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How Much Stress is Too Much Stress in Pregnancy?

Originally posted September 26, 2012.

I’d love to share with you a chapter from new book, BirthTouch: Shiatsu and Acupressure for the Childbearing Year.

So – good question – how much stress in pregnancy is too much?

Like many things in life, the question of how stress affects a woman’s pregnancy does not have a simple answer. Because each individual has her own emotional and physical tolerance for stress, exactly how much stress is a causative factor for depression and anxiety is not known.

Plus, there are different types of stress. There is chronic stress, major negative life events and everyday stress.

Chronic stress, such as poverty, and major negative life events, such as the death of a family member, has been shown in research to have a direct adverse effect on the pregnancy and birth process.

Chronic poverty has direct adverse effects on pregnancy and birth outcome as the family often has little access to good pre-conception healthcare, prenatal care, good nutrition, good social support. Poverty is also a risk factor for emotional distress, such as depression and anxiety. Chronic poverty is a risk factor for prematurity and low birth weight. And infant prematurity is directly related to life-long problems such as infant demise, cerebral palsy, and developmental delays (March of Dimes).

Regarding a major negative life event and pregnancy, research has revealed that more pregnancy complications occur if the emotionally distressing event occurs during the second trimester. D’Onofrio and his colleagues studied 2.6 million pregnancies. If a negative event occurs during the second trimester, there was more likely an adverse effect on the pregnancy birth and baby. For example, women experiencing the death of a first-degree relative or the death of the baby’s father during the fifth and sixth months of pregnancy were significantly more likely to have low birth-weight infants (less than 2500 g) , babies who were small for their gestational age (birth-weight less than 2 standard deviations below the mean for gestational age), and babies with shortened gestational age (less than 37 weeks’ gestation) or babies born premature (D’Onofrio et al, 2011).

And then we come to daily stress. How much daily stress is too much stress during pregnancy? Well, it varies from woman to woman.

Here’s what the research shows. Research about “regular” maternal stress has been ongoing for several decades. Generally, these types of studies have been done on small sets of pregnant women and use different measurement methods.

On one hand, the studies have not consistently found a definite link between “normal” stress and negative pregnancy outcome. On the other hand, however, there is one specialized research team with some interesting results regarding stress and pregnancy.

Professor Christine Dunkel-Shetter directs the Health Psychology training program at the University of Los Angeles. She and her team focus specifically on the effects of stress on pregnancy. Their research finds cumulative evidence that psychosocial stress and daily hassles are associated with prematurity and low birth weight, particularly in African-American women (Parker-Dominguez et al, 2008).

Other replicated studies by Dr. Dunkel-Schetter and her colleagues indicate pregnant women who experience a particular type of anxiety, an anxiety concerning the impending birth and the health of her child, are consistently at risk for preterm birth (Dunkel-Schetter, 2009).

So, then, how much “normal” stress is too much stress for a pregnant woman? It is an individualized question. It is important to realize occasional doubt and anxiety do not harm the mom or unborn baby. After all, stress is a normal part of life.

But, spending a lot of time in an anxious state during pregnancy is not good for mom and baby, and may have some adverse effects. In general, constant fear and anxiety about pregnancy and birthing make it harder to come to a place of trust and relaxation about the birth. A negative birth process can feed into postpartum depression, anxiety, and post-traumatic stress.

Addressing your fears during pregnancy is part of good prenatal care and exquisite self-care!

When to Get Professional Help & Using Other Types of Help

If your fears and anxiety are interfering with your everyday life, seek help from a professional counselor. What does interfering with your everyday life mean? It means if you are experiencing conflict in major areas of your life, such as your relationships at home, your friendships, work relationships and quality of work, then you need to obtain professional help.

If you have significant life stressors, such as a current or past history of a mental health diagnosis, introducing a baby into a complex, high-conflict, blended family, or past sexual, physical or emotional abuse issues which are re-surfacing in the pregnancy, then you need to obtain professional help.

For complementary care, allied birth professionals, such as childbirth educators or doulas, can provide support and education around childbirth and teach prenatal relaxation techniques, helping fill your emotional bank account with confident and calming messages.

For self-care, learning and using complementary mindbody methods, such as mindfulness and relaxation practices during your prenatal experience helps promote emotional health and wellness, calming the reactivity of your nervous system, and building an emotional bank account of tranquility.


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