You’re pregnant. But instead of feeling blissful, you’re experiencing a variety of emotions. You’re happy about the baby and looking forward to being a mother, but somehow you can’t shake off feelings of anxiety and stop worrying. Sometimes you’re feeling downright stressed. You start wondering: “Is there something wrong with the baby?” or “What if I can’t handle childbirth?” or “Why isn’t my partner as happy about the baby as I thought he’d be?”
Such thoughts are quite common among pregnant women. Since pregnancy is a time of change, marking the transition to motherhood or expanding the family, it seems only natural that it might be accompanied by worry and anxiety. For some women, however, such negative emotional states take over, pushing feelings of happiness to the background and leaving them feeling stressed and gloomy.
“Heightened stress and anxiety during pregnancy affect a child’s physical and mental development.”
But do worry, stress, and anxiety truly have a negative impact on a woman and her baby? One might assume that an unborn child would be protected from the mother’s emotional turmoil. Should we be concerned about a problem that is only temporary? Scientific research on both animals and humans suggests that we should.
Heightened stress and anxiety during pregnancy affect a child’s physical and mental development, and this applies not only to children of mothers who suffer from very high levels of anxiety or depression. Stress leads to changes in a pregnant woman’s body. The level of stress hormones may increase, for example, affecting fetal development. Indeed, maternal psychological distress is associated with such negative outcomes as preterm births, more illnesses and greater irritability in infancy, and in childhood with impulsivity and a tendency to be easily distracted.
It is not only the child who suffers, however. Mothers, too, may experience the consequences of heightened stress: (postnatal) depression, relationship problems, and physical challenges such as obesity. In sum, the effects of prenatal maternal stress are far from trivial.
Creating a toolbox of stress-reducing treatments
Helping pregnant women with elevated stress is not an easy task. The first step is to identify women with high levels of stress; gynecologists and midwives are the natural candidates to take up this challenge. During physical checkups, they need to allow enough time and opportunity so that women will feel comfortable sharing their concerns.
It is also important to design a high-quality questionnaire to screen for elevated stress levels. Finally, care during pregnancy could include an interview with a psychologist specializing in pregnancy and early parenthood, just as a consultation with a dietician is often part of prenatal care.
The next step would be to provide effective treatment. Unfortunately, however, scientists have not yet been able to devise an intervention or treatment that has been proven to drastically reduce stress or anxiety during pregnancy.
“Which treatment will work for a specific woman will depend on that person’s personality, preferences, and earlier experiences.”
Research has shown mixed effects of treatments and preventive interventions, probably because women’s worries, stressors, and anxieties are as diverse as the women themselves. Which treatment will work for a specific woman will depend on that person’s personality, preferences, and earlier experiences. One size does not fit all.
The good news is that once the specific cause of stress and the pregnant woman’s preferences have been identified, health care professionals should be able to offer a choice of solutions. These can be divided into two broad categories: communication-based solutions and solutions focusing on physical symptoms. In most cases, a combination of both is most likely to be effective at reducing stress.
- Communication-based solutions include discussing the woman’s worries and providing information tailored to the needs of each individual, in either one-on-one or group sessions. Group sessions have the advantage of allowing women to receive social support from other pregnant women, and have become a regular component of prenatal care in a number of countries.
- Solutions that focus on physical symptoms include relaxation sessions, support in making dietary choices, exercise, and sleep advice. Improving physical well-being also helps to enhance psychological well-being, as studies on the general population have shown.
“Health care professionals need to pay more attention to women’s psychological well-being early in pregnancy, since this may prevent the development of excessive stress in the first place.”
It is clear that stress in pregnancy should be taken seriously, since it has consequences for both the mother and the baby. More research is needed to produce a toolbox of evidence-based stress-reducing treatments for pregnant women. Furthermore, health care professionals need to pay more attention to women’s psychological well-being early in pregnancy, since this may prevent the development of excessive stress in the first place.
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Zijlmans, M.A.C., Riksen-Walraven, J.M., de Weerth, C. (2015). Associations between Maternal Prenatal Cortisol Concentrations and Child Outcomes: A Systematic Review. Neuroscience and Biobehavioral Reviews, 53, 1-24.
Beijers, R., Buitelaar, J.K., de Weerth, C. (2014). Mechanisms underlying the effects of prenatal psychosocial stress on child outcomes: Beyond the HPA axis. European Child & Adolescent Psychiatry, 23(10), 943-956
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