“The closest I came to making life was the closest I came to death.” Florence Welch’s haunting words about her ectopic pregnancy in an interview with The Guardian cut through any illusion that pregnancy loss is a quiet, contained grief. It is raw. It is dangerous. And it is deeply misunderstood.
As a trauma psychologist, I want to confront an uncomfortable truth: pregnancy loss is not just a medical event. It is a rupture that travels across physical, psychological, and existential domains. And when that loss is life-threatening, as in an ectopic pregnancy, the psychological impact is compounded by the chilling proximity of death.
“The closest I came to making life was the closest I came to death.”
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most often in a fallopian tube. Roughly 1 in 90 pregnancies are ectopic (NHS, 2023). While rare, the consequences can be catastrophic if untreated: rupture, internal bleeding, emergency surgery, and sometimes death.
But what happens psychologically when the body’s first attempt at nurturing life instead threatens the woman’s own survival?
For Welch, the experience was surreal. She describes how she performed on stage, unaware that her fallopian tube had already ruptured, her body filling with blood. Hours later, doctors told her she needed emergency surgery to live. “I tried to run away,” she recalls, describing the primal panic as her body fought to comprehend imminent mortality.
This overlap of birth and death, the possibility of creation collapsing into the threat of annihilation, is uniquely destabilizing. Research shows that women who experience ectopic pregnancies can struggle with post-traumatic stress symptoms, grief, and identity disruption (Farren et al., 2016). Not all pregnancy losses are equal in their psychological aftermath. Miscarriage, while devastating, is rarely life-threatening. Women often grieve in silence, feeling their grief minimized by a culture that treats early pregnancy loss as an invisible sorrow. But an ectopic pregnancy? It merges grief with the visceral memory of a medical emergency.
But what happens psychologically when the body’s first attempt at nurturing life instead threatens the woman’s own survival?
Welch’s openness offers a rare window into the complexity of this grief. Days after her miscarriage, she returned to the stage. Her resilience looked superhuman, but in her words, “Emotionally, I’m an absolute nightmare. Literally, will crumble. But broken bone? Fine. Internal bleeding? Let’s go.”
Her paradox, pushing through with stoic performance while breaking internally, is one many women recognize. Women often describe themselves as “coping” in public but collapsing in private. Social expectations that minimize pregnancy loss reinforce the silence. Women fear being told “at least it was early,” or “you can try again,” invalidating their pain.
Welch’s story also underscores another layer: the cultural invisibility of ectopic pregnancy. When she first shared that she underwent life-saving surgery, she did not disclose the ectopic nature of her pregnancy. She later admitted that she didn’t feel strong enough to go into the reasons for it. This is not uncommon. Many women hesitate to tell the truth, fearing misunderstanding, judgment, or retraumatization.
Women often describe themselves as “coping” in public but collapsing in private.
Psychological trauma is not just about the event; it’s about its impact. For women after ectopic pregnancy, the traumatic imapct can manifest as:
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Intrusive memories: reliving the emergency, the hospital scene, the moment of being told “we need to operate now.”
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Hypervigilance: obsessively monitoring the body, fearing it will betray them again.
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Identity rupture: the body as both life-giving and life-threatening, leading to feelings of shame and disconnection from self.
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Complicated grief: mourning not only the loss of the child but the loss of safety, trust in one’s body, and sometimes reproductive capacity.
Here lies the tragedy: the medical system often saves women’s bodies but abandons the psyche. Emergency surgery ends the crisis but not the trauma. A 2021 study showed that women with a history of ectopic pregnancy or miscarriage were significantly more likely to experience anxiety and depression in subsequent pregnancies (Quenby et al., 2021). And yet, psychological aftercare is rarely standard protocol.
How can we call an intervention complete if we only stitch the body, leaving the psyche to bleed out unseen?
Here lies the tragedy: the medical system often saves women’s bodies but abandons the psyche.
Welch describes how she turned instinctively to cats, foxes, and the silent life of her garden for comfort. “It was a real need to be around things that couldn’t speak, but had a life force or energy to them. I found that the most healing.”
This is not surprising. Trauma often leaves words inaccessible. Survivors describe a sense of unspeakability. Healing, then, may require what psychologist Bessel van der Kolk calls bottom-up regulation, or connecting with body, senses, and the nonverbal world (van der Kolk, 2015).
Welch’s garden became a sanctuary because it allowed her to grieve in a space where words were unnecessary. This aligns with trauma research showing that embodied practices like nature immersion, art, movement can help integrate experiences that language alone cannot.
One of the most haunting things Welch describes is the sense of stepping through a door into a room “full of women, screaming.” She is right: she stepped into a lineage of unspoken grief. And yet most of those women never tell their stories.
Why?
Because pregnancy loss is still taboo. Because ectopic pregnancy, despite its life-threatening reality, is treated as a medical oddity rather than a profound existential rupture. Because women are expected to recover, remain silent, and carry on.
But what would it mean if we broke this silence?
One of the most haunting things Welch describes is the sense of stepping through a door into a room “full of women, screaming.”
If we are to address the psychological impact of ectopic pregnancy and miscarriage honestly, we must demand more than emergency surgery. Survivors need:
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Immediate psychological support in hospitals following diagnosis and surgery.
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Long-term trauma-informed care, recognizing PTSD, complicated grief, and anxiety as real consequences.
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Community narratives that validate loss, break shame, and end silence.
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Nonverbal healing spaces (gardens, animals, art, rituals) that allow integration beyond language.
The medical world must recognize that saving the body without tending to the mind is incomplete care. The question we must ask is this: When the closest brush with life is also the closest brush with death, how do we help survivors live fully again?
References
Quenby, S., Gallos, I. D., Dhillon-Smith, R. K., Podesek, M., Stephenson, M. D., Fisher, J., Brosens, J. J., Brewin, J., Ramhorst, R., Lucas, E. S., McCoy, R. C., Anderson, R., Daher, S., Regan, L., Al-Memar, M., Bourne, T., MacIntyre, D. A., Rai, R., Christiansen, O. B., Sugiura-Ogasawara, M., Odendaal, J., Devall, A. J., Bennett, P. R., Petrou, S., & Coomarasamy, A. (2021). Miscarriage matters: The epidemiological, physical, psychological, and economic costs of early pregnancy loss. The Lancet, 397(10285), 1658–1667. https://doi.org/10.1016/S0140-6736(21)00682-6
van der Kolk, B. A. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.
