Miscarriage is a heart-wrenching experience that affects several women. It is the sudden loss of a pregnancy before the twentieth week. While regarded as a somewhat common experience, the emotional toll remains profound.

Nearly 20% of women who experience a miscarriage become symptomatic for depression and/or anxiety, and in a majority of those affected, symptoms persist for 1 to 3 years, impacting quality of life and subsequent pregnancies.

Gaps in Clinical Psychological Support

Unfortunately, there is little to no clinical psychological support for women who find themselves in this situation, relying solely on family or external groups for help.

This was the case of Morenikeyi, who suffered a miscarriage in 2011.

I found out I was pregnant, but when I had my 12-week scan, there was no heartbeat. I was devastated and asked for several ultrasounds to confirm. I chose to stay home until my body naturally released the foetus, which only occurred two weeks later. I was heartbroken and plunged into depression; my saving grace was support from my family.

After I left the hospital, I was not offered any support or allocated a mental health professional to ensure that I was coping. I discovered that women who experienced miscarriages did not have adequate aftercare and must rely solely on family or another support group outside the health sector to support them. My mental wellbeing was not taken into consideration.

Rael Okoth, a Ministry of Health integrated Community Health Volunteer (CHV) and trained midwife, notes that much focus is often placed on the cause of the miscarriage, with little to no support for grieving mothers who constantly face stigma and blame, exacerbating their emotional distress. 

Loss, Stigma, and Grieving

Chioma, who had lost a six-month-old pregnancy, followed by two other miscarriages, shared that some neighbours claimed it was because she had an abortion in the past, so her womb was weak.

Expressing the emotional damage that did to her, she explains “Exiting a pregnancy empty-handed pushes you into levels of pain, anguish and bitterness that are impossible to explain. My heart was bleeding. You cannot run away from feeling responsible, and I started to believe that somebody bewitched me.”

In other quite common instances, women and their partners may lack social support systems while grieving, since most people may not have been aware of the pregnancy. There are also certain concerns following such losses (the risk of recurrent miscarriage, desire to conceive, and fears about their reproductive abilities), which can result in higher levels of anxiety, paranoia, social withdrawal, drug abuse, and even suicide.

Mental Healthcare and Public Sensitisation

It is, therefore, crucial that mental healthcare be integrated into maternal health packages as part of a holistic and comprehensive approach to improving women's health.

Health facilities should also offer accessible services such as child loss bereavement support, individual therapy for loss and grief, counselling for children and adolescents, and postpartum depression support.

These sessions should aim to dispel myths surrounding pregnancy and child loss, identify implications for future pregnancies and address gaps in newborn death care.

In addition, public health sensitisation should be carried out regularly so members of the public are well informed about the facts surrounding miscarriage and how they can offer non-judgmental support to women and families in such situations.