What common psychological traumas (post-traumatic stress disorders, PTSD) are reactivated during the preconception period?

From the Guidelines

Common traumas that can be reactivated during the preconception period include past pregnancy losses, birth trauma, childhood abuse or neglect, sexual trauma, and medical trauma from past fertility treatments or gynecological procedures, as these experiences may resurface and trigger anxiety, depression, or post-traumatic stress symptoms. These traumas can have a significant impact on an individual's mental health and well-being, and can be exacerbated by the physical and emotional changes that occur during the preconception period 1. Some of the key traumas that can be reactivated during this time include:

• Past pregnancy losses, such as miscarriages, stillbirths, or abortions
• Birth trauma from previous deliveries
• Childhood abuse or neglect
• Sexual trauma
• Medical trauma from past fertility treatments or gynecological procedures
• Intergenerational trauma passed down through families
• Relationship trauma that affects one's sense of safety with a partner
• Body-related trauma that may be reactivated by the anticipated physical changes of pregnancy It is essential to address these traumas before conception through therapy, mindfulness practices, and open communication with healthcare providers, as this can help manage potential triggers during fertility treatments or prenatal care, and improve mental health outcomes during the conception journey and subsequent pregnancy 1. Creating a trauma-informed care plan with medical professionals can also help individuals cope with these traumas and reduce the risk of morbidity, mortality, and poor quality of life 1. By prioritizing the recognition and addressing of these traumas, healthcare providers can play a critical role in supporting individuals during the preconception period and promoting positive mental health outcomes.

From the FDA Drug Label

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From the Research

Common Traumas Reactivated with Preconception

• Pregnancy loss is a common trauma that can be reactivated with preconception, with approximately two-thirds of pregnant women with a history of pregnancy loss exhibiting moderate to severe psychological distress 2
• Recurrent pregnancy loss can cause significant psychological burden, including depression, anxiety, and post-traumatic stress disorder (PTSD) 3, 4
• The intensity and duration of these psychological conditions can vary, but they can be long-lasting and affect not only the woman but also her partner 4
• Other traumas that may be reactivated with preconception include:
  • Previous miscarriages or ectopic pregnancies 4
  • History of infertility or difficulty conceiving 5
  • Previous traumatic experiences, such as abuse or neglect 6

Factors that Contribute to Trauma Reactivation

• The number of previous pregnancy losses can increase the risk of moderate to severe psychological distress 2
• The type of pregnancy loss (e.g., miscarriage, ectopic pregnancy) can also affect the level of psychological distress 3
• The inter-pregnancy interval, or the time between pregnancies, can also play a role in trauma reactivation, with shorter intervals potentially leading to increased psychological distress 2
• Individual circumstances, such as maternal age and fertility status, can also influence the risk of trauma reactivation 3, 5

Importance of Addressing Trauma Reactivation

• Recognizing the potential for trauma reactivation with preconception is crucial for providing appropriate support and care to women and their partners 2, 4
• Early screening and targeted psychological interventions can help mitigate the effects of trauma reactivation and promote healthier outcomes 2
• Healthcare providers should be aware of the potential for trauma reactivation and provide sensitive and supportive care to women and their partners throughout the preconception and pregnancy process 3, 4