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

From the Guidelines

Common traumas that get reactivated during the preconception period include past pregnancy losses, birth trauma, childhood abuse or neglect, medical trauma, and intergenerational trauma, which can significantly impact an individual's mental health and well-being. When individuals begin planning for pregnancy, these experiences can resurface as the prospect of becoming a parent triggers memories and emotional patterns. Past pregnancy losses such as miscarriages or stillbirths often create significant anxiety about future pregnancies 1. Previous difficult birth experiences may generate fear about labor and delivery. Childhood experiences of abuse, neglect, or attachment disruptions can raise concerns about one's ability to parent effectively. Medical traumas, particularly those related to reproductive health like fertility treatments or gynecological procedures, may intensify during preconception planning. Additionally, intergenerational trauma passed down through families can emerge as individuals contemplate continuing family lineage.

These reactivated traumas typically manifest as anxiety, depression, intrusive thoughts, hypervigilance, or avoidance behaviors. Addressing these traumas before conception through therapy, particularly modalities like EMDR, cognitive-behavioral therapy, or trauma-focused approaches, can help process these experiences and reduce their impact on the preconception period and future parenting 1. Some key points to consider include:

• The importance of preconception care in identifying and addressing potential traumas and mental health concerns 1
• The need for targeted interventions to mitigate the development of PTSD and related symptoms among women experiencing recent trauma 1
• The potential benefits of early intervention and therapy in reducing the impact of reactivated traumas on mental health and well-being during the preconception period and beyond 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Common Traumas Associated with Preconception

• Recurrent pregnancy loss, which affects approximately 2.5% of women trying to conceive, can cause significant psychological burden and trauma 2, 3
• Infertility can lead to feelings of guilt, helplessness, and depression, affecting the overall quality of life of individuals trying to conceive 4
• The stress and emotional tension associated with infertility and recurrent pregnancy loss can have a profound impact on mental health 4, 3
• Factors contributing to recurrent spontaneous abortion, such as anatomical and chromosomal abnormalities, genetic factors, and environmental exposures, can also contribute to psychological trauma 3

Trauma Reactivation

• The experience of recurrent pregnancy loss and infertility can reactivate existing traumas and emotional vulnerabilities 2, 4
• The emotional burden of these experiences can be exacerbated by the lack of standardized definitions, uncertain pathogenesis, and variable clinical presentation of recurrent pregnancy loss 2
• The use of complementary therapies, such as acupuncture, may be beneficial in reducing stress and anxiety associated with infertility and recurrent pregnancy loss, although more research is needed to fully understand its effects 5, 6