Overview

During the first trimester, there is little external reassurance that everything is progressing normally. You do not look pregnant yet; you cannot feel your baby move. While ultrasounds and hearing your baby’s heartbeat are reassuring, you have very few prenatal appointments in the first trimester. Feeling nervous and worrying about your baby’s health is entirely natural. In this episode, we explore why early pregnancy can feel so emotionally overwhelming and share practical, evidence-based tools to help manage anxious thoughts. Whether you are experiencing ongoing anxiety or just the occasional moment of doubt, these strategies can help you feel more grounded, calm, and confident during the early stages of your pregnancy.

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Article and Resources

Hi Vanessa,

First, I just want to say how much I love your podcast—it’s such an incredible resource, and I’ve learned so much. I always walk away feeling more informed and reassured.

A little backstory: my husband and I started trying to conceive right after we got married in October 2023. We finally got pregnant in September 2024, but sadly, it ended in a miscarriage due to a blighted ovum at 8 weeks.

It was such a hard experience, and your episode on miscarriage really helped me feel less alone. It opened my eyes to how common this is and gave me a lot of comfort during a tough time.

After that, we decided to see a fertility specialist and ended up doing our first IUI at the end of March 2025. Last week, we found out we’re pregnant again!

We’re so excited—but also super anxious. The fear of another loss is real. I was wondering if you had any tips for easing that anxiety in the first trimester? We’re lucky to have a 6-week ultrasound already scheduled with our fertility specialist, but I find myself constantly symptom-spotting and worrying.

Do you have any advice on how to not spiral or drive myself crazy with every little thing? I know it sounds silly, but I’ve caught myself wishing for more nausea or symptoms just to feel reassured.

Thank you again,

Madeline

Understanding Anxiety About Pregnancy Loss

Madeline, thank you so much for your kind words about the podcast. I really appreciate you sharing your story, and I’m so sorry for your loss. Getting married and starting a family is such an exciting chapter, and I know how devastating it can be when things don’t go as planned. Experiencing a miscarriage is incredibly hard, and my heart goes out to you.

Miscarriage

This episode focuses on managing anxiety during pregnancy, especially during the first trimester. However, it is essential to acknowledge how common miscarriage is. A miscarriage refers to a pregnancy loss before 20 weeks. It’s estimated that 10 to 20% of known pregnancies end in miscarriage. According to the American College of Obstetricians and Gynecologists, about 10% of clinically recognized pregnancies result in a loss. The actual number may be even higher since some losses happen before someone realizes they are pregnant or has a pregnancy confirmed by a doctor. The reassuring news is that most women who experience a miscarriage go on to have a healthy pregnancy. Repeat miscarriages are relatively rare, occurring in only about 2% of cases.

Managing Anxiety About Miscarriage

Madeline, it is wonderful that you have the resources for a fertility specialist, and I am so excited for you. Congratulations on your pregnancy! At the same time, it is entirely understandable to feel anxious. Anxiety during pregnancy is very real, and after going through something as difficult as a miscarriage, it is normal to worry that something might go wrong.

Since miscarriage is so common, these feelings are shared by many expecting parents. The risk of miscarriage does decrease as pregnancy progresses. About 80% of losses happen in the first trimester. That means the likelihood of a loss significantly drops once you reach week 13.

One of the hardest things to accept is that chromosomal abnormalities cause most miscarriages. You cannot prevent or fix this, and it is entirely out of your control. Chromosomal abnormalities can result from a damaged sperm or egg, or an error that happens when the embryo is dividing. That lack of control can be incredibly frustrating and anxiety-provoking.

Navigating the First Trimester

The first trimester can be one of the most emotionally challenging parts of pregnancy. Physically, you may not yet appear pregnant, and you are not able to feel your baby moving. This means there is often very little external reassurance that everything is progressing as it should. You are essentially asked to trust that everything is going well, which is much easier said than done.

You mentioned that you find yourself symptom-spotting and feeling worried. I want to reassure you that this is completely normal. Many expecting mothers become hyper-aware of every sensation or the absence of specific symptoms, wondering if it means something is wrong. Ironically, some of the most unpleasant symptoms, like morning sickness or fatigue, can feel comforting because they are seen as signs that the pregnancy is continuing. Although morning sickness is very common, not everyone experiences it, and a lack of feeling nauseous is not a sign that something is wrong.

It is also very common for expecting moms to take multiple pregnancy tests, even after receiving a positive result. There can be a strong desire to keep confirming the pregnancy, even though logically you know that repeating the test does not offer any new or useful information. All these feelings and behaviors are part of trying to cope with the uncertainty present in early pregnancy.

Strategies to Manage Anxiety

There is no one-size-fits-all solution for easing anxiety during pregnancy, but there are many simple strategies that may make a meaningful difference. The key is to find what resonates with you and to build small habits that support your emotional well-being. The following tools can help you manage anxious thoughts, stay grounded, and feel more in control as you navigate the early weeks of pregnancy.

Focusing on What You Can Control

When so much feels uncertain, it can be helpful to shift your focus to the things within your control. You have control over avoiding potentially harmful substances, such as excessive caffeine, alcohol, or tobacco. You can support your body by taking a high-quality prenatal vitamin, eating balanced meals, staying hydrated, and prioritizing sleep. Caring for your mental and emotional well-being is just as important. This could involve journaling, practicing mindfulness, talking with a therapist, or simply making time to relax and unwind.

Although it may feel difficult, focusing on what you can do, rather than what you cannot, is a powerful way to shift from feeling helpless to feeling empowered. This is especially true during the early weeks when so much is unknown.

Tips to Ease Anxiety

Having an ultrasound can be very reassuring, especially if you can have one as early as six weeks. Most healthcare providers do not perform ultrasounds before eight weeks, which can make the time between getting a positive result on a home pregnancy test and confirming the pregnancy with a doctor feel especially stressful and uncertain.

Using Breathing to Calm Your Body

One effective technique you can use in the moment to regulate your stress response is controlled breathing. This can be helpful if you are having acute anxiety, like if you are having trouble focusing on work because all you can do is worry about your baby. One specific method is called the physiological sigh. This involves taking two inhales in a row, one full breath followed by a short second inhale. Then releasing a long, slow exhale. This pattern helps your body release excess carbon dioxide and can immediately create a sense of calm. Performing this breathing technique just one to three times can significantly reduce your stress response and slow down your heart rate.

This is a technique I learned from Dr. Andrew Huberman, a neuroscientist who shares science-based tools to improve mental and physical well-being. If you want to learn more about stress management tools, I encourage you to watch this video. The Huberman Lab podcast is terrific for neuroscience and science-based tools for everyday life.

Mindfulness, Affirmations, and Positive Self-Talk

Another simple but powerful way to manage anxiety is through mindfulness and positive self-talk. Pausing, breathing, and gently bringing your attention to the present can help quiet racing thoughts. Practicing mindfulness does not need to be complicated. It can be as easy as noticing your breath, feeling the weight of your body in your chair, or observing a few things around you. Pairing this with affirmations can reinforce a sense of calm and confidence. You might try silently repeating phrases like, “I am doing my best for my baby,” “Right now, I am safe and supported,” or “It is okay to feel anxious and still have hope.” These gentle reminders can ground you in the moment and help shift your mindset from fear to reassurance.

Connecting With Your Baby Through Visualization

You have likely thought about what it would be like to experience something in the future with your baby. That could be thinking about walks in your neighborhood, celebrating your baby’s first Christmas, or having a picnic in the park. Thinking about the future and imagining positive things or happy moments you will enjoy with your baby or as a family is an excellent way to bond with your baby. You can even talk to them and tell them how excited you are for them to meet their grandparents or how you can’t wait for them to see the ocean for the first time. Use your imagination and envision what your life looks like with your baby.

Journaling to Ease Anxiety

Journaling can also be a powerful tool for easing anxiety, especially during pregnancy when emotions can feel heightened. There is no right or wrong way to journal. You can write about anything: how you are feeling, what you are grateful for, something you are looking forward to, or even a moment that felt hard. The simple act of putting thoughts on paper can help you process emotions and bring clarity to anxious feelings. Aim to journal daily, even if it is just a few sentences. Like any habit, it gets easier with time and consistency. Whether you prefer pen and paper or a journaling app, choose whatever feels most comfortable. If privacy is a concern, apps like Day One allow you to keep entries password-protected.

Building Resilience Through Support

There is a large body of evidence showing that social connection plays a significant role in physical and mental health. Human beings are wired to connect with others, and those connections become especially important during major life transitions, like pregnancy.

Leaning on Social Connection and Support

One study examined 27 different stress indicators during pregnancy, including psychosocial, physical, and lifestyle-related factors. The researchers identified three groups: 66.8% of participants were considered psychologically and physically healthy, 17.1% experienced elevated levels of perceived stress, depression, and anxiety, and 16% showed signs of physical stress, such as higher blood pressure and increased caloric intake. What distinguished these groups most was the level of social support they reported.

The study identified three key types of support: having people to talk to, people to spend time with, and people to rely on for material help. These forms of connection can make a meaningful difference in how you experience pregnancy, especially when navigating anxiety. Starting or growing your family involves significant life changes, which can impact your routines, priorities, and relationships with those around you. Trying to manage pregnancy or early parenting without a strong support system can make everything feel more overwhelming. If you are feeling isolated, reaching out to a trusted friend, family member, or even joining a support group, whether in person or online, can be incredibly valuable. You do not have to go through this alone.

When to Contact Your Doctor or Midwife

When it comes to your health and your baby’s health, it is best to err on the side of caution. If something feels off or your instincts tell you something is not quite right, please trust yourself and reach out to your doctor or midwife. You know your body better than anyone else, and your concerns are always valid. Even if you are unsure whether something is cause for concern, it is better to speak up and get the reassurance or care you need. Your care provider is there to support you and help guide you through this journey, especially during moments of uncertainty.

While some anxiety during pregnancy is normal, if at any point anxiety begins to interfere with daily functioning, consider seeking out therapy or mental health support. Your current doctor or midwife is a great starting place to find other sources of support if you are having trouble managing your anxiety.

Shifting Your Perspective

Although you may not be able to see your baby growing just yet, it can be reassuring to learn what is happening inside your body each week. A great resource for tracking your pregnancy each week is the 40 Weeks Podcast. Each episode is about six minutes long and covers each week of pregnancy. You will hear about how your baby is developing, what changes are happening in your body, what to expect at upcoming prenatal appointments, and even a helpful tip for dads and partners. Taking a few minutes each week to learn about your pregnancy can help you stay informed and celebrate your progress, even in those early weeks when everything can feel uncertain.

Anxiety and worry often come from the unknowns of pregnancy. Those same unknowns can also be a source of wonder. When you notice yourself feeling anxious, try to reframe that energy as anticipation and excitement. Your body and mind are preparing for something amazing. Instead of focusing on what could go wrong, shift your thoughts to what could go right. It is easy to let your mind wander into a rabbit hole of anxiety. With practice you can get better at shifting your focus on your amazing parenting journey ahead.

Additional Resources

• Pregnancy Loss
• Miscarriage
• Waiting for Your First Prenatal Appointment
• Stress and Anxiety During Pregnancy
• Building a Bond and Connecting with Your Baby During Pregnancy

Thank you to Pathways.org for supporting this episode.