Trusting Your Body Again: A Therapist’s Advice for Pregnancy After Miscarriage

By Dr. Emily Guarnotta, PsyD, PMH-C

Pregnancy after loss often feels like holding your breath. This article offers advice from a perinatal psychologist on how to reconnect with your body and navigate the emotional landscape of pregnancy after loss. 

One of my clients, I’ll call her Sarah (her name has been changed to protect her privacy), became pregnant six months after a miscarriage. When she found out she was pregnant, rather than feeling overcome with joy, she was overcome with anxiety. She described it like holding her breath. Sarah felt like she couldn’t trust her body and wondered “what if it happens again?”

If you’re reading this, you might see yourself in Sarah’s experience. After pregnancy loss, many women find themselves navigating complex emotions. Every sensation and symptom is scrutinized and you feel robbed of the joy and innocence of pregnancy. Navigating pregnancy after loss can feel like a lonely journey, but millions of women have walked this past and found their way back to trusting their bodies again.

Understanding the Mind-Body Disconnect After Loss

When you experience pregnancy loss, so many areas of your life are impacted, including how you feel toward your body. What once felt like a trusted home suddenly feels unreliable and scary. You might lose trust in your own body to do what it was meant to do.

This reaction to pregnancy after loss is a normal response to trauma. Your nervous system is designed to protect you. In an attempt to keep you safe, you become hypervigilant. You question every symptom and lie awake at night analyzing every sensation. This trauma response is self-protective when you are going through loss, but it can be exhausting when it continues into pregnancy. 

Emotions are complex and grief and hope can coexist. It’s possible to feel excited about your pregnancy, while still mourning your loss. Your body remembers the pain of your loss and is trying to hold space for both experiences. 

Cultivating Mindful Awareness

The journey back to trusting your body again starts with understanding the difference between anxious monitoring and mindful awareness. Anxious monitoring is driven by fear. It’s constantly checking your symptoms, seeking reassurance, or avoiding out of fear. On the other hand, mindful awareness is noticing your body’s sensations and thoughts without judgement and responding with kindness.

When it comes to pregnancy after loss, we’re vulnerable to anxious monitoring. This is an adaptive response. We are hypervigilant in an effort to prevent anything terrible from happening to us again. Unfortunately, this comes at a cost.

I would never tell a client who is pregnant after loss to ignore these feelings. Rather, I feel that it’s important that they recognize them and take a step back to get curious. Instead of assuming that every symptom is catastrophic, I want to help her notice what is coming up for her and consider the range of possibilities that it could be, rather than jumping to fear.

One way that I do this is with breathing exercises. The 4-7-8 breathing technique is one such exercise that activates your parasympathetic nervous system, which helps to calm down your nervous system. To practice, you simply inhale for four counts, hold for seven, and then exhale for eight. You repeat this several rounds.

Gentle movement can also be helpful in rebuilding trust in your body. Whether it’s walking, stretching, or prenatal yoga, movement helps you check in with your body and notice what you are feeling without needing to analyze or “fix” it.

Managing Pregnancy Anxiety and Intrusive Thoughts

Learning to tell the difference between anxiety and intuition is crucial when you’re pregnant after loss. Anxiety is typically repetitive, catastrophic in nature, and spirals quickly, while intuition is calm, clear, and actionable. We have thousands of thoughts each day and have to be careful to not assume that every thought is a fact. We can do this by taking a deep breath and asking ourselves questions like “what are the chances that this thought will happen?” or “what other possibilities could be true?” Because anxiety often comes from a perceived lack of control, I also encourage my clients to focus on what they can control.

The 5-4-3-2-1 grounding technique is another helpful exercise for bringing you back to the present moment when your anxiety is at a peak. This involves naming five things that you can see, four things that you can touch, three things that you can hear, two things that you can smell, and one that you can taste. This helps create some distance with your fears by reconnecting with your environment.

Building Your Support Network

Support from professionals, as well as loved ones, is critical as you’re navigating pregnancy after loss. While these techniques can be beneficial, sometimes our anxiety is greater than what we can manage on our own. If you are feeling anxious more often than not and it’s interfering with your life, it is important to speak with a trained mental health professional that specializes in pregnancy after loss. I highly recommended searching for a Certified Perinatal Mental Health Provider (PMH-C) who practices trauma-informed care. 

Communication with your medical team is important. They should be aware of your history and heightened anxiety so they can help you navigate it as your pregnancy progresses. Sometimes anxiety can lead you to seek constant reassurance from your provider. Asking questions is helpful and necessary, but if you’re constantly reaching out to your provider and do not feel reassured long after speaking with them, you might be in an anxious cycle. If this happens, talk with your provider about a plan for when to reach out with questions and when to sit with it. It can be helpful to write this down along with some exercises you can do on your own. 

Unfortunately family and friends do not always understand the complexities of pregnancy after loss. Sharing articles and resources and inviting them to attend appointments can help them better understand what you are going through and how to support you. 

Online communities like Rhea are another powerful resource for navigating pregnancy after loss. Connecting with others who are walking the same path is incredibly healing. They remind you that your feelings are normal and you are not alone.

Moving Forward with Self-Compassion

Rebuilding trust in your body after pregnancy loss is not a linear path. It’s often windy and messy. Some days you might feel centered and grateful and other days you might be bombarded with worry and fear. This is completely normal and doesn’t mean that you’re moving backward. Healing happens in layers.

Breathing and grounding exercises are effective ways to calm your nervous system on hard days. Even when things are going well, practicing these techniques can foster resilience. Also, taking a step back from your thoughts and getting curious about them, rather than taking them at face value, can help you notice when you’re being driven by fear. 

Seeking professional support, communicating with your medical team, and joining online communities like Rhea can help you build a strong support system to lean on. Support is critical throughout your journey.

Most importantly, practice self-compassion and forgiveness toward your body for all that it has been through and done. It’s okay that you’re having a hard time trusting it fully right now. Often what causes the most distress is judging ourselves for how we are feeling. Let’s make a commitment to make space for, rather than judge, all of our feelings throughout this pregnancy journey.

Dr. Emily Guarnotta is a licensed psychologist and Certified Perinatal Mental Health Provider (PMH-C) with a passion for supporting individuals through the emotional challenges of infertility, pregnancy, postpartum, and reproductive loss. She is the founder of Phoenix Health, an online therapy practice dedicated to reproductive mental health. Through her clinical work and writing, she helps clients navigate anxiety, grief, and healing with compassion and expertise.

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