Stress and Pregnancy: What Are the Effects?

by Marjorie Greenfield, M.D.

reviewed and revised by Marjorie Greenfield, M.D.
I'm writing this article during the second week of September 2001. Thousands, if not
millions, of people around the world have suffered grief, anger, and tremendous
aniet! in the past few da!s. Some of these people are undoubtedl! pregnant and
must deal with their distress as the! tr! to take care of themselves and their babies"
to"be. #ven those who didn't have a direct or personal relationship with an! of the
thousands who have been lost have been changed forever b! the horrible events that
we witnessed.
$dded to that is the worr! that these intense feelings might somehow complicate the
pregnanc! or hurt the bab!""a concern for man! epectant mothers during times of
stress. %ere is some basic information for !ou about the effects of stress on
pregnanc!.
Can crying cause complications of pregnancy?
&o one knows if cr!ing too much or feeling great sadness could cause a complication
of pregnanc!. 'an! of m! patients actuall! have been told b! well"meaning friends or
relatives that their drawn"out cr!ing spells were hurting their unborn bab! in some
wa!. %owever, the realit! is that tragic life events happen, and !ou can't make
!ourself feel differentl! than !ou do""even if !ou tr! to ignore or suppress the
emotion. (rief is part of living and loving.
I know a woman who lost one parent in her first pregnanc! and her other parent while
epecting her second child. )et, even though she spent much of both pregnancies
cr!ing and grieving, her pregnancies went well medicall! and her children, b! all
accounts, are *ust fine.
It's hard to *udge cause and effect with stress""the best thing to do is to modif! what
!ou can. Sometimes taking a positive step in the midst of traged! can make !ou feel
more in control and less helpless.
Research on stress
Stress results in the perception of emotional strain as well as ph!sical responses,
such as an increase in heart rate or stress hormones. +esearch on stress can be
done in a number of wa!s, b! asking sub*ects about their perceived level of stress,
b! actuall! measuring ph!sical markers of stress, or b! taking both factors into
account. Stud! results on the effects of stress on pregnanc! outcome have been
conflicting. Some findings have shown that during the first trimester and postpartum
stress is felt more deepl!, or at least has a greater effect on ph!sical factors.
There seems to be some buffering from the severit! of stress in the second trimester
and even more so in the third trimester, although no one knows wh! this is. -or
instance, one stud! found that heart rate is less affected b! stress .that is, the
numbers aren't as high/ in epectant mothers during the second and third trimesters
compared with women who aren't pregnant. +egardless of the studies, however, it's
fair to sa! that a pregnant woman's emotional response to stress ma! still be severe.
Complications of pregnancy
Some studies have shown a greater risk of miscarriage late in the first trimester and
more birth defects if there has been severe stress in earl! pregnanc!. Some of these
findings are unreliable, though, because the patients were asked about stressors
after the! alread! knew about their pregnanc! complications, which probabl! led to
what is called recall bias""meaning that !ou're more like to remember an earl!
pregnanc! stressor if !ou had an overall bad eperience in the pregnanc!.
0ne disturbing stud! that looked at pregnanc! outcomes after the death of an older
child""which is not sub*ect to recall bias""did find more birth defects in the offspring of
mothers who were in their first trimester when the traged! occurred. 'ore research is
needed in order to see if these associations are real and to determine how eactl!
stress could bring about these complications.
0ther findings have indicated that more premature and small"for"date babies are
born to mothers who eperienced severe stress, particularl! during their first
trimester. Some research in this area showed medical effects of stress onl! in women
of lower socioeconomic status or in women who tended to have pessimistic
personalities.
$gain, these studies often are fraught with recall bias. In man! studies where
researchers prevented recall bias b! asking the patients about stress before
pregnanc! complications occurred, findings did not show a greater likelihood of
complications in women who eperienced critical life events.
0ne interesting report surve!ed pregnant women in 1alifornia after the &orthridge
earth2uake""which registered 3.4 on the +ichter scale""struck in 1556 and found that
the earth2uake was rated most stressful b! mothers in their first trimester and least
stressful b! those in their third trimester. The ratings for the postpartum period were
similar to earl! pregnanc!.
This pattern of responses indicates that an advanced pregnanc! ma! somewhat
protect women from the ps!chological effects of acute stress. 7regnanc! outcomes
were not measured in this stud!.
RELATED INFORMATION
Stress Management in Pregnancy
Emotions During Pregnancy
Times of Crisis
Created Setember !", #$$!
%eviewed and revised &uly #', #$$(