OBJECTIVE: This study investigated the hypothesis that following a pregnancy loss, women have more mental health complaints than women who give birth to a living baby. METHOD: Mental health was assessed for 2,140 women during their first trimester of pregnancy through use of the Dutch version of the SCL-90. A total of 227 women who had lost their babies and 213 women who gave birth to a living baby were followed over a period of 18 months, during which their mental health was reassessed four times. RESULTS: When mental health complaints at the beginning of pregnancy and reproductive loss history were taken into account, data analysis revealed that up to 6 months after their pregnancy loss, women showed greater depression, anxiety, and somatization than women who gave birth to living babies. Over time the mental health of women who had experienced a loss was found to improve and at 1 year was comparable to that of women who gave birth to living babies and to that of women in general. CONCLUSIONS: The majority of women are able to recover from pregnancy loss without psychiatric treatment in about 1 year. A pregnancy loss is nevertheless a stressful life event that can give rise to a marked deterioration in a woman's mental health, particularly in the first 6 months following loss.