Stress in Pregnancy

Evidence

https://onlinelibrary.wiley.com/doi/full/10.1002/sono.12073

Afrooz Najafzadeh

The belief that the maternal emotional state during pregnancy may influence the development of her fetus has existed since ancient times across all cultures. Empirical studies examining the effects of prenatal psychological stress first appeared in the literature in the 1950s.1 The transition to parenthood involves major psychological and social changes. For women, it is a period of heightened maternal emotions, and many experience physiological and physical changes and desire to adapt to these changes. The pregnancy experience for some women today is characterised by a lack of adequate resources, both socioeconomic and psychosocial. Both psychological and social stressors can influence the maternal mental state and can cause anxiety and depression in pregnancy.

Education

While some degree of stress in our lives is normal, once this stress starts taking over, it can become distress and impact on your ability to function at your full capacity.

Understanding stress

Often stress is associated with a feeling of losing control or not having the resources or ability to manage challenges that lie ahead.

Factors that may increase stress:

• having a difficult or unplanned pregnancy
• having a prior negative pregnancy, birth or early parenthood experience (such as a premature or sick baby, inadequate sleep, breastfeeding difficulties, or an unsettled baby)
• experiencing complications in the pregnancy
• being a single parent or adolescent may also cause you to feel more stressed or overwhelmed, as you contemplate how you will manage
• experiencing relationship difficulties with your partner can also greatly increase your feelings of distress and concern for the relationship as well as your feeling of security for your growing family.

Both physical stress and mental stress can result in an increase of hormones to be produced. These hormones increase your blood pressure and reduce the flow of blood to the placenta. This can cause the amount of food and oxygen to the baby to be reduced which can cause your baby to develop more slowly than normal.

Certain hormones and proteins in the blood that help control the contraction of the uterus and the production of infection fighting cells are increased in times of stress. These can lead to increased risk of infections, uterine irritability and thereby increasing the risk of preterm birth.

High blood pressure also increases the chance for preterm labour. Too much stress also can cause you to have trouble sleeping, headaches, loss of appetite or to overeat which can be harmful to the baby.

Stress can be acute or chronic, with acute stress it is short lived and the body returns to its normal state whereas chronic stress is ongoing and the body may never return to its normal state. With acute stress e.g., having an occasional fight with your partner you are not at a higher risk to go into preterm labour whereas with chronic stress e.g., dealing with a divorce or a death of a loved one it can increase your chance of preterm labour.

Empowerment

How can you reduce stress during pregnancy?

Many pregnant women and their partners find that using various relaxation techniques can help to reduce levels of stress and maintain a feeling of wellbeing during pregnancy.  These techniques can be undertaken for free, at any time and in any quiet space that you have to yourself. This makes them relatively easy strategies to employ if you are looking to feel more relaxed and less stressed during your pregnancy.

Some recommended techniques that women find effective during pregnancy include:

Guided muscle relaxation

This technique involves tensing and relaxing specific muscle groups around your body.  This can help release the muscle tension caused by stress. It can also assist you with sleeping if you are dealing with pregnancy-related insomnia.

Breathing exercises

Become aware of your breathing.  Breathing in and out deeply and evenly can ensure you have the right balance of oxygen and carbon dioxide in your system.  This form of controlled breathing keeps your mind and body functioning well. It can also lower your blood pressure, promote feelings of calmness and help you to de-stress and relax.

Guided mental imagery

Close your eyes and imagine that you are in a safe, calm and relaxing place. This can be an effective way to remove yourself from current stressors in your environment and, as a result, relieve feelings of stress.

There are many apps, websites and podcasts available to help you with these self-help strategies for relaxation. Keep in mind though, that some of the digital tools work better for some people than others. Don’t be surprised if it requires some trial and error to find the one that works best for you; you may indeed prefer to join a community group class.

Other ways to manage stress during pregnancy include:

• Know that the discomforts of pregnancy are only temporary.
• Stay healthy and active. Eat healthy foods, get plenty of sleep and exercise (with your provider’s OK). Exercise can help reduce stress and also helps prevent common pregnancy discomforts.
• Cut back on activities you don’t need to do. For example, ask your partner to help with chores around the house.
• Try relaxation activities, like prenatal yoga or meditation. They can help you manage stress and prepare for labor and birth.
• Take a childbirth education class so you know what to expect during pregnancy and when your baby arrives. Practice the breathing and relaxation methods you learn in your class.
• If you’re working, plan ahead to help you and your employer get ready for your time away from work. Use any time off you may have to get extra time to relax.
• With economic problems or other situation related problems a consultation with a social worker may help find solutions.

The people around you may help with stress relief too. Here are some ways to reduce stress with the help of others:

• Have a good support network, which may include your partner, family and friends. Or ask your provider about resources in the community that may be helpful.
• If you think you may have depression or anxiety, talk with your provider right away. Getting treatment early is safe in pregnancy and important for your health and your baby’s health.
• Ask for help from people you trust. Accept help when they offer. For example, you may need help cleaning the house, caring for other children or you may want someone to go with you to your prenatal visits.

Useful Links

COPE – Centre for Perinatal Excellence

https://www.cope.org.au/expecting-a-baby/staying-well/stress-in-pregnancy/

Reduce stress during pregnancy with the Ready to COPE app - https://www.cope.org.au/readytocope/

Women who are pregnant or have recently had a baby can download Ready to COPE, a free app that delivers timely information, advice and reassurance throughout pregnancy and the first year of parenthood. 

Miracle Babies Foundation

https://www.miraclebabies.org.au/content/post-traumatic-stress-disorder-ptsd/gm8ozk

Panda - Perinatal Mental Health

https://panda.org.au/