Trauma and the unborn child: PTSD, major depression and relationship quality following late pregnancy loss

Abstract

Background and objective

Late pregnancy loss (PL) is recognized as a very difficult life experience. Often, PL is regarded as a “feminine” trauma, experienced individually by the woman, thus neglecting the role of the parental dyad in coping with the loss. This study aimed to examine:

– the prevalence of PTSD and major depressive disorder (MDD) following late PL;

– the role of spousal relationship measures in vulnerability and resilience following PL.

Methods

Participants were 100 women, ages 24–49 (M = 35.07, SD = 5.28), who have experienced late PL. The mean pregnancy week of loss was 27.29, with the average woman being 22 months post-loss. 84.6% experienced stillbirth. Participants completed self-report questionnaires assessing PTSD, MDD, dyadic adjustment and dyadic self-disclosure.

Results

We have found high rates of both PTSD (32.7%) and MDD (53%) among women following late PL, as well as high PTSD-MDD comorbidity rates. Interestingly, a negative association was found between the number of previous pregnancy losses and the severity of MDD, perhaps indicating an innoculation process. Both PTSD and MDD were negatively associated with the levels of dyadic consensus, dyadic self-disclosure regarding guilt and shame, and dyadic affectional expression.

Conclusions

Late PL entails a heavy burden of PTSD and MDD, presumably since mothers are already strongly attached to their unborn child. PL is often experienced by both expecting mother and father. Thus, the quality of the spousal relationship following PL is an important protective factor. Therefore, there is a pressing need for novel interventions in couples therapy following PL.

Disclosure of interest

The authors have not supplied their declaration of competing interest.