Miscarriage as a psychological trauma: a comprehensive review of psychiatric sequelae and clinical implications

Abstract Background Miscarriage, affecting 15–25% of clinically recognized pregnancies, carries substantial but underrecognized psychiatric consequences for both women and their partners. While medical care often prioritizes physical management, growing evidence highlights persistent psychological morbidity following pregnancy loss. Main body This review synthesizes high-quality literature from 2014 to 2024 on the prevalence, clinical presentation, temporal course, and risk factors of psychiatric sequelae after miscarriage, as well as current practices in screening and intervention. Within six weeks post-loss, pooled estimates indicate that 32.5% of women experience anxiety, 30.1% develop depression, and 33.6% report significant stress, with post-traumatic stress disorder affecting 29% at one month and 18% at nine months. Complicated grief occurs in 25–30% of parents, and 15–20% develop chronic or delayed psychopathology. Male partners also experience considerable distress, with anxiety affecting up to 66.3% and depression 19% following recurrent loss. Risk factors include previous losses, pre-existing mental health conditions, lack of social support, poor partner relationships, childlessness, lower socioeconomic status, and dissatisfaction with healthcare. Protective factors comprise strong social support, high-quality marital relationships, the presence of living children, and satisfaction with medical care. Despite validated screening tools and evidence-based psychosocial interventions, routine mental health assessment after miscarriage is rare. Conclusions Miscarriage thus represents a major public health concern with lasting psychiatric impact. Bridging the gap between psychological need and clinical practice requires universal screening, referral pathways to evidence-based support, integration of biopsychosocial care models, clinician education, and societal acknowledgment of miscarriage as a legitimate source of grief.