We’re talking about miscarriage more—but what about the anxiety that follows?

Though it’s harder to talk about the mental health impact miscarriages have on a woman. Amongst the wave of emotions a loss of a pregnancy can bring, one is a lingering sense of anxiety. Anxiety after miscarriage is a common outcome, and there is anecdotal evidence that women experience anxiety six to nine months after a pregnancy loss. 

There are a lot of reasons for miscarriage anxiety, but one thing women’s health experts say is that it’s commonplace. “It’s very common to have high anxiety after a miscarriage,” says Elisabeth Netherton, MD, a psychiatrist focused on women’s mental health at Mindpath Health. “It’s also very common for women to develop symptoms of PTSD and other trauma-related anxiety symptoms after miscarriage.”

Is it normal to feel anxious after a miscarriage?

Very normal. In one 2019 study, 24% of women who had a miscarriage a month prior showed moderate to severe anxiety symptoms. While some recovered from miscarriage anxiety, 17% continued to show symptoms after nine months. 

Whitney Casares, MD, a pediatrician and CEO of the Modern Mamas Club app says it’s completely understandable for previous moms-to-be to feel anxious or depressed after losing your child. “Miscarriage is a trauma to your body and mind,” she explains. “You were planning on having a live child, and all of a sudden, you’re not anymore.”

Related: How to handle miscarriage anxiety during pregnancy, according to experts

Why do people experience anxiety after miscarriage?

Anxiety after a miscarriage can come from the grief and guilt that you’ve lost a child—and blaming yourself for it. “Women are very good at assigning blame to themselves, as society has conditioned us to feel this way,” said Dr. Casares, who experienced her own miscarriage scare. 

For example, she says that women may feel guilt-ridden for deciding to put their career first and delaying having a child, as conception after age 30 has been linked to increased miscarriage risk.

“There is this false belief that women are to blame for pregnancy outcomes,” adds Dr. Netherton. “That if we do all the right things—eat only what we’re told and get the right amount of sleep—that we can manifest the perfect outcome, which becomes damaging when things don’t go well since those outcomes are fundamentally outside of our control.”

Related: It’s time to stop calling infertility a women’s health issue

Getting older makes it harder to get pregnant in the first place, and someone who invested time and money in procedures like in vitro fertilization (IVF) may feel worse anxiety over the loss. 

“After all the work you put in to get pregnant only to lose that child would absolutely cause grief,” adds Dr. Casares. 

Having a miscarriage late in your pregnancy may increase your anxiety risk because you were likely more mentally prepared or anticipated becoming a parent. 

Dr. Casares says that despite reading up on pregnancy and potential miscarriage, it’s difficult to override your nervous system in moments of severe shock and anxiety. 

Related: 8 things you need to know about miscarriage

“‘Was it the fish I ate?’, ‘Was it the drink I had one time when conceiving?’ Right in the beginning, your thoughts start to go there,” she explains. “The more traumatic experiences with pregnancy loss, the more likely someone is to question all the things they did wrong to make [the miscarriage] occur.” 

For people who already deal with existing anxiety, a miscarriage can exacerbate these symptoms.  

Like postpartum anxiety and depression women experience after giving birth, a miscarriage can cause a sudden hormone shift. “Across the duration of pregnancy, we see rapidly rising estrogen and progesterone levels that drop off precipitously at the time of delivery,” explains Dr. Netherton. “With miscarriages, that process happens as well and that hormone drop creates a biological precipitant for developing low mood and anxiety.”

How to spot miscarriage anxiety

Everyone reacts differently to a miscarriage, and the same can be said for miscarriage anxiety. You may exhibit a few or all of the symptoms of anxiety, such as:

• Difficulty concentrating
• Often feeling tired
• Sleep problems
• Feeling on edge
• Acting short-tempered or irritable

Both experts say that women with anxiety after miscarriage may manifest the condition differently. For example, symptoms may include:

• Ruminating out loud to friends and family what went wrong with the pregnancy
• Having uncontrollable feelings of worry over small or improbable things such as getting into a car crash or not getting somewhere in time
• Blaming someone else for their pregnancy loss
• Talking excessively about a subject for a long length of time
• Not eating regularly
• Getting distressed about things that ordinarily wouldn’t upset them

How long does it take for anxiety after a miscarriage to go away? 

There is no set timeline on when miscarriage anxiety ends. Most recover after six weeks, but some research estimates that of the women who get anxiety after miscarriage, 20% will have it for one to three years. 

Dr. Casares says the large discrepancy is that there’s usually only a six-week follow-up to assess the physical and emotional effects of a miscarriage. But there are times when a doctor may not even conduct a follow-up if women have no issue getting their periods again. “We need more mental health surveillance for these moms, more screening, and more open discussion about it,” says Dr. Casares. “We don’t know exactly how long [anxiety after miscarriage lasts], but it’s because we’re not asking the question.”

While there’s no timetable of when anxiety goes away, the possibility of it lasting the rest of your life is extremely low. “There’s no reason that anxiety needs to last forever,” explains Dr. Netherton. “When the anxiety is severe or gets in the way of daily functioning, that’s enough reason for women to seek some professional support with a therapist or psychiatrist.”

Sources

Farren J, Jalmbrant M, Falconieri N, Mitchell-Jones N, Bobdiwala S, Al-Memar M, Tapp S, Van Calster B, Wynants L, Timmerman D, Bourne T. Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study. American Journal of Obstetrics and Gynecology. 2020 Apr 1;222(4):367-e1.

Magnus M C, Wilcox A J, Morken N, Weinberg C R, HÃ¥berg S E. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ 2019; 364 :l869 doi:10.1136/bmj.l869

Nynas J, Narang P, Kolikonda MK, Lippmann S. Depression and anxiety following early pregnancy loss: recommendations for primary care providers. The primary care companion for CNS disorders. 2015 Jan 29;17(1):26225.