...

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“It was short-lived happiness. We were only happy for a week before we lost the baby. I don’t think I have words to explain the whirlwind of emotions I experienced during that time.”

Miscarriages are traumatizing, both physically and mentally. Women who have access to proper healthcare facilities might receive suitable physical care after a miscarriage, but even they don’t receive emotional and mental health support. People tend to trivialize the experience because of how common it is. 

About 32% of pregnancies end in spontaneous miscarriage in India, as per this study. Spontaneous miscarriage makes it even less likely for the mother to receive mental health care. But so much attention is paid to the physical well-being of the mother post the miscarriage that medical professionals often neglect the very real emotional aspect of losing a baby.

And that lack of attention can have far-reaching consequences. A recent study by the National Center for Miscarriage Research found that women with early pregnancy loss might experience Post Traumatic Stress Disorder (PTSD), anxiety, and depression. While women who had a previous mental health problem are at greater risk of PTSD, all women should be considered at risk. 

The devastation and guilt: Feelings left after miscarriage

Vinita Gahlot

Vinita Gahlot, now the mother of an 18-month-old, lost her first baby in 2019. 

“It was only a week after the doctor told me I was pregnant when I lost the baby,” she says, “I was stressed because of some things. And just a week later, I started bleeding.”

“From then on, it was a blur of emotions. I was devastated, hurt, and guilty. I blamed myself for taking the stress and losing my baby. Then the anger came. I was angry at the people who were the reasons behind my stress during that time.”

Vineeta did not get any mental health support during this rough phase. The following year was even more mentally draining for her. “For a year after my miscarriage, I could not conceive. That heightened my feelings of guilt and filled me with doubts over my ability to be a mother. Living in India, it was common for our family and acquaintances to constantly ask if we were trying for a baby and why is it not happening. I frequently lashed out at them.” 

Talking about why she never sought counseling, she says, “Growing up, we never talked about mental health. So while going through all this, it never struck me to go and seek mental health support. I went to 3-4 doctors when I couldn’t conceive, and none of them told me to seek help. They were only concerned about the symptoms of my body, not my mind. Even when I told them that my miscarriage happened due to stress.”

“Now when I think about it, I believe seeing a therapist would have helped me process my grief and emotions better. But at that point, I was not aware, and none of my doctors advised me to do this. Fortunately, I had the support of my husband and family that helped me pass through that rough phase.”

Many women in India experience PTSD and depression without even knowing it due to the lack of awareness around mental health. Our society has glorified motherhood and stigmatized miscarriages. We don’t talk about miscarriages, just as we don’t talk about mental health, which makes the impact of miscarriage on mental health even less likely to be acknowledged.  

Professor Bourne’s study found that even women with no history of mental health issues experienced PTSD and depression after the miscarriage. “This research should send an important message to clinicians: even a diagnosis of loss very early in the pregnancy, often referred to as ‘biochemical pregnancies,’ and a loss with mild physical symptoms, may result in significant psychological distress later, and must be treated with compassion,” said Professor Bourne. He also suggested using virtual reality headsets to reduce pain during a painful miscarriage procedure.

“I was anxious and a nervous wreck”

Niti Nadarajah, a senior lawyer and LinkedIn’s Top Voice, went through two consecutive early pregnancy losses. She was a mother of a 3-year-old kid when they decided to try for a second baby. “I went to the obstetrician for a scan at 8 weeks of my pregnancy. We were confident because we had been through this before. But then I saw my obstetrician’s face change, and I could see the light disappear in his eyes. He told me that I had had a miscarriage.”

Talking about how it affected her life, she says, “I had this story in my head that we will wait for a few weeks and then try for a baby again. But because I had a molar pregnancy, the doctors had to take my blood samples for the next 6 months. Those months were hard. I was getting older, and my biological clock was working against me. Our daughter knew about the baby, and it was really hard to tell her because she kept kissing my belly.”

Her second miscarriage happened in 2018. “After 10 months of my first miscarriage, we tried again. We did the scan at 7 weeks, and everything was fine. I went back after 9 weeks without my husband. And the same thing happened. I lost the baby again.”

Niti’s healing journey

Talking about her healing journey, “Not many people knew about it because, at that time, I wasn’t used to sharing. Then one day, I was sitting in a meeting with someone who handled mental health for the group I was working with. And all of a sudden, in the meeting, she asked if I was okay. My initial instinct was to say yes, but something stopped me from saying that. The two years’ worth of things I was dealing with came out. Sharing what had happened, where I was mentally started my healing journey.” 

Niti had her rainbow baby later that year. “I had told my husband that this is the last time I will try. I can’t do the trauma and grief that came with losing a child again. Fortunately, everything went fine. I was anxious and a nervous wreck. When you have even one miscarriage, it makes all the pregnancies afterward anxiety-ridden.”

Niti is now an ambassador of Pink Elephants, an organization that provides emotional support to people who have faced pregnancy loss. She is vocal about her loss and many other issues on LinkedIn and other platforms. “The days after my miscarriages were filled with grief and self-blame. The silence that surrounds the first trimester protects you from sharing the sad news with people but that also means you don’t talk to people about it when a miscarriage happens. I thought a lot about the fact that there’s so much silence around early pregnancy loss. I wished I had known more and been less naive. This is where I knew that at some point I had to share my story.”

Nishtha Budhiraja

And Niti is not alone in her experience. We talked to Nishtha Budhiraja, a Psychotherapist and Child Psychologist, about her experience with grieving mothers. “A lot of my clients come for grief processing after a miscarriage. They ask questions about why it happened to them and doubt their competence as a mother.

There’s grief, self-doubt, anxiety, and depression. PTSD is more common in mothers who have had traumatizing miscarriages.

Then when they start trying for a child again, fear comes in.”

Talking about the role of Indian hospitals in caring for women’s mental health after pregnancy loss, she says, “Hospitals don’t recommend it. Doctors with their private practice sometimes do. But many gynecologists take up that role themselves since they are trained in maternal mental health. I approached 6-7 gynecologists for collaboration, and only 1 agreed on the collaboration. None of them were interested in sending their patients to seek mental health support. Medical science can help you understand what the body needs, not the mind.”

And what about Bourne’s idea of using VR headsets to reduce pain and anxiety? “I have worked extensively with VR in treating anxiety. I can see its relevance, and it can be helpful. However, it has to be used very cautiously. If you are giving an alternate reality to the mothers’ on such a vulnerable stage, you need to equip them to distinguish between reality and the environment they are experiencing.” 

According to her, every woman should receive the proper mental health support after miscarriage. “A mother should receive mental health support right from the moment they decide to conceive. It’s rare in India that they get it but equally necessary.” 

Miscarriages have a profound impact on mental health. It is necessary that women, and their partners, receive the right mental health care. Studies have found that even after having a healthy child, the mother could still face depression from the previous pregnancy loss. Paving the way after losing a child is not easy, but it could be made easier by processing the grief and unresolved feelings.

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