The Effects of Stress During Pregnancy: First of a Series

PregnancyA significant amount of research over the years has been conducted in an effort to determine the effects of stress during pregnancy. While it would be helpful to have a straight forward answer to this question, conflicting results, weaknesses in research methodologies, and the intricate nature of the relationship between pregnancy and stress, make easy answers difficult.

The general hypothesis of those who believe that stress can negatively affect pregnancy is that difficult life events produce increased levels of the stress hormone cortisol. Since studies have shown that persistently high levels of cortisol in adults have been linked to negative health effects such as increased blood pressure and heart disease, the exposure of the fetus to high levels of cortisol must also have a detrimental effect. The belief is that too much cortisol in amniotic fluid affects the developing brains of foetuses. There are certainly studies that have shown that increased stress leads to premature birth and lowered birth weight. Other studies have also shown that increased stress during pregnancy is related to ADHD, learning problems and even schizophrenia later in life. One study even linked severe stress in the six months prior to conception to preterm birth. Given all this research and the headlines they generate, one begins to wonder whether the stress related to exposure to this research is having a negative effect!

The Effects of Stress During Pregnancy: Second of a Series

HeartYesterday, we reviewed the research on the effects of stress on pregnancy. As was mentioned, the results can leave one feeling confused and more stressed! Despite this, there is a general trend in the research that does allow for a some relatively straightforward truths.

The main question is, does stress negatively effect pregnancy? The answer is, yes, if the stress is unusually intense. That is, intensely stressful experiences like the death of a loved one, abuse, or trauma, tend to be associated with premature birth or low birth weight. These outcomes have, in turn, been linked to difficulties later in life for some children (e.g., learning disabilities). However, it is also true that these types of experiences are difficult to avoid. Given this fact, it begs the question, what benefit is gained from knowing that intense stress can negatively effect your pregnancy? While we cannot control traumatic events in our life, we can turn to resources both internal and external in response to these stressors. Stress reduction techniques are within our control and have been proven to be effective.

The answer to our question also leads us to another common wisdom gleaned from the research. If you are pregnant and are under low or moderate levels of stress, ┬áthere is no need to worry – it will only make you more stressed! Pregnancy, by its very nature, typically brings with it low to moderate levels of stress. And rightly so. For the majority of us who live in a modern urban atmosphere where we feel as though life is within our control, watching nature take over our body to produce life can be anxiety provoking. Miscarriages, morning sickness, birth complications, childbirth, and birth defects, are just some of the fears expecting parents have to deal with. If these very common stressors were the cause of significant pregnancy complications then nearly everyone could expect negative consequences. Fortunately, this is not the case. While the average stress that accompanies pregnancy need not, in and of itself, be a source of worry, dealing with this stress will make for a more pleasant and rewarding pregnancy. Therefore, here again, stress reduction techniques are recommended.

The Effects of Stress During Pregnancy: Third of a Series

Relaxed PregnancyOur first article on the effects of stress during pregnancy focused on the complexity and confusion surrounding research in this area. Yesterday, the focus was on a couple of “truths” gleaned from the research. More specifically, the research suggests that intensely stressful events can have a negative impact on pregnancy, while mild to moderate stress is normal, and as such, should not be an extra source of worry. Of course, this current wisdom could change as new studies emerge. Today, we’ll focus on stress reduction, as it can be useful regardless of the particular circumstances you find yourself in, or the stress levels you are experiencing.

Eight Tips to Help Reduce Stress During Pregnancy.

1.┬áCognitive restructuring. This is the term psychologists use to describe the effects that thought can have on emotions. Peoples’ interpretation of events can vary widely. A mildly stressful event can be turned into a very stressful experience depending on your interpretation of that event. If, for example, your pediatrician has said something that has caused you to worry, don’t mind-read. Talk to the physician about your fears and ensure you have gained the proper interpretation of what was said.

2. Deep Breathing, Meditation, Massage. Your body can carry your cognitive and emotional stress. It deserves some attention. Get a professional massage or simply ask your spouse for one. Deep breathing and relaxation exercises help place the body into a relaxed state. Get some assistance so that you are doing it right. Breathing too shallow or quickly can increase your stress.

Stress and Pregnancy: What about post-partum?

Post Partum DepressionThis week, Dr. G has written about the lack of clarity in the pregnancy/stress research, the findings that are more consistent, and he gave some hints about how mothers can reduce stress. But, even though many parents are relieved after the birth of their healthy child, the stress doesn’t disappear in the post-partum period. Probably everyone reading this has heard of post-partum (or perinatal) depression (PPD). Although some research has estimated the rates of PPD at 10-20% of women post-delivery, a closer look at the statistics indicates that there is a high degree of variability between and within countries. Lee & Chung in 2007 estimated that rates varied between 0.5% to over 60% depending on the population.

Mothers with PPD may experience a number of symptoms, many of which overlap with Major Depressive Disorder:

  • Sad mood, crying, and tearfulness
  • Lack of enjoyment
  • Low energy
  • Insomnia or hypersomnia
  • Change in appetite
  • Concentration problems
  • Feelings of helplessness and/or inadequacy

For some mothers, PPD interferes with the development of their bond with their infant; they may feel emotionally detached from their baby or from other family members. Mothers may also lose their temper with the baby, and in some cases, they may wish to harm their infant. This anger and irritability sometimes surprises new moms, who may have expected to feel sad rather than irritable and short-tempered. An article on the Baby Ready blog described one mother’s experience that was later identified as PPD:

Do I feel depressed? Not exactly. Do I sit and weep inconsolably? Who has time? So, how do I feel? Angry. Ridiculously, illogically, uncontrollably angry. I am irritable, impatient, and resentful. Then I feel guilty, which makes me feel angry all over again.

FA058 – Anatomy of Pregnancy Stress

Pregnancy and StressDoctors Brian and Giuseppe talk about the impact of stress during pregnancy, along with post-partum depression, and what to do about it.

Listen here:

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Note: Posts on Family Anatomy are for education only. If you need to talk to someone about family or mental health issues, you can get a referral from your family doctor.

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