Miscarriage Puts Both Partners at Risk of PTSD, Research Shows

When it comes to pregnancies and all of the complexities that come along with those experiences, both hospitals and researchers tend to focus primarily on the parent that is giving birth. A study in the October issue of Ultrasound in Obstetrics and Gynecology, however, found that losing a pregnancy at an early stage can lead to post-traumatic stress in both partners.

While the birth-giving partner is more likely to suffer from PTSD following pregnancy loss, the new study showed that non-birthing partners may also experience symptoms, though to a lesser degree.

What Did the Study Show?

This study surveyed 192 couples in the United Kingdom, and within this sample size, all couples were comprised of one man and one woman. Participants were approached in the hospital units designated for early pregnancies; consenting participants completed online surveys one, three, and nine months after early pregnancy loss.

An important step of this process was to determine which participants met the criteria for anxiety, depression, or post-traumatic stress (PTS) following their miscarriages, and the researchers utilized the Hospital Anxiety and Depression Scale (HADS) and Post‐Traumatic Diagnostic Scale (PDS) within the surveys to determine.

There are similarities and differences when it comes to how parents respond to a loss. Both share negative feelings, but due to societal pressures on men and the emphasis placed on the birth parent, the emotional response is often disparate.

“There are multiple noticeable differences in the response of birthing and non-birthing partners to this event," says Zaher Merhi, MD, OB-GYN, a reproductive endocrinology and infertility specialist and founder of Rejuvenating Fertility Center in Connecticut.

"For starters, non-birthing partners tend to feel the need to be supportive and to give emotionally and physically to the birthing partner, whereas the birthing partners will most likely become more introverted and reclusive. Typically, the non-birthing partner will be inclined to try to 'fix things' emotionally and physically for the birthing partner,” he says.

What Is Post-Traumatic Stress?

Post-traumatic stress disorder can occur in individuals that have experienced an unsettling event. Events that cause PTSD symptoms can be isolated or recurring. Symptoms of PTSD are broken down into four categories, including:

• Avoidance
• Hyperarousal
• Negative Thoughts or Beliefs
• Re-experiencing

The new study found that the most common PTSD symptom occurring in both partners after pregnancy loss was re-experiencing, followed by avoidance and hyperarousal.

Kenda Sutton-El, a birth worker and executive director of Birth in Color in Richmond, VA, has witnessed this during her experience working with couples going through this difficult time. “Non-birthing partners attempt to be strong for the mom because they feel as that is their role, but they will grieve in silence," she says. "They both become extremely terrified of even trying for another baby.”

Given that all of the non-birthing partners in this study were men, researchers say that the part of issue surrounding PTSD symptoms and the subsequent silence surrounding the condition is that men are less likely to ask for help. "Men are generally less likely to seek support for mental health and may have poorer peer support," the researchers note.

This can compound and result in poorer health outcomes. “Both partners are likely to experience grief in its different stages, maybe in different sequences and maybe each at his/her own pace," says Merhi. "Most importantly, each individual should allow the other partner freedom to experience their grief in their own way.”

How Can This Study Be Helpful?

Feelings of Loss For Both Partners Are Normal

Miscarriages are very common within the first trimester of pregnancy, with 10 to 20 percent of known pregnancies ending in a loss. This includes ectopic pregnancies, which occurs in 1–2% of all pregnancies as an embryo implants outside of the uterus and is unable to develop, resulting in pregnancy loss.

While it is common for the non-birthing partner to forego their emotions in an effort to care for the birthing parent, a shared loss means the grief can be shared as well. Keeping lines of communication open as well as seeking out resources can aid in an emotionally difficult situation such as a pregnancy loss.

“I recommend seeking counseling help from a professional as soon as possible to help navigate the waves of emotion and pain," says Talitha Phillips, a certified labor and postpartum doula and CEO of Claris Health in Los Angeles. "It’s important to communicate how the partner as well as other friends and family can help."

Phillips adds, "This includes the need for physical help and a safe place to talk and process the loss. Loss can drive couples apart, but it can also bring them closer together. There is a closeness and tenderness that can form as people journey through this together.”

Additional Resources are Needed for Both Couples

A 2017 review suggested that research on the effects of pregnancy loss on non-heterosexual and non-cisgender men is lacking, and that understanding how miscarriage affects the mental health of male non-birthing partners across different cultures could lead to better health care outcomes. The new data could serve as evidence that additional considerations and protocols for both parents, regardless of gender or sociocultural context, should be in place for all outcomes of pregnancy.

In addition to mental health providers, seeking out a doula (either for birth or following miscarriage) can assist both partners throughout the journey of conception, birth, or losing a pregnancy, and is a viable option for support.

Potential Next Steps for Couples

Merhi advises:

• Be sensitive to each other. Talking about other pregnancies may be the non-birthing partner’s way of trying to fix things, however what the birthing partner usually needs is someone to listen and be there.
• Support your partner. Taking the time to sit with each other, talk, and engage in activities together will help both partners heal faster.
• Ask for support. Support groups, counselors, and even therapists can be of great help to both partners.
• Get busy. Keeping yourself busy through this process is important, to decrease the constant thoughts that you have about the miscarriage. One or two new projects are adequate to keep busy while handling this change.
• Give it time. Give yourself and your partner enough time to fully experience this and come out the other side.