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Recent studies have repeatedly associated posttraumatic symptoms with women's experience of pregnancy loss. Using a nationally representative sample of American women (N = 2,894) from the National Survey of Fertility Barriers, the current study examines long-term psychological outcomes and reactions to pregnancy loss and infertility among mothers and involuntarily childless women. In general, childless women who had experienced pregnancy loss or failure to conceive reported the lowest life satisfaction and highest levels of depression despite a considerable period of time (7 years) since the loss or first year without a conception. However, women with the dual experience of pregnancy loss and involuntary childlessness reported the most fertility-related distress. Results of the current study suggest that the “non-event” of involuntary childlessness may serve as an additional stressor in the traumatic …