Dr. Kim Foster: Wicked Health


The Truth About Stress In Pregnancy

Worried Sick?

During pregnancy, we take good care of our bodies: we choose healthy foods, we take our vitamins, we banish harmful substances like cigarette smoke and alcohol.

But what about mental health? If you’re pregnant—is stress something you need to be concerned about?

The effects of a mother’s emotions during pregnancy has not, until recently, been well-researched. But recent studies are beginning to give credence to folk wisdom: that too much stress for a pregnant woman is harmful for her developing baby.

The most clearly recognized effects are increased rates of preterm birth and low birth weight. Preterm infants are at higher risk of health complications: lung disease, developmental delays, and learning disabilities. Most recently, studies have suggested a link between excessive stress in mom and depression, irritability, and lower IQ in baby. Other possible outcomes? Increased rates of cerebral palsy, ADHD, anxiety, and language delay—although much more research is needed here.

So what happens, exactly, in the body of a chronically tense and overwrought mom?

Stress hormones surge and blood vessels constrict, reducing placental blood flow. The placenta itself increases production of CRH (corticotropin releasing hormone). This hormone, known as the ‘placental clock,’ helps control the onset of labor. When CRH levels are too high, the risk of preterm labour increases.

Measuring your stress

Of course, we’re all under a certain amount of pressure. But here's the tricky question: how much stress is too much?

Researchers are working on objective methods, like blood tests, to measure this. In the meantime, we have to rely on softer methods.

Try the assessment tool developed by Dr. Calvin Hobel, director of maternal-fetal medicine at Cedars Sinai Medical Center in LA. For each question, answer “yes,” “sometimes,” or “no.” Three or more “sometimes” or “yes” answers? You may have excessive stress.

  1. I feel tense.
  2. I feel nervous.
  3. I feel worried.
  4. I feel frightened.
  5. I have trouble dealing with problems.
  6. Things are not going well.
  7. I cannot control things in my life.
  8. I am worried that my baby is abnormal.
  9. I am concerned that I may lose my baby.
  10. I am concerned that I will have a difficult delivery.
  11. I am concerned that I will be unable to pay my bills.
  12. I live apart from my partner or spouse.
  13. I have extra-heavy homework.
  14. I have problems at work.
  15. Have you and your partner or spouse had any problems?
  16. Have you been threatened with physical harm?


What now?

Let’s say you’ve decided your stress level is too high and you’re worried about the effects on your unborn baby. What to do?

Fortunately, there are numerous strategies for coping. For starters, identify your particular sources of stress. Is it the pregnancy itself that’s got you worried? Or are there other factors in your life? Some soul-searching is in order, here, as you search for creative ways to deal with your triggers.

Next, simplify. Today, we assume we can continue to do it all throughout pregnancy: work full-time, take care of household and family, maintain a full social life, hit the gym on a regular basis, and make time for the myriad tasks that tug at us. While you’re pregnant, put aside those superwoman urges, and prune out everything but the most important. For instance, cut back on household chores. Taking time to rest and rejuvenate with a soothing bath or a good book is more important than a sparkling kitchen floor.

Practice saying no. Resist taking on more responsibilities. And speaking of superwoman, you might want to reconsider your work schedule. If you can scale back, or start your maternity leave early, do it. These days it’s common for women to work right up until they deliver. But perhaps it’s time to rethink this.

Get back to basics.

Sleep is crucial. Get to bed early and nap when you can. Consider shaking up your routines—for example, try showering at night, and enjoy an extra 45 minutes of sleep in the morning. And make sure you’re eating well. Take time for breakfast, and have frequent meals—prolonged periods without food can increase CRH levels.

Nurture your spirit. Spoil yourself with a prenatal massage or manicure. Attend prenatal yoga classes. Sign out a book from the library on relaxation, breathing, and meditation techniques.

Remember that it’s natural during pregnancy to have more mood swings and anxieties than usual. Your body is morphing, your hormones are doing crazy things, and you’re trying to prepare for an enormous life change.  It’s also natural to worry about your unborn baby, too. Is she healthy? Is he developing normally? Trouble is, this creates a catch-22, knowing that anxiety itself can be harmful. What to do? Beyond the above ideas, make sure you’re communicating with your partner. Confide in family and friends. And talk to other moms-to-be: chances are these women are going through the same things you are.

If all this is still not helping, it’s time to ask your caregiver to refer you to a counselor or therapist.

Above all, remember that pregnancy should be a time to slow down and take care of yourself—body and soul—which in turn takes care of your precious cargo.

More stress busters? Read this. And this.