The psychological implications of spontaneous abortions

Spontaneous abortion occurs in approximately 15% of obstetric patients. Our efforts to decrease bleeding and prevent infection do not take into account the emotional stress of the patient or the sense of grief and loss she might be feeling. Predominantly, the women in this study were concerned with what caused the miscarriage and why it happened. They described themselves as unhappy, depressed, hostile and anxious. In addition, the patients were often misinformed and frequently desired more accurate data. Approximately 25% answered yes to having a psychiatric problem. One-fourth of the patients had been seen earlier in their pregnancies with a threatened abortion; 17.3% had had a previous miscarriage, and 25% felt they were personally responsible for the miscarriage. Recognition of an attention to these facts enables the obstetrician-gynecologist to offer better patient care in the form of reassurance and information at several points of interaction with the patient experiencing a spontaneous abortion.