The psychological impact of losing an unborn baby can last for several years, a British and US study has found.
Mothers may still suffer depression or anxiety long after going on to have a healthy baby, researchers report in the British Journal of Psychiatry.
They studied 13,000 women and said past pregnancy loss should be considered when assessing depression risk.
It underlines the need for midwives to spend time with pregnant women to discuss worries, say midwife leaders.
Losing an unborn baby through miscarriage is common but most women go on to conceive again.
As many as one in five pregnancies ends in miscarriage, while stillbirth happens in about five in every 1,000 births.
Past studies have shown women who have lost a baby are more likely to experience anxiety and depression when they get pregnant again.
But few studies have looked at whether these symptoms fade after the birth of a healthy child.
Researchers studied more than 13,000 women taking part in the University of Bristol’s children of the 90s study.
It tracks the progress of about 14,000 children born in the early 1990s in the former county of Avon, England, and their parents.
The UK/US team found women who had lost a baby in the past experienced significantly higher levels of anxiety and depression during their next pregnancy.
This continued nearly three years after they gave birth to a healthy baby.
Professor Jean Golding, founder of the Avon project (Avon Longitudinal Study of Parents and Children) said: “This study is important to the families of women who have lost a baby, since it is so often assumed that they get over the event quickly, yet as shown here, many do not.
“This has implications for the medical profession as well as the woman and her family.”
Dr Emma Robertson Blackmore, of the University of Rochester Medical Center in New York, US, added: “We know that maternal depression can have adverse impacts on children and families.
“If we offer targeted support during pregnancy to women who have previously lost a baby, we may be able to improve health outcomes for both the women and their children.”
Louise Silverton, deputy general secretary of the Royal College of Midwives, welcomed the report.
She said: “It underlines the need for midwives to be able to spend time with women to discuss their pregnancy and their worries and fears.
“This is so that they can spot signs of depression when it is happening, offer timely advice and give these women the best possible care.
“I worry that because of the significant time pressures on midwives and the fact that we do not have enough of them, this may mean that women suffering from perinatal depression will not get the help they need.”
Postnatal depression affects one in seven-to-10 mothers.
Women can also get depression during pregnancy – this affects about one in 10 women.
Perinatal depression is a term used to describe depression before or after the birth of a baby.
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