Coping with Grief and Anxiety while Pregnant or Trying to Conceive after Pregnancy Loss

Pregnancy loss occurs in as many as 10-20% of pregnancies each year. No matter the week of the loss, how long it has been since the loss, or whether the pregnancy was planned or not, one can experience overwhelming grief. Grief is such a small word for the intensity it can bring, making itself known both in our bodies and our minds. Grief is surprising and creative. It can create thoughts and feelings that you never thought you would have, which can make experiencing grief doubly difficult. It can make you doubt your very sense of self or wonder if you are losing your mind (You aren't; You're human). Here are some ways that grief shows up in our bodies and minds. Please know that these examples are but a grain of sand compared to the many thoughts and feelings each unique person has in grief. If you don't see yours here, it is still grief and it still matters.

In Our Bodies: Common physical sensations of grief

• Chest pain: Tightness, heaviness, or a feeling of pressure in the chest, heart racing

• Stomach issues: A hollow feeling in the stomach, nausea, or vomiting

• Shortness of breath: Difficulty breathing or feeling breathless, shallow breathing, gasping

• Muscle weakness: Feeling weak or shaky

• Fatigue: Feeling tired or exhausted, feeling weighed down/heavy, sleeping too much

• Hyperarousal: difficulty sleeping, restless, being sensitive to noise/changes

• Appetite changes: Losing your appetite, comfort eating, or having an increase or decrease in appetite.

In Our Minds: Common thoughts related to grief

• "This can’t be real. It doesn’t feel real."

• "I should’ve done more. Maybe if I had done XYZ, this wouldn’t have happened."

• "Why did this happen? It’s so unfair."

• "No one understands what I’m going through."

• "Everyone has moved on. My baby is forgotten."

• "It's as if my baby never existed."

• "I shouldn't have tried. I set myself up for pain and loss."

• "I'll never be myself again."

• "What is the point in anything?"

• "I should be 'over it' by now"

• Sense of foreshortened future ("I will not live very long" or there is no happiness in the future; it would be wrong to be happy).

• Sometimes it's not a thought, but reliving a memory of the loss, or imagining a lost future.

Grief following a pregnancy loss can be compounded even further by other stressful life events, such as relationship dysfunction (e.g., your partner doesn't understand your pain or is going through their own pain and isn't there fore you), death of loved ones, serious illness, and other traumas and stressors. Some women will experience recurrent miscarriage, which can be profoundly distressing, as it can deteriorate hope for an improved future and create a sense of helplessness, loss of control, and a feeling that something is "wrong" with them. Individuals who have had recurrent miscarriage may grieve a loss of parenthood or their desired future as a whole.

Anxiety on top of Grief: Trying to Conceive after Pregnancy Loss

If you are trying to conceive after a pregnancy loss, you may become quickly aware of how much you have changed since first trying to conceive. You may feel like a completely different person. The excitement of "trying" is now replaced by a heavy weight of fear, grief, and uncertainty.

• You may look back on your old self and yearn for her.

• You may wish you could be back in her shoes, to rewind time.

• You may feel guilt for wanting that, as it means it erases the existence of your pregnancy and child.

• Alternatively, you may judge your past self for their hope.

• You may wish that your past self had been "more prepared," or "done things differently" or not hoped so much.

• You may wish she could have made a different choice somewhere along the way, that would change the outcome....that would lead you to place where your pregnancy continued and you weren't here trying again.

As you notice how changed you are by grief, you also notice the weight of something else. Something that doesn't just look at the past, but also looks at the future. Something that is gripping tightly, that is searching for control. As you are trying to conceive after a loss you may experience the following anxiety symptoms in both body and mind:

Some ways anxiety shows up in the body

• Muscle tension (shoulders up, jaw clenched, hip flexor tension, furrowed brow)

• Difficulties with penetrative sex (clenching, lack of lubrication, dissociation)

• Shallow breathing, shortness of breath

• Tightness in chest, pinching feelings

• Heart palpitations

• A sense of being on edge, easily startled

Some ways anxiety shows up in the mind (usually thoughts that aren't true or helpful)

• "Trying again means I don't care about my lost child(ren)."

• "Trying again means I am moving on too soon."

• "It will happen again."

• "We'll be stuck in this pain forever."

• "Will my body let me be pregnant again?"

• "Is it safe?"

• "Is it too soon?"

• "Am I meant to be a parent?"

Anxiety can be overwhelming and intrusive, making it feel as if every moment is filled with worry. The worry and bodily sensations of anxiety can be exhausting, and it can feel like they’re constantly intruding on the present moment, preventing you from feeling settled or at ease.

How These Thoughts Try to Help, Even When They’re Painful

In Acceptance and Commitment Therapy (ACT), we often explore how these anxious thoughts aren’t "bad" or wrong—they’re actually an attempt by your mind to protect you. It’s natural to want to prepare for the worst to avoid more hurt. And, in many ways, these worries are your brain’s way of trying to keep you safe. This can be difficult to accept, as it can feel frustrating when anxiety takes over, but the reality is that relaxing or letting go of the anxiety can feel like a threat. It may feel like if you stop worrying, something might go wrong. ACT teaches us that while we can’t always control our thoughts, we can learn to interact with them differently.

The question becomes: Would you give up the bad feelings/thoughts if it meant giving up the good feelings/thoughts, too?

You may not be able to rid yourself of these thoughts, but by acknowledging them with acceptance rather than resistance, you can begin to free yourself from the hold they have on you.

Cognitive Defusion: A Tool to Cope with Anxiety

One of the most powerful ways to deal with these anxiety-provoking thoughts is through cognitive defusion—a technique that helps us distance ourselves from our thoughts rather than identify with them. The goal isn’t to get rid of the thought; it’s to loosen its hold on you. Here are a few ways to practice cognitive defusion:

• Label the thought: “I am having the thought that…”

• Sing the thought: Try singing your anxious thought to a tune (the goal isn't to be funny but to notice that the thoughts are words; they are part of you, not ALL of you)

• Watch the thought: Visualize your thought floating away on a cloud, like it’s passing by. (It's not going away for ever, it's still in your vision; but it isn't in your face).

• Name it: Call it a name, like “Worry” or “Anxiety,” to remind yourself that it’s just a thought, not reality.

  
  

By defusing from these thoughts, you create space between yourself and the anxiety, lessening its power to control your feelings and actions.

Being Present and Focused on What You Can Control

When you begin to reduce the control that anxious thoughts have over you, it becomes easier to refocus your attention on what is within your control. This might mean focusing on your self-care, connecting with supportive people, or simply enjoying the small moments of the day. The more space you create from anxiety, the more freedom you have to direct your attention to things that nurture your well-being—things that don’t heighten your worries. This present-focused mindset can offer relief and help you feel more grounded as you navigate the complexities of trying to conceive after loss and pregnancy after loss. 

Conclusions

Grief and anxiety are passengers in the journey to conceive after a pregnancy loss. These passengers are painful and distressing. We both don't want to feel them, and yet, we cannot fathom not feeling something about our loss. ACT aims to help you to tolerate painful feelings that will be along for the ride, take the edge off of them in productive ways, and open up space to do the things that matter to you (e.g., taking care of yourself, trying to conceive even though it's terrifying, taking care of your partner, letting go of tight grip on things that aren't serving you). If you are curious about how ACT and the concepts described above might be able to help you, talk to your therapist or reach out to us today to consult about starting therapy.