What does research tell us about pregnancy after loss and perinatal mental health?

Amneet Graham, Founder of Willow's Rainbow Box

After 7 years of helping families through their experiences of a new pregnancy after baby loss, I wanted to take the opportunity during Rainbow Baby Week to highlight some of the research that is out there around the impact of a new pregnancy after loss on perinatal mental health.

Around 600,000 women give birth in England and perinatal mental illness affects up to one in five new and expectant mums (NHS England, 2024). Alongside this, maternal suicide remains  one of the leading causes of maternal deaths between six weeks and one year after the end of pregnancy (MBRRACE-UK, 2025). These statistics illustrate why support for perinatal mental health is incredibly important. 

The impact of pregnancy after loss on perinatal mental health has been evident through my personal journey, through the stories we receive at Willow’s Rainbow Box and through research. Research specifically covering the relationship between perinatal mental health and pregnancy after loss remains limited. Here is what research currently tells us. 

A meta ethnography (Fernandez-Basanta et al, 2023) synthesised 11 different studies into women’s experiences of pregnancy after loss. The study found that women reported these key experiences:

• Ambivalent feelings about their pregnancy. They reported feeling hope and excitement, as well we fear, worry and vulnerability. The fears often impacted on their ability to feel ‘happy and confident’ in their pregnancy. Some also reported constant worry about experiencing another loss, or complications in pregnancy or when the baby is born - leading to problems in sleep and daily life. 

• Being careful in a new pregnancy. The study showed that women tried to emotionally distance themselves from the pregnancy to help protect themselves. Other protective measures included continuously monitoring the pregnancy through symptom tracking, ultrasounds and setting goals for themselves throughout the pregnancy. Some women changed their lifestyle and habits in an attempt to try to reduce the risk of experiencing another loss. 

• Leaning on others. Peer support, religion and a good relationship with healthcare staff were some of the reported coping mechanisms in this study. 

These experiences, alone or together, have the potential to play a huge part in perinatal mental health. Support is a necessity for families navigating a variety of emotions in one situation, particularly when they are also handling uncertainty. Another study reported more depressive symptoms in women pregnant after perinatal loss (Haney and Steinman, 2026).  

Emotional distancing is a protective mechanism for families - and can manifest in not wanting to plan too far ahead, not wanting to engage in activities such as shopping for baby products, planning activities around the baby and some may not want to tell others or even engage in discussion around the baby. These are all protective mechanisms, but care needs to be taken to support families with this before entering early parenthood. This is where perinatal mental health services could have a big impact. 

Another study explored anxiety, stress and depression in women and their partners during pregnancy after loss (Hunter et al, 2017). The meta-analysis found a connection between perinatal loss and increased anxiety and depression, but the impact of loss on stress levels in women was not significant. They actually found that the impact on anxiety and depression was larger for men than women, but the quality of studies in this meta-analysis is a limitation, as well as the data available around psychological distress effects for partners.  Further research is needed. 

As someone with lived experience who has also worked with many families through pregnancy after loss, I have seen the coping mechanisms families put in place for themselves through pregnancy after loss. Some families turn to distraction, mindfulness and finding their network. It can be hard for families to break through their worries, anxieties and their mind’s perception of a new pregnancy journey that has been shaped by their lived experience. 

There are still gaps in research about pregnancy after loss and mental health for fathers and other parents. There are also gaps in research around pregnancy after loss experiences for those with diverse cultural backgrounds and intersectionalities. More research is essential to understand the bigger picture.

In the studies above, there is not enough exploration of different types of loss. One study mentioned a focus on miscarriage and a need for more ‘targeted studies by perinatal loss type’ (Hunter et al, 2017). The meta ethnography also talks about the lack of representation for ‘voluntary interruptions of pregnancy due to fetal anomalies’ (Fernandez-Basanta et al, 2023). 

There is a lot of potential for future research. It could also be interesting to explore how pregnancy after loss specifically impacts parenting after loss and mental health in the postnatal period - and how healthcare professionals and organisations can support these families through the transition into parenthood. 

References:

Fernández-Basanta, S., Dahl-Cortizo, C., Coronado, C. and Movilla-Fernández, M.-J. (2023) ‘Pregnancy after perinatal loss: A meta-ethnography from a women’s perspective’, Midwifery, 124, p. 103762. Available at: https://doi.org/10.1016/j.midw.2023.103762 (Accessed: 28 July 2026)

Haney, C. and Steinman, K.J. (2026) ‘Depressive symptoms during pregnancy after pregnancy loss: A prospective cohort study’, Journal of Affective Disorders, 389, pp. 332–339. https://doi.org/10.1016/j.jad.2026.05.119 (Accessed: 28 July 2026). 

Hunter, A., Tussis, L. and MacBeth, A. (2017) ‘The presence of anxiety, depression and stress in women and their partners during pregnancies following perinatal loss: A meta-analysis’, Journal of Affective Disorders, 223, pp. 153–164. Available at: https://doi.org/10.1016/j.jad.2017.07.004 (Accessed: 28 July 2026). 

MBRRACE-UK (2025) Maternal mortality 2021–2023. National Perinatal Epidemiology Unit, University of Oxford. Available at: https://www.npeu.ox.ac.uk/mbrrace-uk/data-brief/maternal-mortality-2021-2023⁠ (Accessed: 28 July 2026). 

NHS England (2024) Record numbers of women accessing perinatal mental health support. NHS England. Available at: https://www.england.nhs.uk/2024/05/record-numbers-of-women-accessing-perinatal-mental-health-support/⁠ (Accessed: 28 July 2026).