Infertility and Perinatal Loss: When the Bough Breaks

Abstract

Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and posttraumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy.

Quality of life, Social Support and Self-Efficacy in Women After A Miscarriage

“…Pregnancy loss is typically experienced as a traumatic, critical event, which may lead to secondary psychological health disorders. Its burden involves both the experience of loss and related medical issues, which are associated with pain, hospitalization, limitation in one's social roles, decreased sense of security, and changes in one's perceived quality of life (QoL) [5,6,7,8,9,10,11].…”

A systematic review and meta‐analysis of nonpharmacological adjuvant interventions for patients undergoing assisted reproductive technology treatment

“…Infertility can bring people as much emotional strain as a traumatic event . It is accompanied by feelings of loss, anger, grief, sadness, shame, and self‐blame, and other negative emotions, and these emotions together constitute a psychological burden that is a major reason for ART discontinuation . Whether this psychological burden also affects the pregnancy outcome is still under debate …”

Miscarriage and Maternal Health

“…Women who experience miscarriage worry about future pregnancies [4] and may perceive a subsequent pregnancy as especially precious and very desirable [5]. Pregnancy after miscarriage can be experienced as emotionally and psychologically distressing [4,6]. According to descriptive studies of pregnancy following miscarriage, for some women the subsequent pregnancy is perceived as threatening [7] and involves tremendous vulnerability and anxiety related to uncertainty about its outcome [8].…”