Can Stress Cause a Miscarriage?

Can Stress Cause a Miscarriage?

Evidence does not suggest a direct cause-and-effect relationship between stress and miscarriages, but studies have found exposure to stressful life events can increase the risk.¹ Unfortunately, miscarriage is not uncommon, affecting approximately 10-15% of confirmed pregnancies.²

Moreover, many women experience stress during pregnancy, with nearly 70% reporting more than one stressful event in the year before giving birth.³ Prenatal stress can increase the likelihood of pregnancy, delivery, and postpartum complications, like premature birth, low birth weight, and postpartum depression.

Stress & Miscarriage: Explaining the Link

As mentioned, several studies have associated stress with a higher risk of miscarriage.^3,4 While researchers do not fully understand the link between stress and miscarriage in humans, some biological evidence suggests the hypothalamic-pituitary-adrenal (HPA) axis may play a role.

Studies on rodents have found an active HPA can possibly affect progesterone production, which is a reproductive hormone involved in conception and healthy pregnancy.⁵ These findings may partially explain the increased risk of miscarriage in stressed moms.

Is Stress During Pregnancy Normal?

Stress during pregnancy is normal, as expecting people experience numerous uncertainties and external stressors. Pregnant women may feel overwhelmed for many reasons, such as financial problems, unemployment, high work demands, relationship conflict, divorce, or the death of a loved one.

People can also experience pregnancy-related stress, like fear of childbirth (tokophobia), anxiety about various tests, or concern about their baby’s health. In other cases, some may struggle with previous substance use, contributing to increased stress as they attempt to quit drinking, smoking, or using drugs.

Other Impacts of Stress on Pregnancy

High stress may not cause a miscarriage but can negatively impact pregnancy and infant health. Anxiety during pregnancy can increase the likelihood of complications like preterm labor and delivery, low birth weight, shorter birth length, preeclampsia, and gestational diabetes.^6,7 Women under stress are also more prone to infection and illness, as they may be less likely to prioritize self-care.

Possible effects of stress during pregnancy include:

• Poor stress response: Experiencing stress releases glucocorticoids in the body, and studies show exposure to this hormone in utero can affect the infant’s response to stress in the future.^6,7 Low birth weight
• Physical health conditions: Preterm birth and low birth weight can have long-term effects on infants, including increased risk of physical health conditions like asthma and allergies.
• Impaired cognitive function: Stress in utero can affect cognition, learning, and memory.
• Mental health conditions: Children exposed to stress in utero may be at higher risk of mental health conditions, such as emotional problems, ADHD, conduct disorder, and childhood anxiety.
• Increased risk of illness: Stress exposure can impact infant immune systems, heightening susceptibility to sickness and infection as they grow older.

Most Common Causes of Miscarriage

Miscarriage can leave women and couples blaming themselves for actions they believe impacted their pregnancies. However, many uncontrollable factors can lead to a miscarriage, and stress during pregnancy is unlikely a cause. In many cases, chromosomal abnormalities are influencers, along with maternal pre-existing mental health conditions or substance use.

Chromosomal Abnormalities

Chromosomal abnormalities are one of the most common causes of a miscarriage. These abnormalities occur because of errors in the genetic material of the embryo or fetus that develop during fertilization or early cell division. In many cases, these complications are not preventable. However, certain factors, like advanced maternal age and a personal or family history of chromosomal abnormalities, can increase the risk.

Physical Health of the Pregnant Person

The physical health of the pregnant person can also play a role in the occurrence of miscarriages. Certain medical conditions, such as polycystic ovary syndrome (PCOS), thyroid disorders, diabetes, and autoimmune diseases, can increase the risk of miscarriage. Additionally, problems with the structure of the uterus (i.e., uterine fibroids or a weakened cervix) can also contribute to recurrent miscarriages

Substance Use

Substance use, including nicotine, alcohol, and illicit drug use, can increase the likelihood of miscarriage. Additionally, smoking can lead to lower fertility rates, alcohol consumption can cause fetal alcohol spectrum disorders, and drug use can have harmful effects on the developing fetus.

Can Miscarriage Be Prevented?

You can take steps to help lower the risk of miscarriage, but pregnancy loss is not always preventable. Many other competing factors are beyond your control, especially chromosomal abnormalities. Consult your doctor or OBGYN about what activities or routines promote healthy baby development to reduce the likelihood of complications. Additionally, keep up with any prenatal treatments and appointments. Remember, you are not at fault for a miscarriage if one happens. Remove the blame from yourself and allow time to grieve.

How to Lower Stress During Pregnancy

Avoid worrying about the link between stress and miscarriage. Focus instead on what actions you can take to support your and your baby’s health. Taking care of yourself, reaching out to others, calming your mind, and addressing the sources of your stress can help you cope.

Below are seven tips for coping with stress during pregnancy:

1. Practice Deep Breathing

Deep breathing is a simple and effective way to decrease stress, improve mood, and lower heart rate and cortisol levels.⁸ You can exercise breathwork in many ways, such as belly or diaphragmatic breathing. For the best results, practice daily for a few minutes to help promote calm and well-being.

Below is an example of diaphragmatic breathing:

• Find a quiet place to sit or lie down.
• Place one hand on your chest and the other on your ribcage.
• Breathe in through your nose for a count of four.
• Notice as your belly expands.
• Gently hold your breath.
• Release your breath through your mouth for a count of six.
• Notice your belly release on your exhale.
• Continue for several more rounds.

2. Ask for Help

Pregnancy can be an overwhelming time. You may be dealing with nausea, fatigue, and anxiety while preparing to welcome your baby. Asking for help can reduce your load and alleviate some stress, whether household chores, errands, baby-proofing, or other tasks. Additionally, your OBGYN may provide support and resources.

Asking for help can be challenging, especially if you think you should handle everything alone. Remember, pregnancy takes a toll on your body and mind, and not keeping up with life at the same pace is okay. Permit yourself to go slow and delegate tasks when you can.

3. Move Your Body

Exercise is an effective tool for dealing with and preventing stress.⁹ Anything that gets you moving is positive, whether cardio, stretching, dancing, yoga, or pilates. Most pregnant women can safely engage in moderate physical activity throughout the week.¹⁰ However, women with high-risk pregnancies should be cautious or avoid strenuous activity. Check with your healthcare provider before starting any exercise routine.

4. Get Plenty of Sleep

Sleep issues like insomnia are common in pregnancy, especially during the third trimester. Researchers believe these problems can be both a cause and an effect of stress, so focus on getting at least eight hours a night.¹¹

Help combat sleep issues by sticking to a consistent bedtime routine, limiting screen time before bed, avoiding caffeine, and creating a relaxing nighttime environment.¹² Additionally, practicing mindfulness or meditation at night may help you decompress and prepare your body and mind for rest. However, talk to your healthcare provider about any chronic sleep problems. They can assess for sleep disorders and provide treatment if necessary.

5. Make Time for Enjoyable Activities

Engaging in fun activities offers opportunities to blow off steam and counterbalance stress. Having fun is an act of self-care and just as important as tending to your physical health. Solely focusing on your pregnancy and preparing for birth will only increase anxiety, so aim to set time aside three times a week to take a break and relax.

6. Target the Reason for Your Stress

Taking steps to address sources of stress is crucial, especially when pregnant. Start by identifying what triggers anxiety or overwhelm. Next, brainstorm what will help alleviate this stress. For example, sign up for a childbirth preparation class if you are concerned about delivery. Or, talk to your doctor, educate yourself, or join a support group if you worry about postpartum depression.

You may not have control over the source of your stress. In these cases, all you can do is practice letting go. Sometimes, acknowledging that something is outside your control can help you feel better.

7. Join a Support Group

Peer-led support and therapy groups can help decrease symptoms of anxiety, depression, and stress.¹³ Attending meetings offers opportunities to connect with other pregnant people experiencing similar stressors. Feeling less alone in your struggle can empower you to make necessary changes that support balance in your life.

When to Seek Professional Help

You may need professional support if you struggle to cope with stress on your own. You can start by sharing your feelings with a doctor, OB-GYN, or midwife. They can assess whether your stress levels are too high and whether you should seek mental health treatment. They can also discuss different treatment options and provide a referral if they recommend additional support.

Therapy for Stress During Pregnancy

Studies show therapy can improve symptoms of anxiety and depression during pregnancy.¹⁴ A therapist will discuss your feelings and help you understand the source of stress in your life. They can also teach you healthy coping skills for dealing with the many challenges of pregnancy and parenthood.

For some pregnant people, cognitive behavioral therapy (CBT) can help them identify and change negative thoughts that contribute to stress. For others, interpersonal therapy (IPT) focuses on improving relationships with others to reduce depression and anxiety. You can find the right therapist in an online therapist directory.