Editing Recurrent miscarriage (section)

== Psychological Impact ==
{{Main|Miscarriage and grief}}Experiencing pregnancy loss can have a significant and at times prolonged psychological impact, including higher levels of stress anxiety, and depression. There is evidence that women struggling with recurrent pregnancy loss in particular may be affected to a greater degree.<ref name="Inversetti_2023">{{cite journal | vauthors = Inversetti A, Perna G, Lalli G, Grande G, Di Simone N | title = Depression, Stress and Anxiety among Women and Men Affected by Recurrent Pregnancy Loss (RPL): A Systematic Review and Meta-Analysis | journal = Life | volume = 13 | issue = 6 | pages = 1268 | date = May 2023 | pmid = 37374051 | pmc = 10301891 | doi = 10.3390/life13061268 | bibcode = 2023Life...13.1268I | doi-access = free }}</ref> Grief is a normal and expected response to the loss of a pregnancy.<ref name="Fertility and Sterility_2012_2"/> However, prolonged and intense grief can be significantly distressing and detrimental to the mental health of the individual. This can particularly be seen in women that developed maladaptive coping mechanisms following a miscarriage, isolated themselves as a result of the cultural and societal stigma, or received inadequate social support from medical providers, partners, families, and other personal relationships.<ref name="Ho_2022">{{cite journal | vauthors = Ho AL, Hernandez A, Robb JM, Zeszutek S, Luong S, Okada E, Kumar K | title = Spontaneous Miscarriage Management Experience: A Systematic Review | journal = Cureus | volume = 14 | issue = 4 | pages = e24269 | date = April 2022 | pmid = 35602780 | pmc = 9118363 | doi = 10.7759/cureus.24269 | doi-access = free }}</ref> In heterosexual couples, men also experience grief as a result of pregnancy loss and have reported feeling obligated to disregard their feelings in order to support their partner.<ref name="Inversetti_2023" /> The psychological effects of RPL on paternal emotional and mental wellbeing has not been studied extensively, however, there are emerging studies that further look into this. According to a recent meta-analysis that compared the psychological impact among men and women with a history of RPL, women were found to have higher levels of moderate to severe depression, stress, and anxiety than women without RPL and than men who experienced RPL.<ref name="Inversetti_2023" />

Given the impact that RPL can have on the mental health and psychologic well-being of couples, mental health evaluation, anxiety/depression screening, and treatment can be considered.<ref name="Fertility and Sterility_2012_2"/><ref name="Inversetti_2023" /> There is also emerging research that suggests that untreated depression and depressive symptoms can lead to adverse outcomes in future pregnancies such as preterm birth and low [[Apgar score|Apgar scores.]]<ref name="Vlenterie_2021">{{cite journal | vauthors = Vlenterie R, van Gelder MM, Anderson HR, Andersson L, Broekman BF, Dubnov-Raz G, El Marroun H, Ferreira E, Fransson E, van der Heijden FM, Holzman CB, Kim JJ, Khashan AS, Kirkwood BR, Kuijpers HJ, Lahti-Pulkkinen M, Mason D, Misra D, Niemi M, Nordeng HM, Peacock JL, Pickett KE, Prady SL, Premji SS, Räikkönen K, Rubertsson C, Sahingoz M, Shaikh K, Silver RK, Slaughter-Acey J, Soremekun S, Stein DJ, Sundström-Poromaa I, Sutter-Dallay AL, Tiemeier H, Uguz F, Varela P, Vrijkotte TG, Winterfeld U, Zar HJ, Zervas IM, Prins JB, Pop-Purceleanu M, Roeleveld N | display-authors = 6 | title = Associations Between Maternal Depression, Antidepressant Use During Pregnancy, and Adverse Pregnancy Outcomes: An Individual Participant Data Meta-analysis | journal = Obstetrics and Gynecology | volume = 138 | issue = 4 | pages = 633–646 | date = October 2021 | pmid = 34623076 | doi = 10.1097/AOG.0000000000004538 | s2cid = 238476058 | url = https://pure.eur.nl/en/publications/30ffc5e2-b044-4071-8a2a-fe1919db0759 }}</ref> Consequently, there has been a rise in [[Antidepressants in pregnancy|antidepressant]] (ie. [[Selective serotonin reuptake inhibitor|SSRI]]) use during pregnancy over the last few years with a prevalence of 1-8%. This decision should be made with the guidance of a medical provider given the [[Teratology|teratogenicity]] and potential adverse effects of antidepressants on the fetus.<ref name="Inversetti_2023" /><ref name="Vlenterie_2021" />

In addition to psychotherapy, psychological care for people experiencing recurrent pregnancy loss can include counseling and other supportive services. There is some evidence to support that women that received bereavement counseling (based on the Guidelines for Medical Professionals Providing Care to the Family Experiencing Perinatal Loss, Neonatal Death, SIDS, or other Infant Death) after pregnancy loss were able to cope better, with women reporting 50% less despair than those that did not receive this intervention.<ref name="Ho_2022" />