How to Cope with Anxiety in Pregnancy After Miscarriage: CBT Therapy & Support

PREGNANCY AFTER LOSS
Written By Aleksandra Balazy-Knas

You're pregnant again after miscarriage. And instead of joy, you feel terror.

Every morning, you check for bleeding. Every bathroom visit, your heart stops. Every twinge makes you think: Is this it? Am I losing another baby?

You might tell yourself you're being "ridiculous" or "too anxious." Your partner says, "Try to stay positive." Friends remind you, "Most pregnancies after miscarriage are healthy."

But here's what they don't understand: your body remembers loss. And until it feels safe again, the fear won't just go away with positive thinking.

If that's you right now—lying awake googling symptoms at 3am, avoiding antenatal appointments because they trigger panic, unable to let yourself feel excited about this pregnancy—I need you to know something:

This anxiety isn't weakness. It isn't "just worrying." It's a completely understandable response to experiencing something devastating and then facing the same situation again.

You're not being irrational. You're being protective. Your nervous system learned that pregnancy can end in loss—and now it's trying desperately to keep you safe from that happening again.

As a perinatal CBT therapist and mental health nurse with over 10 years of experience supporting women through pregnancy after loss, I understand how exhausting it is to carry both hope and fear. I also know that you can feel calmer—not by forcing positivity or pretending your loss didn't happen, but by giving your mind and body real tools to feel genuinely safer.

This guide will show you how.

Understanding Anxiety in Pregnancy After Miscarriage (You're Not Alone)

When you're expecting a baby after experiencing loss, it's like carrying two things at once—your growing baby and an invisible backpack full of fear, grief, and hypervigilance.

The research tells us something important: you're far from alone in these feelings.

The statistics are striking:

Research shows that women pregnant after miscarriage are twice as likely to experience anxiety compared to those without a history of loss (Geller et al., 2004). More recent studies paint an even clearer picture: women with a history of miscarriage show significantly higher levels of pregnancy-specific anxiety during the first trimester compared to women without prior loss (Bergner et al., 2008).

A 2025 systematic review found that within six weeks following miscarriage, a significant proportion of women experience anxiety, depression, and stress—and these symptoms often persist into subsequent pregnancies. The study highlighted that up to 23 million miscarriages occur worldwide each year, affecting approximately 15% of all recognized pregnancies (Quenby et al., 2021).

Perhaps most telling: recent research from 2024 revealed that women with a history of pregnancy loss face an elevated long-term risk of developing anxiety and stress-related disorders, even years after the loss (Shen et al., 2024).

These aren't just statistics—they're a reflection of how deeply loss can impact our mental health and emotional wellbeing. Your anxiety isn't a personal failing. It's a common, valid response to trauma.

Why Does Everything Feel So Different This Time?

That innocent excitement you felt with your first pregnancy? It's completely normal if it feels impossible to access now.

Instead of daydreaming about your baby, you're catastrophizing.

Your mind might cycle through thoughts like:

  • "What if I lose this baby too?"

  • "Why don't I feel as sick today? Does that mean something's wrong?"

  • "Should I let myself get attached?"

  • "What if it happens again at the same gestation?"

This isn't pessimism. This is your brain trying to protect your heart from another devastating loss.

Here's what's happening in your nervous system:

When you experienced miscarriage, your brain created a protective association: pregnancy = potential loss. Now, every pregnancy symptom (or lack of symptom) gets scanned for danger.

  • Nausea easing? Your mind panics: "The baby stopped growing."

  • Cramping? Immediate fear: "I'm miscarrying again."

  • Feeling fine? Anxiety spikes: "Something must be wrong if I don't feel pregnant."

This constant scanning isn't irrational—it's your nervous system doing exactly what it learned to do: stay vigilant to protect you. But it also means you can't just "relax and enjoy" this pregnancy, no matter how much people tell you to.

Those Daily Moments That Can Feel Overwhelming

Let's talk about those everyday triggers that make your heart race and your mind spiral:

Morning check-ins

Every morning can feel like holding your breath until you're sure everything's okay. Before you even fully wake up, you're checking—for blood, for symptoms, for signs this pregnancy is still viable. It's exhausting to start every day from a place of fear rather than hope.

Bathroom visits

That quick glance. That moment of anxiety before you look. These are normal responses when you're carrying such precious cargo and your body remembers what loss looks like. Your nervous system is trying to give you early warning—but it's also keeping you in a constant state of alert.

Before appointments and scans

The wait before seeing your baby on the screen can feel endless. You might find yourself making deals with the universe, preparing for bad news, or feeling physically sick with anxiety. The hours or days before scans can be some of the hardest—your mental health might feel particularly fragile during these times, and that's completely understandable.

Reaching "milestone" dates

If you lost your previous pregnancy at a specific week, that approaching date can feel like a deadline. You might find yourself thinking, "If I can just get past 8 weeks..." or "Once I reach 12 weeks, then I'll feel safe." But often, crossing one milestone just creates a new one to worry about.

Other people's pregnancy announcements

Seeing someone else's joy can trigger complicated emotions—happiness for them mixed with fear for yourself, or painful reminders of what you've lost. These feelings don't make you a bad person. They make you human.

Where Are You Right Now? Find Your Path Forward

Different stages of pregnancy after loss need different kinds of support. Find yourself below:

📍 "I just had a miscarriage and I'm terrified to try again"

You're not pregnant yet, but the thought of going through pregnancy again fills you with dread. You might be avoiding trying to conceive, even though you want another baby.

What helps: Processing the grief and trauma of your loss BEFORE getting pregnant again can help you feel more emotionally prepared. We can work on building resilience and coping tools so you feel more resourced when you do conceive.

💬 Next step: Book a free consultation to talk about preparing emotionally for pregnancy after loss.

📍 "I'm newly pregnant after miscarriage and I'm panicking"

You're in the first trimester and every day feels like survival. You might be checking symptoms constantly, avoiding getting attached, or feeling like you can't breathe until you reach a "safe" milestone.

What helps: Immediate support to manage acute anxiety, specific CBT techniques for intrusive thoughts, and tools to help you stay present rather than catastrophizing about the future.

💬 Next step: Book a free consultation so we can start supporting you this week. You don't have to white-knuckle your way through this alone.

📍 "I'm further along but the anxiety isn't easing"

You thought you'd feel better after the first trimester, or after anatomy scan, but the fear is still overwhelming. You might feel guilty for not enjoying your pregnancy or worried that your anxiety is harming your baby.

What helps: Understanding why anxiety persists (even when milestones are reached), processing unresolved grief from your loss, and learning how to coexist with uncertainty rather than trying to eliminate it.

💬 Next step: Book a free consultation to explore why anxiety is lingering and how therapy can help.

📍 "I've had multiple miscarriages"

You've experienced recurrent pregnancy loss and now you're pregnant again (or considering it). The cumulative trauma feels unbearable, and you might feel like you can't survive another loss.

What helps: Trauma-focused therapy to process multiple losses, building a sense of agency when so much feels out of your control, and creating realistic coping strategies for high-risk pregnancies.

👉 You might also find this helpful: Why Miscarriage Grief & Trauma Matter—Even If No One Talks About It

💬 Next step: Book a free consultation to talk about supporting you through recurrent loss and this pregnancy.

How CBT Helps With Pregnancy Anxiety After Miscarriage

CBT isn't about "thinking positive" or pretending your fears don't exist. It's about helping your brain and body process loss while making space for hope about this pregnancy.

Here's what it actually looks like in practice:

1. Identifying and Challenging Catastrophic Thought Patterns

Your anxious brain creates worst-case scenarios automatically. In CBT, we learn to notice these thoughts and gently challenge them—not by dismissing your fears, but by adding balance.

Anxious thought: "Every twinge means I'm miscarrying."

CBT reframe: "Twinges and cramps are normal in pregnancy. They don't always mean loss. Right now, in this moment, I don't have evidence that something's wrong. I can notice this sensation without spiraling into panic."

Anxious thought: "If I let myself get attached and lose this baby, I won't survive it."

CBT reframe: "My fear of attachment is understandable, but avoiding connection won't prevent loss. It will only prevent me from experiencing this pregnancy. I survived my last loss—I'm stronger than I think."

Anxious thought: "Something feels different today. That means the baby stopped growing."

CBT reframe: "Pregnancy symptoms fluctuate daily. Feeling different doesn't equal loss. I can tolerate this uncertainty until my next appointment."

2. Challenging All-or-Nothing Thinking

After loss, your mind might operate in extremes: "I'm either completely safe or definitely losing this baby." There's no middle ground.

All-or-nothing thought: "I can't relax until I reach 12 weeks/20 weeks/viability."

Compassionate truth: "Safety isn't binary. I can hold both caution and hope. I can protect my heart AND connect with my baby. These things can coexist."

All-or-nothing thought: "If I don't constantly monitor symptoms, I'll miss the signs of miscarriage."

Compassionate truth: "Hypervigilance doesn't prevent loss. It just exhausts me. I can trust my body to signal if something's truly wrong, without checking every hour."

3. Behavioral Experiments: Gradually Reducing Safety Behaviors

Safety behaviors are things you do to try to prevent anxiety or loss—like checking symptoms constantly, avoiding certain activities, or refusing to buy anything for the baby.

While these behaviors feel protective, they actually reinforce anxiety. In CBT, we gradually test whether these behaviors are truly keeping you safe, or just keeping you trapped.

Example experiment:

Instead of checking for bleeding every time you use the bathroom, we might gradually extend the time between checks—proving to your nervous system that you can tolerate brief periods of uncertainty without something bad happening.

Example experiment:

Instead of avoiding all talk about the baby or refusing to use the word "baby," we might practice saying it out loud: "My baby is growing." This helps your brain learn that connection doesn't cause loss.

4. Grounding Techniques for When Panic Strikes

When you're spiraling at 3am convinced something's wrong, you need tools that work in the moment:

The 5-4-3-2-1 Technique:

  • Name 5 things you can see

  • 4 things you can touch

  • 3 things you can hear

  • 2 things you can smell

  • 1 thing you can taste

This interrupts the panic spiral and brings you back to the present moment, where—right now—you and your baby are okay.

Body Grounding:

  • Feel your feet firmly on the floor

  • Place one hand on your chest, one on your belly

  • Breathe slowly, following the rise and fall

  • Say to yourself: "Right now, in this moment, my baby and I are safe."

The "Evidence Detective" Exercise:

When anxiety tells you something's wrong, become a detective:

  • What's my evidence that something's wrong? (e.g., "I feel less nauseous today")

  • What's my evidence that things might be okay? (e.g., "Nausea fluctuates normally," "I felt the same yesterday and baby was fine," "I have no bleeding")

  • What would I tell a friend in this situation?

5. Building Self-Compassion Into the Cognitive Work

One of the most powerful elements of CBT for pregnancy after loss is learning to speak to yourself with the same kindness you'd offer a friend.

Instead of: "I'm being ridiculous. I should be over this by now."

Try: "I'm scared because I've been hurt before. That's completely understandable. I'm doing the best I can."

Instead of: "I'm a bad mother for not enjoying this pregnancy."

Try: "I'm not a bad mother—I'm a grieving mother who's also trying to hope again. Both of those things are hard. I'm allowed to feel complicated emotions."

Instead of: "My anxiety is going to harm my baby."

Try: "My anxiety is my body trying to protect both of us. I can work on calming my nervous system while trusting that my baby is resilient."

This self-compassion work isn't "fluffy"—it's essential. The harsh voice in your head is often what makes anxiety unbearable.

⭐ "The process was as smooth as can be, and from our first chat, where I unloaded all my burdens, my fears, where Aleksandra understood all that I had gone through, I felt a ray of hope that perhaps I could one day enjoy the pregnancy that was passing too quickly for me."
— Anonymous client, Pregnancy After Loss Therapy

The Research Behind CBT's Effectiveness for Pregnancy Anxiety After Loss

Let's look at what the science tells us about how CBT and structured psychological support can help manage anxiety during pregnancy after loss.

Research from Farren et al. (2020) shows that targeted psychological interventions like CBT can significantly reduce pregnancy anxiety symptoms in women who've experienced early pregnancy loss. The study found that post-traumatic stress, anxiety, and depression are common following miscarriage—but they also respond well to evidence-based treatment.

A 2025 systematic review analyzing data from over 35,000 participants found that early identification and treatment of mental health symptoms after miscarriage are crucial for improving outcomes in subsequent pregnancies. The research emphasized that women who receive psychological support during pregnancy after loss show better mental health outcomes compared to those who don't access help.

Studies specifically examining pregnancy after loss have found that women with a history of miscarriage experience significantly higher levels of pregnancy-specific anxiety, particularly in the first trimester (Bergner et al., 2008). However—and this is important—research also shows that structured CBT interventions can help reduce these anxiety levels and improve quality of life during subsequent pregnancies.

What this means for you: Your anxiety has a scientific basis (your nervous system responding to past trauma), AND it's treatable. You're not stuck feeling this way for your entire pregnancy.

Building Your Support Network (You Can't Do This Alone)

Professional therapy is important, but it's just one piece of your support system. You also need:

Understanding from your partner or support person

Your partner might not fully understand why you can't "just relax," especially if they didn't experience the physical loss themselves. Help them understand: "I need you to listen without trying to fix it. I need you to say 'I'm scared too' rather than 'everything will be fine.' I need you to come to appointments with me when I ask."

👉 If your partner is struggling to support you: Share this post with them: 7 Things I Tell My Clients Who Are Pregnant Again After Miscarriage—That They Can't Find on Google

Connection with others who've walked this path

Other mothers who've experienced pregnancy after loss "get it" in a way that others simply can't. You don't have to explain why you're not excited yet, or why you can't buy maternity clothes. They understand.

Your healthcare providers as allies

Tell your midwife or doctor about your history and your anxiety. A compassionate provider will:

  • Offer earlier or more frequent scans if appropriate

  • Validate your fears without dismissing them

  • Help you develop a plan for when anxiety peaks

Self-care that honors both your needs

This might look like:

  • Allowing yourself to rest without guilt

  • Limiting time on pregnancy loss forums (they can increase anxiety)

  • Choosing which pregnancy milestones to celebrate (it's okay to wait)

  • Giving yourself permission to feel however you feel

👉 For more support: Pregnancy After Miscarriage Anxiety: Affirmations That Truly Support Healing

Practical Steps You Can Take Today

These aren't "fixes"—they're ways to make the day-to-day slightly more manageable:

Notice & Name Your Anxiety Without Judgment

Instead of: "I shouldn't feel this way."

Try: "I notice I'm feeling anxious right now. That makes sense given my history. What do I need in this moment?"

Create "Worry Time" Boundaries

Instead of letting anxiety consume your entire day, designate a specific 15-minute "worry window." When anxious thoughts arise outside this time, acknowledge them: "I see you, anxiety. I'll give you attention during worry time." This helps your brain learn that not every anxious thought needs immediate action.

Build a Safety Plan for Triggering Moments

Before your next appointment or scan, create a plan:

  • Who will I bring with me?

  • What grounding technique will I use in the waiting room?

  • What will I do if I start panicking?

  • Who can I call afterward?

Practice Staying in the Present

When your mind jumps to worst-case scenarios, gently bring yourself back:

  • "Right now, in this moment, what's actually happening?"

  • "Right now, my baby and I are okay."

  • "I don't have to manage all nine months today. I just have to manage today."

Celebrate Micro-Wins

Notice small victories:

  • "I made it to my appointment without spiraling."

  • "I let myself feel a moment of excitement about the baby."

  • "I challenged an anxious thought instead of believing it automatically."

These tiny shifts matter. Healing isn't linear—it's made of small, repeated moments of choosing differently.

When Pregnancy Anxiety After Miscarriage Needs Professional Support

Consider reaching out for therapy if:

  • Your anxiety is interfering with daily life

    You're unable to work, care for other children, or function normally because the fear is so consuming.

  • You're avoiding prenatal care

    If anxiety about appointments is causing you to skip essential medical care, that's a sign you need support.

  • You're experiencing panic attacks

    Frequent panic attacks, especially ones that feel uncontrollable, respond well to CBT but need professional guidance.

  • You're having intrusive thoughts about loss

    If you can't stop imagining losing this baby, or if you're having disturbing images or thoughts, trauma-focused therapy can help.

  • You're struggling to bond with this pregnancy

    If you feel completely disconnected or numb, or if you find yourself referring to "it" rather than "my baby" because attachment feels too dangerous, therapy can help you navigate this protective response.

  • Your grief from your loss is unprocessed

    Sometimes pregnancy after loss triggers grief you haven't fully worked through. You might need space to grieve your lost baby while also making room for hope about this one.

  • The anxiety is affecting your physical health

    If you're unable to eat, sleep, or care for yourself because of anxiety, or if your anxiety is causing physical symptoms like chest pain or shortness of breath, seek help immediately.

  • You're having thoughts of self-harm

    If you're thinking "I can't survive another loss" in a way that feels dangerous, please reach out to your GP, call Samaritans (116 123), or go to A&E. You deserve support.

What Therapy for Pregnancy Anxiety After Loss Looks Like (Working With Me)

Many women hesitate to start therapy because they're not sure what to expect. Here's what our work together might look like:

In our first session:

We'll talk about your loss—what happened, how you made sense of it, and how it's affecting this pregnancy. I'll ask about your current anxiety: when it's worst, what triggers it, and what (if anything) helps. Together, we'll identify your goals: what would feeling "better" look like for you?

In early sessions:

We'll focus on building your toolkit—grounding techniques you can use immediately when panic strikes. We'll start exploring the thought patterns that keep anxiety alive. And we'll work on self-compassion: learning to speak to yourself more gently.

As therapy progresses:

We'll process your grief from your loss (if you haven't yet), challenge the beliefs that fuel your anxiety, and gradually help your nervous system learn that this pregnancy can have a different outcome. We'll prepare you for upcoming milestones and work through any triggers as they arise.

Week by week, you'll notice:

  • Scans feel less terrifying

  • You can think about the baby without immediately catastrophizing

  • You have tools that actually work when panic hits

  • You're able to hold both caution and hope

  • You start to believe that maybe—just maybe—this pregnancy might be okay

This isn't about erasing your fear or pretending your loss didn't happen. It's about making space for this baby while honoring the one you lost.

FAQ: Anxiety in Pregnancy After Miscarriage

Is anxiety in pregnancy after miscarriage normal?

Yes, completely normal. Research shows that women pregnant after miscarriage experience significantly higher levels of anxiety compared to women without prior loss. Your anxiety isn't a personal failing—it's a natural response to trauma. Your nervous system learned that pregnancy can end in loss, and it's trying to protect you.

How long does pregnancy anxiety after loss last?

It varies. Some women find anxiety peaks in the first trimester and eases as pregnancy progresses. Others experience anxiety throughout pregnancy, especially around milestone dates or scans. Studies show that structured support like CBT can significantly reduce anxiety levels during pregnancy after loss. You don't have to white-knuckle your way through nine months—therapy can help you feel calmer sooner.

Can pregnancy anxiety harm my baby?

This is one of the most common fears, and it adds a layer of guilt to already-existing anxiety. Here's the truth: normal pregnancy anxiety, even when it's intense, is unlikely to harm your baby. Your baby is remarkably resilient. That said, if anxiety is preventing you from eating, sleeping, or caring for yourself, or if you're experiencing severe panic attacks, it's worth seeking support—not because you're harming your baby, but because you deserve to feel better.

What's the difference between grief and anxiety after miscarriage?

Grief is the emotional response to loss—sadness, longing, anger about the baby you lost. Anxiety is fear about the future—worry about losing this baby, hypervigilance about symptoms, catastrophic thinking. Often, they coexist. You can grieve your lost baby AND feel anxious about this pregnancy at the same time. Both are valid, and both deserve support.

Should I tell my midwife about my miscarriage history and anxiety?

Yes. Your midwife needs to know your history so they can provide appropriate support. This might include earlier scans, more frequent appointments, or referral to perinatal mental health services. A compassionate midwife will validate your anxiety and work with you to create a care plan that helps you feel safer. If your midwife dismisses your concerns, it's okay to advocate for yourself or request a different provider.

Can CBT help with pregnancy anxiety after loss?

Yes. Research shows that CBT is effective for reducing pregnancy-specific anxiety, especially in women with a history of loss. CBT helps you identify and challenge catastrophic thought patterns, reduce safety behaviors that reinforce anxiety, and develop coping tools for when panic strikes. It's not about forcing positive thinking—it's about giving your nervous system evidence that you can handle uncertainty.

How do I bond with my baby when I'm scared of losing them?

This is one of the hardest parts of pregnancy after loss. You might feel like you need to protect your heart by not getting attached. But here's the truth: avoiding attachment won't prevent grief if you experience another loss—it will just prevent you from experiencing this pregnancy. Start small: place your hand on your belly and say hello. Let yourself acknowledge "my baby" instead of "it." Allow tiny moments of hope without demanding that you feel 100% confident. Bonding after loss is a gradual process, and it's okay if it feels complicated.

Will I feel this anxious in future pregnancies?

Not necessarily. Many women find that successfully carrying a pregnancy to term after loss helps their nervous system learn a new pattern: pregnancy CAN end in a healthy baby. However, some women continue to experience anxiety in subsequent pregnancies, especially in early weeks or around the gestation they previously lost. Therapy can help you process this pregnancy in a way that reduces future anxiety, but every pregnancy and every person is different.

What helps with scan anxiety after miscarriage?

Scans can be one of the most triggering parts of pregnancy after loss. What helps: bring a support person who understands your fear, use grounding techniques in the waiting room (like the 5-4-3-2-1 method), tell the sonographer you're anxious and need them to tell you immediately if they see the heartbeat, and plan something gentle for after the scan (whether the news is good or hard). Some women find it helpful to have more frequent scans in early pregnancy, while others find that each scan just creates more anxiety. There's no right way—do what feels most supportive for YOU.

👉 For more on this: Beyond Breathing Exercises: A Trauma-Informed Guide to Transforming Scan Anxiety in Pregnancy After Loss

When should I seek therapy for pregnancy anxiety after loss?

If your anxiety is interfering with daily life, preventing you from attending prenatal care, causing frequent panic attacks, making it impossible to bond with your pregnancy, or if you're having thoughts of self-harm, seek therapy now. But honestly? You don't have to wait until things are "bad enough." If you're struggling, you deserve support. Early intervention often prevents anxiety from escalating as pregnancy progresses.

Your Next Step: You Don't Have to Carry This Fear Alone

Pregnancy after miscarriage can feel impossibly lonely. You might feel like you're supposed to be grateful and excited, but instead you're terrified. You might feel like no one understands why you can't "just relax and enjoy it."

But here's what I know after 10 years of supporting women through pregnancy after loss: you don't have to choose between protecting your heart and connecting with this baby. You don't have to white-knuckle your way through nine months of panic. And you don't have to do this alone.

Healing is possible. Not the kind of healing where you forget your loss or pretend it didn't happen—but the kind where you can hold both grief for the baby you lost and hope for the baby you're carrying now.

As a perinatal CBT therapist and mental health nurse who specializes in pregnancy after loss, I understand how exhausting it is to be constantly bracing for bad news. I also know how to help your nervous system feel safe enough to make space for hope.

In our work together, we'll process your grief, challenge the anxious thoughts that keep you stuck, and build practical tools you can use when panic strikes. We'll move at your pace, honor your loss, and help you find a way to experience this pregnancy—even when it feels scary.

If you're ready for support, you can book a free 20-minute consultation below. We'll talk about what's been hardest, what you need most, and what therapy might look like for you—no pressure, just a compassionate space to begin.

💬 Book Your Free Consultation Here

Additional Resources for Pregnancy After Miscarriage Support

UK Support:

NHS Support:

  • Find your local NHS Talking Therapies: NHS Service Finder

  • Ask your GP or midwife about specialist perinatal mental health services

  • Request referral to Early Pregnancy Assessment Unit (EPAU) for early reassurance scans if needed

Worldwide Support:

References

I have space opening up for new clients, and I'd be honored to support you through this journey. You can book a consultation, where we can explore how CBT might help you navigate this precious time.

 

Hi, I’m Aleksandra

DON’T MISS THE NEWEST BLOG POST!

Stay updated with the newest posts and other great resources to support your journey to HOPE.

Let’s connect:
therapy for Pregnancy after loss
book a free consultation
More about aleksandra
Aleksandra Balazy-Knas
Previous

How to Cope with Scan Anxiety After Miscarriage: Practical Support & Tools
Next

Navigating the Emotional Turbulence of Pregnancy After Loss: Coping Strategies and Support