StorkNet's Week By Week Guide to Pregnancy
|StorkNet > StorkNet Site Map > Pregnancy > Pregnancy Articles
Stress in Pregnancy
By Henry Lerner, M.D.
As a psychologist friend of mine once told me if you don't feel stress in your life you're not paying attention. Everyone experiences stress, even pregnant women. What is not clear, however, is whether stress can have harmful affects on pregnancy.
For years obstetricians have looked to see whether an increase in stressful events can either cause miscarriage, result in preterm delivery, or in some other way harm a fetus. Up until recently the consensus had been that while excessive physical work can bring on preterm labor, emotional stress did not seem to have negative effects on pregnancy outcomes. This conclusion, however, has recently been challenged. There now is information to indicate that stress can cause the body to produce certain hormones that can perhaps cause miscarriage and that very likely can bring on preterm labor. Additionally, even if doctors have no "smoking gun" linking stress with negative pregnancy outcomes, pregnant women would want to decrease the amount of stress they have to contend with just because of how unpleasant it makes them feel. These emotional consequences of stress can range from a mild sense of being overwhelmed to severe episodes of depression. They can eventually lead to pregnant women feeling withdrawn and being unable to function.
Are there things pregnant women can do to reduce the stress they have and to change how it makes them feel? The answer is yes. Below are listed several techniques that both women and the clinicians who care for them have found useful in helping to relieve the sense that life is getting out of control. I have divided these techniques into two groups: (1) readjusting your lifestyle to reduce stress and (2) specific maneuvers and activities you can do to change how you feel -both physically and emotionally-about the stress you are under.
Gaining control of your life
- Take a close look at your lifestyle. Make yourself do this on paper. Look at your work activities, home and family responsibilities, other obligations (church, community activities, clubs and organizations to which you belong). Then look to see how "doable" it is. Make sure you include in your calculations time for yourself for such activities as exercise, down time, and socializing. Once you
have done this, be honest with yourself as you ask the following: Is this schedule achievable? Sustainable? Satisfying? If not, accept the reality that you have to change the schedule.
- Accept the fact that even if you currently can thrive on your busy and demanding lifestyle, you likely will not be able to sustain it as pregnancy progresses and makes more physical demands on you. Therefore prepare yourself to cut back on what you're doing and to allow yourself more time for rest and relaxation. You will need to sleep more. You will need to change the time you a lot for meals to make sure that you are able to eat a balanced diet. You will feel better if you allow time to engage in a reasonable exercise program. Finally you will need to allow yourself some "mental growth" time. This is time for reading, thinking, and planning for the new, incredibly important role of mother you will soon assume.
- Be prepared to give up some control over the life-style you have worked so hard to attain. Many things about pregnancy are not in your control. You may experience severe morning sickness. You may have overwhelming fatigue. You may develop a pregnancy complication requiring hospitalization or home bed rest. For many women, especially those who have demanding jobs, the thought that biology might interfere with their responsibilities borders on the intolerable. But it happens. Be prepared to accept this.
Techniques for dealing with stress
- Make up your mind that you, and not your husband or your mother or your boss or your friends, are going to determine how you feel about your pregnancy and how you cope with it. Other than your medical care providers, you are the best person to determine what your needs are, how hard you should work, how much you should rest, what you should eat, and all other aspects of your behavior during pregnancy. Certainly listen to the advice of both medical professionals and friends and family members that you trust. But don't allow yourself to be made to feel bad by the well-intentioned but often incorrect comments and claims of others.
- Keep lines of communication open with those you love, especially your spouse. Your spouse, parents, and friends--unless they are currently pregnant themselves--will not know exactly what you are experiencing and cannot anticipate what your wants and needs will be. Let them know. Tell them how you are feeling and how they can help. At the same time you must also be sensitive to the concerns and anxieties your spouse might have, especially if this is your first pregnancy.
- Don't be a hero. This is especially important if your work environment is in a traditionally "macho" field. Such professions as law, medicine, and corporate life often make demands that are simply impossible for a pregnant woman to fulfill if they are to remain in good health and reasonably sane. Discuss with your spouse and your boss what you can and cannot reasonably do and make
adjustments accordingly. Your employer certainly wants you to work as long as you can into your pregnancy. By adjusting your work environment in minor ways you often will be able to contribute much more to your organization than by following your former rigid schedule.
- Do your homework. Learn as much about pregnancy and its ramifications as you can. Read, talk to friends, attend classes, and talk to your doctor or midwife to learn as much as possible not only about the biology of pregnancy but about its emotional implications as well. In this way if you do begin to experience new and disturbing emotions you'll at least not be surprised by them.
- Give yourself permission to relax. This means making time specifically for relaxation and not doing so only when the odd spare moment occurs. Take time to do whatever makes you feel good. Read a book, see a movie, have a massage, sleep in late when you can. Each of us has his or her own means of personal "profit-taking". Make sure you do some, do your best to enjoy it, and by no means allow yourself to feel guilty about it.
- Teach yourself--or get taught--relaxation techniques. It has been shown by many researchers, notably Herbert Benson, M.D. and Alice Domar, PhD., that by learning to elicit a state of deep physical rest on command, both your body and your mind return to a calm, relaxed state. Heart rate, blood pressure, stress hormone levels, and muscle tension will drop. The mind experiences a
marked diminution in tension and the perception of stress. This is called the Relaxation Response. Techniques for eliciting the response can be learned from health care providers or by reading the excellent description of it in Dr. Alice Domar, Self Nurture.
- Talk to yourself--and write it down. The process of specifically identifying thoughts and feelings and putting them into written
form is an excellent way both to come to grips with what you are experiencing and to help resolve any of these feelings that are troublesome. Doing so will give you better insight into yourself and will often relieve the pain of previously disturbing thoughts or feelings.
- Test the origins of your emotions for validity. This process is called "cognitive restructuring". All of us get feedback and messages from those with whom we deal in the world. Often we make negative assumptions about ourselves based on this feedback and thus feel badly about interactions we have had and about ourselves. This process of negative thinking occurs spontaneously and can often be overwhelming. But if you can begin to identify these repetitive negative thoughts and write them down
to make sure you have a clear understanding of them, you can then begin the process of seeing what triggers them and determine whether your thought or the emotion it evokes is reasonable. Whenever you get one of these thoughts look to see what caused it. Ask yourself if what happened-a comment, a cool look, etc--deserves the negative response you have given it. By so doing you can start to
break the cycle of automatic negative feelings sparked by common events in your life.
- Finally, and not at all the least important, consider the possibility of obtaining professional help. The field of psychopharmacology has advanced so much over the last 15 years that seeing a therapist no longer automatically involves years of once a week visits to talk about your feelings. Although such "talk therapy" can be helpful, there are now many medications that are safe for pregnant women to take. These medicines have very few side effects yet can transform how you feel. Depressed moods are often caused by changes in the biochemistry of the brain. There are medicines that can safely adjust the levels of brain chemicals. These medicines, just like the insulin the diabetic takes, can correct abnormal biochemistry and make you feel better and happier. If you and your health are provider decide that such medications would be useful for you, by all means try them. They will not cause a miscarriage or harm your baby.
Life is complex and often hard. Stress will not be going away anytime soon. There are, however, ways that you as a pregnant woman
can go about evaluating the stress you are under and make changes in your life to better be able to deal with it. By so doing, you'll have a healthier pregnancy and be a happier person.
Click Here to visit StorkNet's interview with author Henry Lerner, M.D., OB/GYN
Click Here to read a review of Dr. Learner's book, MISCARRIAGE: Why It Happens and How Best to Reduce Your Risks
Copyright © 2003-09 Henry Lerner. All Rights Reserved. Used With Permission.
Henry Lerner, M.D., OB/GYN is the author of Miscarriage: Why It Happens And How Best To Reduce Your Risks. A graduate of Harvard Medical School, he has been an obstetrician/gynecologist for more than twenty years. He has appeared on "Nightline," "Larry King Live," and "Firing Line" and has been interviewed for magazines including Time and People. He lives in Newton, Massachusetts.
If you like this article, we'd be honored if you shared it using the button below.