SharecloseShare pageCopy linkAbout sharingThis video can not be playedTo play this video you need to enable JavaScript in your browser.Tens of thousands of women in the UK may be experiencing symptoms of post-traumatic stress disorder (PTSD) after miscarriages each year, a leading researcher warns.Prof Tom Bourne estimates the number affected could run to 45,000 annually. But he says most are not given prompt psychological support that could help prevent PTSD developing. His team is trying out a variety of new approaches – including virtual reality – to help address the issue. Kellie’s story: ‘I felt so alone after my baby died’Kellie Cunningham lost her baby boy five months into her pregnancy in 2017. She named him Henry. “It changed my life,” she says. “I went into hospital one person and came out a totally different person.” Kellie said she did not get any NHS follow-up or mental health support after she left hospital, and went on to develop PTSD, only picked up by a support group led by the baby loss charity, Sands.She began to pay for her own therapy. “I was just left to pack up my things in hospital that day, take the little memory box they gave me, and leave the building. I felt so alone.Image source, Kellie Cunningham”People think because your baby never lived, you cannot feel a close bond with them.”But as soon as you find out you are pregnant, you are planning your futures. For that to be taken away from you in a second has a big impact,” she said. Kellie now raises money for Sands, and is a befriender for the charity, helping other women who have lost babies. She continues to suffer with PTSD and anxiety five years after the loss of Henry. “I strongly believe if I had been given support when I left the hospital I would not have ended up with PTSD, or still be in therapy, years later.”Estimates suggest there are about 250,000 miscarriages in the UK each year, with most occurring in the first three months of pregnancy. But miscarriage rates are not officially monitored in the UK, or most countries around the world, making it very difficult to know the true scale of pregnancy loss and the psychological impact that follows.Prof Bourne, who works at Tommy’s National Centre for Miscarriage Research at Imperial College London, has studied this for many years.In one of the largest studies of its kind, published in 2019, he attempted to estimate just how common PTSD symptoms are.The surveys focused on women at three London hospitals who experienced miscarriages in the first three months of pregnancy, and some who had ectopic pregnancies – where the baby develops outside the womb and cannot survive.Of 338 women who completed the study, approximately 18% had some symptoms of post traumatic stress nine months after their loss.If these numbers were replicated around the UK, some 45,000 women would experience symptoms of PTSD each year, according to Prof Bourne’s calculations.But he says this is likely to be an under-estimate, because the research did not look at miscarriages that happened at home or those that happen later in pregnancy. Symptoms of PTSD are wide-ranging and can include:Reliving aspects of what happened, such as having flashbacks and intrusive thoughtsAlertness or feeling on edge, such as being easily upset or angry and experiencing a feeling of extreme alertness Avoiding feelings or memories, including turning to alcohol or drugs or feeling physically numb or detached from your bodyDifficult beliefs or feelings, including blaming yourself and feeling like nowhere is safeSOURCE: MindTherapies available on the NHS include talking ones such as trauma-focused cognitive behavioural therapy, eye movement desensitisation and reprocessing, and sometimes medication. But the Miscarriage Association says there is an urgent need for better access to talking and other psychological therapies for those affected. At present, most women have to ask for help themselves rather than support being in place.Prof Bourne believes there needs to be more research into other ways of helping people experiencing loss. One idea his team is experimenting with is offering women virtual reality headsets during miscarriage procedures. It builds on previous work that shows VR headsets can help reduce pain during some medical procedures. Researcher Dr Nina Parker says the aim is “to transport them to sort of a more calm, virtual reality world for distraction from the pain and anxiety during the procedure”.She adds: “There is nothing that we are ever going to be able to do that takes away from the loss and the trauma of losing pregnancy and having a miscarriage. “But if we can do everything that we can to minimise any additional trauma we might be adding to in the interactions that are had within the hospital, then we are obligated to do that.”Image source, ?????Meera had a miscarriage before Christmas and was offered use of the VR headset at Queen Charlotte’s hospital in London. She said she was glad to use it while having what’s called a manual vacuum aspiration procedure to remove pregnancy tissue from the womb – and would encourage others to try it.”I shed a tear but without feeling suffocated or overwhelmed by what was happening because I felt I was in this other space, watching this totally different scene,” she said.”But I still felt present for what was happening to me, which was important to me too.” Dr Parker is also investigating whether immersing people in brief tasks – such as playing a modified computer game or listening to a podcast – immediately after recalling a painful memory, can help prevent PTSD and other psychological problems developing. The theory is that getting someone to do a task in this way could have an impact on the way the brain processes difficult intrusive memories, and may help prevent them from developing more distressing and persistent symptoms. A Department of Health spokesperson said: “We’re committed to making the NHS the safest place in the world for maternity care and supporting anyone who experiences a miscarriage.”A maternity disparities taskforce was launched recently to ensure all mothers and babies receive the best care.The government said it had also set up 26 maternal mental health hubs for 24,000 more expectant or bereaved mothers to access treatment for a range of mental health issues in England.The BBC Action Line has details of organisations offering support.Follow Tulip on TwitterMore on this storyMiscarriage: ‘I was in pain – they did not listen’Pregnancy loss podcasters: ‘I’d cry in the car’Virtual reality game aids burns victimsRelated Internet LinksPTSD and birth trauma – Mind.websiteTogether, for every baby – Charity for Babies Tommy’s.websiteSands Stillbirth and neonatal death charity.websiteThe BBC is not responsible for the content of external sites.

SharecloseShare pageCopy linkAbout sharingImage source, Isabel Gomes Obasi Research shows black women are at a 40% higher risk of pregnancy loss than white women.It is an urgent problem, which the Royal College of Obstetricians and Gynaecologists says needs greater attention, with many complex reasons driving this higher risk. These include a lack of quality research involving all ethnicities – but RCOG head Dr Edward Morris says implicit racial bias is also affecting some women’s experience of care.Isabel Gomes Obasi and her husband, Paulson, from Coventry, are expecting a baby boy in March. They are excited but extremely anxious. Almost a year ago, their baby boy Andre died four months into Isabel’s pregnancy. She also had stillborn twins, in 2012. ‘Laughed at’Giving birth to Andre was extremely traumatic, Isabel says, but how she was treated when in severe pain and bleeding, in the days before her loss, made the experience worse.”We knew something was wrong, so we went into hospital and waited five hours to be seen by a doctor,” she says. “I remember being laughed at by one of the nurses, who said, ‘Just go home. Why do you keep coming in?'”Isabel was checked over and told the baby was fine but says her intuition and pain were belittled and ignored. “It got to the point where I started questioning myself,” she says. “‘Am I going crazy? Am I making these symptoms up?'”Within 48 hours of going home, Isabel began bleeding heavily.There is little doctors can do at this relatively early stage of pregnancy to save a baby’s life. But the feeling of not being listened to has stayed with Isabel ever since. “I just shut down,” she says. “The experience made me anxious and depressive, if not suicidal.”Asked why she was not listened to, her shaky voice becomes steely. “The colour of my skin,” she says – the attitude of some staff was: “‘You have black skin – you are not from here – you can wait.'” Higher risksAbout one in five pregnancies ends in miscarriage. About half of all losses are thought to involve severe chromosomal issues affecting a baby’s genetic code, meaning the baby would never have survived.Conditions including high blood pressure, some infections and gynaecological conditions such as endometriosis can contribute to higher risks. But other potential causes remain unclear. This video can not be playedTo play this video you need to enable JavaScript in your browser.And while all ethnicities can have difficult experiences of pregnancy and care, black women are four times more likely to die in childbirth than white women and face higher rates of stillbirth and miscarriage.Miscarriage Association trustee Natasha Necati, from Essex, who has had eight miscarriages, says there was no “blatant racism” in her care – but, like Isabel, there were times she was not listened to. “I haven’t always felt I have been taken seriously,” she says. “I have, in some cases, complained about serious amounts of pain during miscarriages and it was kind of pooh-poohed.”One of Natasha’s key concerns is little research is funded into why black women face higher risks.”Surely if it was deemed important, tens of thousands of pounds would be being spent on getting answers,” she says. “It makes you question whether it is seen as important – and if it is not important, why not?”‘Stark difference’Dr Morris says it is “unacceptable” women belonging to ethnic minorities face worse outcomes than white women – especially in maternity care. “Implicit racial bias from medical staff can hinder consultations and negatively influence treatment options,” he says.And this can stop some women engaging with healthcare. Dr Christine Ekechi, who co-leads an RCOG taskforce launched in 2020 to tackle these inequalities, says more needs to be done to include black women’s experiences in conversations and research around miscarriage and raise awareness among ethnic minorities. But she warns against reducing the reasons for the higher rates of miscarriage to ethnicity alone. “The thing that needs greater consideration is the understanding that every woman irrespective of their ethnicity, or race, is of value,” Dr Ekechi says. “I really push against the homogenisation or the grouping of all black women as one, that their thoughts and their beliefs and experiences are all the same – they are not.”And so really where the problem occurs is when we don’t see black women as equal to any other women.”We want all women to feel heard and valued and treated with kindness – but in understanding better the causes of miscarriage in all women, we may get closer in understanding why we see this stark difference for black women.”Image source, Prof QuenbyLeading researcher Prof Siobhan Quenby, who runs the Tommy’s National Centre for Miscarriage Research at University Hospital Coventry, says there is a lot to investigate – black and Asian women have higher rates of gestational diabetes, for example, and may have higher blood sugar levels in early pregnancy. Studies also show the balance of bacteria in the vagina may differ between ethnicities. “We have also not worked out yet whether, for example, black and Asian women respond differently to the hormone progesterone,” Prof Quenby says.The National Institute for Health and Care Excellence has guidance for the NHS on recurrent miscarriages The BBC Action Line has details of organisations offering supportOrganisations such as Five X More put together campaigns and work with black women to provide support Prof Quenby’s team are working on an app where people add details such as ethnicity, weight and whether they have had previous miscarriages and then receive evidence-based advice on how to lower risks – such as taking certain medications or maintaining a healthy weight.Some feel the issue so complex, with so many factors, it is unsolvable, she says, but there are solutions – and many women will one day be given the right treatment and care for what is currently unknown.Follow @Tulip Mazumdar on Twitter.RCOG – Royal College of Obstetricians and GynaecologistsThe BBC is not responsible for the content of external sites.