Some stress during pregnancy is normal, just as it is during other times of life. But if stress becomes constant, the effects on you and your baby could be lasting. During pregnancy, stress has specific dangers for the physical and emotional wellbeing of the baby, mother and family unit as a whole.
“A stressful pregnancy matters — it can affect a baby’s genes”
Everyone has heard of postnatal depression, but not everyone knows that mothers are as likely to be depressed during pregnancy as afterward. As well as the distress of the mother herself, this matters because of the effects on the developing baby in her womb. We have long known that how we turn out depends on how our genes interact with our environment. We now know the environment starts before birth. How we develop there can affect our health and wellbeing for the rest of our lives.
The effects of stress
In pregnancy, stress exposure is associated with a higher risk for preterm delivery and lower birth weight. Preterm birth is the major cause of death and disability in children up to the age of five in Australia.
Many pregnant women are anxious or depressed, and this can affect how the baby’s brain develops. This, in turn, leaves the child at greater risk of anxiety, depression, slow learning or behavioral problems such as ADHD later. If the pregnant woman is in the top 15 percent of the population for symptoms of anxiety or depression this doubles the risk of her child having emotional or behavioral problems. The risk of the child at 13 years old having a mental health problem goes from about 6 percent to 12 percent. The children of mothers who reported multiple stressful events during pregnancy are more likely to develop behavioral problems throughout childhood. Studies also show reduced cognitive abilities in children whose mothers experienced a natural disaster while pregnant.
Relationships, especially with the father, matter too. A supportive partner can buffer against these effects, but an unsupportive or abusive one can stress the mother in a way that harms her developing baby.
How does this happen?
What many of us have difficulty conceptualizing is how something that is experienced in the mind can translate into both mental and physical health problems in the child. It’s suggested that experiencing stress results in increased circulation of the stress hormone cortisol, which then crosses the placenta to the fetus, changing the hormonal makeup and compromising fetal development, both neurological and physical. Exposure to elevated cortisol could prepare the developing fetus for a world that the mother perceives as stressful. In this way, outcomes such as behavioral problems might be seen as adaptive.
The changes we see in the child may have been protective in such an environment. More anxiety means greater vigilance and more ability to detect danger. Readily distracted attention, as in ADHD, may have helped to spot the danger more quickly. Rapid aggression may have helped also. But these changes, adaptive in the presence of real danger, are disadvantages in our society.
How to reduce stress during pregnancy
Some ways to reduce stress include utilizing social support, either by spending time with friends or accepting help from those around you to relieve the stress of daily activities. Light exercise, yoga, meditation, and relaxation can all assist in managing stress. While yoga class might be perceived as inaccessible or elitist. Scheduling time to rest and discussing work demands in pregnancy with your employer are other ways to reduce stress.
The good news is that we should be able to do something about all this. At the moment most anxiety, depression, and stress in pregnant women are not detected by health professionals and very little is done to help. Mental health is the most neglected aspect of obstetric care. But it is not difficult either to detect or to help. If we can help the pregnant woman we will be helping the next generation too.
Building resilience in families and children in the face of stress is extremely important, and this is why it’s vital we include stress management strategies into not just pregnancy care, but also the early years of parenting and child development.
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