How does stress affect pregnancy?

Everyone experiences stress – even if you’re pregnant.

“Experiencing the full range of human emotions during pregnancy is to be expected,” says Elizabeth Werner, PhD, researcher and assistant professor of behavioral medicine in obstetrics, gynecology, and psychiatry at Columbia University Medical Center. “This is normal and healthy, and what we should be doing.”

Don’t worry that day-to-day pressures, like working and caring for other children, will harm your baby or your pregnancy, she says.

“There is nobody who expects someone to lead a stress-free life,” says Werner. “It’s just not possible. Some stress in our lives, which we all experience, is absolutely to be expected and we are not concerned that it could seriously harm the fetal environment.”

Stress can describe many things, from everyday worries to traumatic events like floods and earthquakes, or the complex effects of living in poverty, says Christine Dunkel Schetter, PhD, researcher and professor of psychology and psychiatry at UCLA. Different types of stress have different effects.

“If you look at stress in this context, there is no single answer,” says Dunkel Schetter. “There is ample evidence that some forms of stress pose a risk to both the mother and the baby and the birth itself.”

What does the research say?

Studies have shown that anxiety during pregnancy is a risk factor for an earlier birth. A 2022 study led by Dunkel Schetter found that pregnant women who reported worrying about their pregnancy, baby, and delivery were more likely to have shorter pregnancies. These results show that anxiety is physiologically important and can affect a person’s birth, she says.

Other studies have found that having a birthing parent with severe anxiety during pregnancy can increase the child’s risk of problems later in life — such as developmental delays, emotional reactivity, or behavioral problems.

Bottom line: Getting help to reduce anxiety is important, says Dunkel Schetter.

“What I want is for that [pregnant people] to consider early in their pregnancy whether they are anxious or predisposed to anxiety or concerned about that particular pregnancy, and if any of these apply, to seek advice from their doctor and online resources,” she says.

Discrimination and racism cause great stress for people of color. This stress can impact pregnancy — a 2008 study found that African-American pregnant women who experienced more racism in their lives and in the lives of their families were more likely to have low-birth-weight babies.

Severe emotional stress and the effects it has on your lifestyle — like diet and sleep — can change the environment inside your womb, says Werner. These changes are complicated and still being studied, but stress can change how the placenta works and affect your hormones, which respond to stress.

“We’re seeing clues, but we still have a long way to go to really mechanistically understand the complex relationship of how all these things happen, even when we consider that the postpartum environment is hugely important and the brain is hugely plastic, especially the infant brain,” says Werner.

Even if a baby’s parents experienced extreme stress during pregnancy, later problems are not inevitable. “They may be more at risk, but a really healthy and nurturing environment after birth can really change that,” says Werner.

When to get help with stress

Taking care of your mental health during pregnancy is a positive step for you and your baby-to-be.

“If you’re really struggling with anxiety or mood disorders, this is a really good time to seek treatment,” says Werner. “Maybe you felt really overwhelmed by it, or it was something you avoid. Sometimes this can be a great time when you feel motivated in new ways.”

While it’s normal to worry, if it feels like they’re preventing you from living a full life, you should consider getting treatment, she says.

“The extent to which it affects your ability to do other things is probably a good indicator,” says Werner. “If you’re just so consumed with worry all the time that it’s really getting in the way of other things, that’s probably a really good time to get help.”

Many OB/GYN offices screen all pregnant patients for anxiety and depression with a questionnaire about how you are feeling; Ask your doctor to get it checked out if you haven’t already.

If your anxiety makes it difficult for you to leave the house or you feel like you can’t get out of bed, seek help. Watch for changes in your diet and mood, says Werner. Friends, family, or your partner may also notice changes in your mental health.

“There are many ways that anxiety and depression manifest themselves, both in the way we think and in our behavior,” says Werner. “Sometimes we think it’s just part of life, this level of suffering, but sometimes there are ways that mental health professionals can help lessen that and lead to a life that feels less painful.”

How to find help

Talk therapy can be very helpful for dealing with stress and anxiety during pregnancy, says Werner. Ask your gynecologist or GP if they can recommend mental health professionals in your area. You can also inquire about services from your insurance company.

Finding a therapist can take work, so keep looking if you’re having trouble finding someone who is available and affordable, says Werner.

Cognitive behavioral therapy, which teaches anxiety management techniques, can be effective in managing prenatal anxiety, Dunkel Schetter says. Mindfulness meditation can also help you live in the present and let go of burdening feelings, she says.

Everyday ways of taking care of yourself can also relieve some stress. Find social support from friends and family, says Dunkel Schetter. Exercise – moderately, as recommended by your doctor – and eat nutritious foods.

“All of these things are part of a healthy pregnancy and can help with stress management,” she says.