Couples' Risk of Break-Up Higher After Pregnancy Loss

From Reuters Health Information


NEW YORK (Reuters Health) Apr 08 - Studies have shown that married couples' risk of divorce can go up after the death of a child, and now new findings suggest that relationships may also become more fragile after a miscarriage or stillbirth.

In a study of more than 3,700 U.S. married or cohabiting couples who'd had at least one pregnancy, researchers found that those who'd suffered a miscarriage or stillbirth were more likely to break up in subsequent years than couples who had a baby.

Specifically, couples who had a miscarriage were 22% more likely than those who had a live birth to separate during the 15-year study period. With stillbirth, the risk was 40% greater.

And while the increased risk associated with miscarriage was seen within three years of the loss, the risk linked to stillbirth persisted for nearly a decade.

The researchers say their study, published online April 5th in Pediatrics, is the first national study to show that couples who suffer a pregnancy loss are at increased risk of a breakup.

The findings are, however, in line with those from past studies of married couples who've lost a child. Those studies have generally found that while bereavement brings some couples closer together, the general risk of divorce appears to climb after losing a child.

Given that research, the current findings are not unexpected, according to lead researcher Dr. Katherine Gold, of the University of Michigan in Ann Arbor.

However, she told Reuters Health by email, she was "honestly surprised" at the strength of the associations between pregnancy loss and relationship breakups -- as well as how lasting the effects, particularly of stillbirth, appeared to be.

"For miscarriage, we saw the strongest risk in the first 1.5 to 3 years after a loss, but for stillbirth the risk lasted nearly a decade after a loss," Dr. Gold said. "That's a much longer period than I think any of us who work in this area would have guessed."

However, Dr. Gold also stressed that "couples should not look at this study and think that on top of a loss their relationship is doomed." Many couples, she said, cope well and can actually become closer after a pregnancy loss.

Still, the current findings point to a need to understand why these couples are at increased risk of breaking up, she said.

The study included 3,707 married or cohabiting women who had a total of 7,770 pregnancies, including 16% that ended in miscarriage and 2% in a stillbirth.

Among couples who had a live birth, more than 40% broke up within 10 years. But among couples who had a stillbirth, that figure was nearly 60%; meanwhile, close to half of couples who had a miscarriage broke up within a decade.

The findings do not prove that pregnancy loss is the reason for the higher rates of breakups, the authors point out. However, even when the researchers accounted for several other factors related to relationship dissolution -- like younger age, lower incomes and cohabitation rather than marriage -- miscarriage and stillbirth themselves were still associated with higher risks of breakups.

It's also plausible that pregnancy loss would lead to separation for some couples, according to Dr. Gold.

"Loss of a baby can be a devastating effect for a couple," she said, "and this study suggests there can be a ripple effect which probably comes from the stress of how two different people cope with the same event."

She noted that men and women tend to react to grief differently, and that may lead to stress, misunderstandings and conflicts for some couples.

She said it is important for partners to anticipate that they may react differently to their loss, and then talk to each other about how they are coping. They should also know that help is available, the researcher added.

"If a couple is struggling," Dr. Gold said, "it's very important that they know it's OK to get help from a counselor, a therapist, their doctor, or someone from their church."

Pediatrics 2010.