Miscarriage as a traumatic event: a review of the literature and new implications for intervention.

This review considers the psychological impact of miscarriage and follow-up care. A fifth of pregnancies end in miscarriage, and the experience leads to emotional consequences such as depression and anxiety, which may last for several months. Some have explored the focus of psychological morbidity and attempted to discover predictors of adjustment, but results are inconclusive. Grief has been identified as a feature of postmiscarriage distress, but trauma associated with the process of miscarriage has been neglected. Despite the recognized impact, there is dissatisfaction with professional emotional care, and there is no routine follow-up. There have been no controlled intervention studies with women who miscarry during early pregnancy, although anecdotal evidence suggests beneficial effects. Such studied have concentrated on loss, but perhaps future research should consider the whole experience of miscarriage. An intervention derived from trauma research has been suggested as a possible strategy for facilitating emotional adjustment and preventing longer term negative responses.