Postpartum Depression After Miscarriage or Stillbirth

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I haven't written much here about postpartum depression after miscarriage or other loss, probably because I just don't a lot of knowledge about that particular experience, but it is clearly an important topic to discuss. Women who suffer miscarriages, stillbirths or other perinatal losses are certainly at a high risk of experiencing postpartum depression as well as grief. I met a mother recently who, when she found out what I do every day, told me that her first child died in his first few months because he suffered from arare disorder that no one knew he had. She talked about the horrible, and completely understandable, depression she experienced and how she got through that time. There are no words …

Dr. Ruta Nonacs, in her book A Deeper Shade of Blue, devotes an entire chapter to this subject.

"Though emotional distress in pregnancy loss is normal, some women may develop more persistent or disabling psychological symptoms … Depression may also complicate the picture. One study found that during the six months following a miscarriage, about 10 percent of women showed signs of depression … Experiencing a stillbirth or neonatal death probably puts you at even higher risk for depression; one study indicated that a mother's risk for depression after stillbirth is about seven times higher than a woman who has a live birth."

Last month I heard from another mom whowanted to share her story of postpartum depression after miscarriage. In her email she wrote:

"PPD is so widely misunderstood and rarely talked about. I've heard even less about living through it after having a miscarriage. I'd love it if you'd talk about this issue on your blog."

Well, let's start today with a link to her story of depression after miscarriage. I welcome hearing from more of you on this topic. I hope other moms inthis situationwill be comforted by your words.

If you are interested in more information on this topic from Postpartum Progress, check out:

3 Ways to Support Women Who've Experience Pregnancy Loss

What Is the Difference Between Grief & Depression After Pregnancy Loss?

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About Katherine Stone

is the founder & editor of Postpartum Progress. She was named one of the ten most influential mom bloggers of 2011, a WebMD Health Hero and one of the top 25 parent bloggers using social media for social good. She also writes the Fierce Blog, and a parenting column for Disney's Babble.com.

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Comments

  1. Thanks for posting that, Katherine. Like you said, this is a very important subject that is really not well understood and almost never talked about. I had a mom in my support group recently who had suffered two miscarriages before bringing a daughter home from the hospital. She was suffering from fairly severe postpartum OCD, and only then realized that she had already had it twice before. She thought those feelings were just what you felt when you had a miscarriage. My heart really broke for her, having to deal with both of those traumas at the same time, and one without even really knowing what one of them was. Paula's essay reminded me of a wonderful and true line from a Fiona Apple song, "Full is not heavy as empty, not nearly…"

  2. Thanks for opening up the topic Katherine. I re-read the post of mine that you linked to and hope that people don't find it too depressing. This one is really tough to talk about but important so that families can feel free to speak openly about their loss and their depression.

  3. Sara Pollard says:

    Hi Katherine…thanks for sharing about this topic.
    I am blessed to work in both the Perinatal Mood and Anxiety Disorder field and Perinatal Bereavement field. Women who experience loss can absolutely experience depression/anxiety but one must be very careful about finding proper support for this very unique group.
    It can be confusing to sort out grief vs. depression as there are many commonalities. We must remember that grief is a very normal reaction to a very abnormal event (losing a baby) whereas depression/anxiety are disease states that need treatment. Grief in and of itself does not require treatment but instead support, education and understanding from appropriate parties.
    Grief can get complicated (depression/anxiety can occur) and it can certainly excacerbate a pre-exisitng condition like depression, anxiety, Bipolar etc. Women who experience Perinatal Loss and have a history of any mental health issue should make sure their provider is aware of this history. Women should also be taught how to differentiate between grief and depression and when to seek help.
    The typical PPD support group, which usually contains at least a mom or 2 who is experiencing regret/ambivalence about motherhood, is not the optimal place for bereaved moms to find support. We know these feelings are normal with PPD but imagine the impact of such words on a grieving mother.
    Check out the Kate Care's website as it has a comprehensive list of resources to help grieving moms and families.

  4. First of all, I am Paula's husband.
    One of the toughest parts of dealing with the PPD after miscarriage was that there are some people who deal with and understand PPD and there are people who deal with and understand miscarriage, but there seem to be few people or resources to deal with the horrible combination of depression and grief that can come when you have both. To make it worse, some of the things that therapists worry about and try to stop in depression patients (like too much sleep) are normal ways of handling grief. There are a number of behaviors that have conflicting meanings or importance depending on if you view it as PPD, grief, or a combination of the two. It takes some real attention to treat them both.
    Frankly, I place a lot of the blame for Paula being commited on a therapist who I don't think really understood half of what was going on and I think often did more damage than good (I sat in on the sessions, so I have heard most of what was said, but that is a different story).
    Luckily when Paula was commited, we looked for new ways to get help and found a wonderful social worker (thanks Lori-Ann Shultz@Foothills Hospital) who really did understand and was able to provide a huge amount of help.
    All I can say to couples going through it is:
    1) it will get better. It really will. Someday you will find a new "normal". It won't be as care-free as it was, but it won't be as bad as it seems.
    2) don't be afraid to seek help. And if at first, you don't succeed, don't be afraid to keep looking. I can not imagine where we would be now if we had not kept trying different things until we met Lori-Ann.
    There is also a blog about our experiences losing Kye at Kye.thebentleys.ca.

  5. This is Paula again. I just wanted to add a couple of things. Thanks to Sara Pollard for pointing out that miscarriage is an abnormal experience. So many people say that it's normal because it's so common. This completely trivializes the loss and the family's feelings about it. Some people (including a psychiatrist) have actually said to me, it(miscarriage) happens even with animals. It's completely normal and to be expected. You need to move on.
    Thanks also to Sara for cautioning moms from attending PPD support groups after a loss. I can't imagine what that would be like!
    Also, isn't my husband fab?
    Thanks Katherine for getting this information out there two days in a row. It's much appreciated and needed!!

  6. thank you so much for posting this! There are so many families suffering in silence, almost feeling as if they don't have a "right" to suffer from PPD, since they don't even have a child to hold.
    I suffered PPD after all of my children. My 3rd child was stillborn at 20wks. It is strange to me that there aren't more resources for PPD after a loss.
    There is an amazing network of women in blog land supporting one another through their losses. I highly suggest anyone who has had a loss or knows someone dealing with a loss check out Whispered Support http://whisperedsupport.blogspot.com/

  7. Carol Birnbaum says:

    I am one of the unlucky ones who has experienced both depression after a miscarriage and PPD after my second pregnancy. I ended up seeking professional therapy for both situations, but have found that the most help has been from that of my peers.
    After miscarrying during my first pregnancy at 12 weeks, I was devastated. My innocence regarding pregnancy was gone forever. I couldn't even relate to other women who were able to first have a healthy child, and then have a miscarriage. The only people who could understand how I felt were women in my EXACT same situation, miscarriage during the first pregnancy. By some unknown power, I became a part of a group of women in this situation through an online message board, and we became each other's lifelines. It has now been over 3 years since we started our conversations, and we all check in with one another daily. Most of us have gone on to have successful pregnancies, but there are a few who we still are supporting through such a difficult time.
    Of all of the women in my group, I was probably the one who was most affected by PPD. Almost all of us had some form of the baby blues, but there were a few who experienced a more difficult postpartum battle. While my group of friends was as helped as they could be, I found that I needed support from people who knew what it was truly like. Through my counselor, I was able to find a PSI support group that helped me through the bleakest of days.
    Through all of this, I have learned the strength and power of women, and am overwhelmingly thankful for the friendships I have found through the women who have shared the same experiences.

  8. Depression says:

    Many people suffer from depression. Depression gnaws into the entire being, be it the physical aspect or the emotional one, It makes person lonely and discouraged. Depressed individual also suffer from pain or physical indicators. Many times even doctors fail to notice that. Some medications and therapy like cognitive behaviour based treatments might help. One should take doctors advice.

  9. It is very hard to find support in a situation like this. I've suffered from postpartum depression with 2 out of 3 of my children. A year ago I lost my 4th pregnancy in the 1st trimester. When I went in for my 12 week appointment I always heard a heartbeat before and everything was great, so I didn't expect anything different that time. It goes without saying it was. That experience was so much harder than the PPD alone after having my sons. I've found many of the support groups for pregnancy and infant loss don't respond well to PPD. Most of the women I found were struggling with infertility and had no other children. I got the how dare you think that way, I have 3 kids I should be happy. I did end up hospitalized less than a month after that loss because of severe PPD symptoms. From there it took some time to get through that and still go through the grieving process from losing the baby. Thankfully I did have a good therapist that did the best she could with this situation, along with my wonderful friends that helped me through the PPD. As for online support for loss, I've found Silent Grief to be helpful to me.

  10. Depression gnaws into the entire being, be it the physical aspect or the emotional one, It makes person lonely and discouraged. Depressed individual also suffer from pain or physical indicators. Many times even doctors fail to notice that. Some medications and therapy like cognitive behaviour based treatments might help.

  11. Hello,
    I suffered a miscarriage 2 days ago and words cannot express my sorrow… I was about 12 weeks / 3 months along. I am 35 years old and my fiance is 38. This would have been our first child. For some reason I had been bleeding… could have been from a partial placental abruption, blood vessels simply rupturing, or simply due to implantion… whatever the reason, the baby was, of course, tiny but fully formed. I held him (it looked like it was a boy)… saw all facial features, hands, feet, toes, ribs, everything. He was beautiful. Although very sad, I am grateful to have had the opportunity to have watched him moving… waving his hands, kicking and tumbling on the ultrasound screen. I had been keeping a journal and wrote a couple of entries to him about how happy mommy and daddy were. For closure I made one last entry and buried my little one in a small box. I am personally a strong person… having suffered the loss of a few family members, including my sister… however, words cannot express my sorrow and sadness. I never expected to feel this way. My heart goes out to all of those who have suffered the loss of a baby.

    • I can relate, I lost my baby girl at 20 weeks, I delivered her and held her but wasn’t able to actually see her, she was wrapped in a blanket. I knew the condition she had and with it she could have looked different so to save my perfect image of her I asked the nurse to decide if I should see her but I did want to hold her. I am glad I did hold her and I still have my perfect image of her in my mind. My PPD has been very bad, I didn’t have it with my son so its a new experience. I had a miscarriage at 8 weeks before I had my healthy son. I seemed to bounce back after both of those but not this one, of course im 10 years older now so that could have something to do with it but I don’t care what stage its just plain hard and hearbreaking. I’m still having a tough time but I have taken some time off work after my dr advised me to do so and I am taking some medication that is helping. I feel better now than I did a week ago so I suppose its small steps and one day at a time. Prayers and hugs for you.

      • Oh Maleah. I’m so sorry for your loss. You are right that it’s hard and heartbreaking and it doesn’t matter how long it has been or what stage you are at. I’m glad you are talking about this with your doctor. Good for you for taking care of yourself.

  12. Im so glad i've found this site. I was diagnosed with PPD yesterday after miscarrying 6 weeks ago. I thought that I was just supposed to feel like this, until I went back to my doctor and was told "most women who have had a miscarriage are over it now and back to work by 6 weeks" I wasnt aware that there was a timescale to be 'over it' I needless to say went to see another GP, who was much more sympathetic and assessed me for PPD.

  13. Thank you so much for the information you've provided; I've learned from both you and from the comments. I am a doula; I have experience in supporting families in pregnancy and labor. I had a miscarriage–my baby was born April 19, 2011. I blogged about it in real time, and have decided to make a miscarriage-specific website. I just posted about being a month past the experience, and how the grieving process is impacted by the way the miscarriage process occured and was treated. You might find it interesting:
    http :www.birthingpains.blogspot.com
    Thank you for checking it out, and again, for the info on this site. (:

  14. I know that losing a child at any age weather the child is not born or has been here a while it is still hard to take i am Trying not replace a child with the one i loss i am having a hard time not feeling like it was my fault for the miscarriage. We told our family cause we never had any problems with my last child. so to tell everyone i lost the baby plus dealing with my own grief is hard enough,

  15. I had pretty bad post partum depression after my very early miscarriage. It was an unplanned pregnancy and I hadn’t decided yet if I would have an abortion or not, yet when I miscarried, I felt tremendous grief, as well as relief for not having to go through with it or many any decision to have an abortion. I was (and still am) very sick with so many health problems, and my hormones were post-menopausal to begin with (I was 23) that when I got pregnant, I actually felt a lot better because my hormones were increasing rapidly due to the pregnancy. After I miscarried, and in addition to the emotional loss, I also felt extremely depressed from the incredible drop in hormones I was experiencing. It lasted for almost a year after. Maybe even longer. While depression after a miscarriage is very real from the loss of a pregnancy (planned, “wanted”, or not), the PHYSICAL/chemical post partum depression is very real, whether you had the baby or not, and whether you miscarried late or early in the pregnancy. I wish more people would talk about this.