Many women report feeling isolated and alone after experiencing a miscarriage, and now research out of Imperial College London finds that many who suffer one fulfill the diagnostic criteria for post-traumatic stress disorder (PTSD).

Reporting in the journal BMJ Open, the researchers noted their survey of 113 women who had experienced early pregnancy loss "surprised" them: The researchers found 38% of those women met the criteria for probably PTSD three months after their loss.

Those women who suffered a miscarriage versus an ectopic pregnancy, where the fetus develops outside the womb, were more likely to report PTSD symptoms at that point: 45% to 18%, respectively.

Distressing or frightening events can trigger PTSD, which can involve flashbacks, nightmares, or intrusive thoughts and is often characterized by anger, depression, or insomnia. New York magazine notes that 40% of the women said the symptoms impacted their relationships, and 33% said it affected their work.

"At the moment there is no routine follow-up appointment for women who have suffered a miscarriage or ectopic pregnancy," notes lead author Dr. Jessica Farren. "We have checks in place for postnatal depression," and the research suggests the same should be true for those who experience a pregnancy loss.

(This country sometimes considers miscarriage to be homicide.)

This article originally appeared on Newser: Your Miscarriage May Have Been Followed by PTSD