Stress during pregnancy is common, with around 78% of pregnant women reporting low to moderate stress and 6% reporting high levels of stress.1 Pregnancy stress is a concern because it is linked to certain complications and can have negative effects on the unborn baby. Fortunately, you can take action to reduce your stress during pregnancy, which can help prevent these problems and improve your overall well-being.
What Causes Stress During Pregnancy?
Stress can be caused by many different things for a pregnant person, and the causes of stress are different for different people. When it comes to stress during pregnancy, stress may be either due to the pregnancy itself or other factors that are unrelated to the pregnancy. Coping with an unplanned pregnancy, managing doctor’s appointments and testing, dealing with complications, and fears related to childbirth or pregnancy loss can all result in considerable stress.2
Other common sources of stress for women during pregnancy are finances, work, family and household responsibilities, and relationships with their spouse or partner.3 Women may feel overwhelmed with running a household and caring for other children while also managing the pregnancy and physical discomfort. Having a baby also changes a woman’s work situation, which can affect finances. The increased pressure of growing a family can have effects on a woman’s marriage or relationship, which can lead to more conflict. All of these factors and more can lead to stress during pregnancy.
What Types of Stress Cause Pregnancy Problems?
High levels of stress are associated with pregnancy problems like preterm birth and low birth weight.3 Experiencing major life events like death of a close family member, divorce, job loss, and catastrophes (such as terrorist attacks or natural disasters) can affect a woman’s pregnancy. Other stressors like homelessness, poverty, racism and discrimination, and crime can also have effects.
Minor stressors, called “daily hassles,” are not likely to lead to pregnancy problems. Examples of these include feeling irritated by one’s daily commute or the stress of cooking dinner for the family. Even though major stressors can lead to pregnancy problems, taking steps to manage stress, like seeing a therapist, may help reduce the negative impact of these stressors.
Symptoms of Stress During Pregnancy
Most pregnant women experience stress at some point during pregnancy, but stress affects each woman differently. For some people, stress may present as physical symptoms such as nausea and headaches. For others, stress may present as emotional or mental symptoms. Stress itself is not a mental health disorder, but if stress persists and gets to the point of interfering with a person’s life, then it may lead to a mental health condition like anxiety.
Some symptoms of stress during pregnancy include:4
- Body aches and pains, including headaches and stomachaches
- Feeling like a person has no control
- Difficulty sleeping
- Low energy
- Lack of pleasure
- Difficulty remembering things
- Skin problems, like rashes
- Low libido
How Does Stress Affect Pregnancy?
Stress during pregnancy can arise for a number of different reasons. People who are pregnant may feel stressed about their pregnancy, especially if they have complications like high blood pressure, gestational diabetes, and preeclampsia. Pregnant women may also feel stressed by other unrelated issues like finances, work or school responsibilities, caring for other children, and conflict in relationships. Pregnancy is a time when a woman undergoes significant hormonal shifts, which may also contribute to an increase in feelings of stress, anxiety, and depression.5
High levels of stress during pregnancy can have a physical and emotional impact on the mother. Mothers who are stressed during pregnancy have a higher risk of miscarriage and are more likely to develop pre-eclampsia, a dangerous condition that involves high blood pressure.6 Stress during pregnancy is also linked to depression and anxiety for the mother.1
Experiencing depression and anxiety during pregnancy is concerning because it increases the risk of postpartum depression, a form of depression that develops shortly after giving birth.7 Women dealing with stress during pregnancy may have a more difficult pregnancy and a hard time enjoying the experience of being pregnant.
Stress and Pregnancy’s Effect on the Fetal Brain
Experiencing too much stress during pregnancy can have harmful effects on an unborn baby. Pregnancy stress is linked to complications like low birth weight and preterm delivery (giving birth before 37 weeks gestation).8 These complications are concerning because they are also linked with infant death and health problems for the baby later in life.
Can high levels of stress in pregnancy hurt your baby later in life?
Children exposed to stress in utero are more likely to have childhood diseases and major congenital malformations, which are birth defects that occur to the structure or functioning of certain parts of the body.6 Pregnant women who experience high levels of stress are also less likely to be proactive about their health. Women dealing with stress are more likely to smoke, consume large amounts of caffeine, and eat an unhealthy diet, which all can have harmful effects on the baby.
10 Tips for How to Reduce Stress During Pregnancy
If you are pregnant, it is likely that you will experience stress at some point. Fortunately, there are steps you can take to help yourself better cope with stress when it does come up. Taking care of your body and mind and seeking support and education are helpful ways that you can combat the impact of stress during your pregnancy.
Here are ten tips for reducing stress during pregnancy:
1. Practice Mindfulness
Mindfulness is the practice of present-moment awareness without judgment. It can involve a formal practice of sitting down to meditate or simply taking a moment to take a few deep breaths and tuning into the present. Several studies on mindfulness during pregnancy have shown that it can help reduce depression, anxiety, and stress.9 Mindfulness can also help pregnant women feel more accepting of their thoughts and feelings, less reactive to stress and avoidant of stressful situations, and more empowered about labor.
You can practice mindfulness in several different ways. If you are a beginner, you may choose to watch a video online, listen to a guided meditation on a mindfulness-based app like Calm or Headspace, or take a meditation class. If you are more experienced or would like to informally practice, you can find a quiet space, get comfortable, and take a few deep breaths. You can then select an “anchor,” which can be anything that you can focus your attention on, such as your breath, sounds in your environment, smells or tastes, or a mantra.
During this practice you may notice thoughts, feelings, and other sensations come up. This is normal. Instead of judging yourself for this or getting your mind caught up in them, make an effort to redirect your attention back to your anchor. Your mind may wander several times during your practice. To practice mindfulness, just continue to bring your attention back to the present moment and your anchor. This is the act of being mindful.
Practicing mindfulness can be challenging, even with experience. The key is to acknowledge and let go of judgments and maintain consistency in your practice. Even just a few minutes of mindfulness each day can help you feel more relaxed and be able to calm your anxiety before it gets out of control.
2. Attend a Pregnancy Support Group
Pregnancy support groups can provide you with a safe space to share your thoughts with a group of women who may be having similar feelings and experiences. They also allow you to give and receive feedback and advice from others. This can help you realize that your feelings are normal and provide you with different ways of thinking about or approaching a problem. Feeling supported during pregnancy can also help you after your pregnancy is over. One study found that having more support during pregnancy was linked to lower rates of postpartum depression.10
Support groups are usually run by a mental health professional or someone who is trained to run groups. You can attend local in-person groups or support groups online. In-person groups can provide you with an opportunity to connect face-to-face, while online groups can be helpful if you don’t have a lot of time, feel anxious about attending in-person, or do not have any groups in your area. Either way, finding a supportive group to speak with can be beneficial.
3. Aim for at Least 8 Hours of Sleep per Night
Sleep is essential for mental well-being, but can be especially challenging during pregnancy. Pregnant women’s sleep may be interrupted by feeling uncomfortable and frequent trips to the bathroom. Lack of sleep during pregnancy can both cause stress and also be a symptom of stress.11 If you are already feeling stressed, you might find your mind racing when it’s time to go to bed. There are steps you can take to try to improve your sleep, but if you continue to have a hard time, consider discussing this issue with your medical provider or a sleep specialist.
To improve the quality of your sleep, try to practice good sleep hygiene.12 This includes avoiding caffeine, sugar, and large meals before bed, not utilizing electronic devices in the evening hours, and making sure that your bedroom area is cool, dark, and quiet. If you need noise to fall asleep, opt for relaxing sounds or white noise, which are less stimulating than having a television on in the background.
Create a bedtime routine that includes laying down and waking up around the same time each day, including on weekends. Try to exercise earlier in the day, which can help you feel more tired during bedtime. Also, if you are having trouble falling asleep, avoid watching the clock. Instead, practice some deep breathing or mindfulness to help you feel more relaxed.
4. Engage in Light Exercise at Least Three Times per Week (With Your Doctor’s Approval)
Exercise during pregnancy can be beneficial not only for your physical health, but also your mental health. Women who exercise during pregnancy show lower rates of depression during pregnancy and the postpartum period.13 Many women describe exercise as being a good stress relief and self-care activity.
Before starting an exercise routine, be sure to speak with your doctor. In general, it is recommended to do light to moderate exercise if you did not exercise much prior to pregnancy, or moderate to high intensity if you were very active prior to pregnancy.13 You can consider low-impact activities like walking, prenatal pilates or yoga, or light weight training at least three days per week.
If you dread the idea of exercising, consider inviting a friend to take a walk or join a prenatal class. Be sure to monitor how you feel while exercising and do not exert yourself to the point that you cannot hold a conversation without losing your breath. If something feels uncomfortable or too difficult, take it easy.
5. Eat a Well-Balanced Diet
Eating a healthy diet can benefit your physical and mental health during pregnancy. When you feel better, you are likely to think better, which can help you more effectively handle stressful situations that may come up. Consuming omega-3 fatty acids has been linked to lower levels of stress in pregnant women.14 Omega-3 fatty acids are a type of healthy fat found in certain fish like salmon, as well as walnuts, flaxseed, and chia seeds. If you are consuming fish during your pregnancy, be sure to avoid those that are high in mercury, like swordfish and shark, and limit it to one to two times per week.
It is recommended that pregnant women eat a diet that contains healthy fats, whole grain carbohydrates, fruits, and vegetables and avoids alcohol, high levels of caffeine, fish that contain high levels of mercury, and foods that increase the risk for foodborne illnesses.15 During pregnancy, women require higher levels of certain vitamins and nutrients, including iron, calcium, folic acid, and vitamin D.
Women who were a healthy weight before pregnancy are encouraged to gain approximately 25 to 35 pounds. Women who were previously underweight should gain more, while women who were overweight should gain less. For more information about how to eat healthy during pregnancy, speak with your doctor, midwife, or a registered dietician or nutritionist.
6. Attend a Labor and Delivery or Newborn Preparation Class
For some women, stress during pregnancy is caused by the unknowns of the future. Pregnant women may feel overwhelmed thinking about labor and delivery or caring for a newborn. To help ease your concerns, consider attending a class that is designed to help you prepare for birth or motherhood. Women who attend birthing classes report feeling more positive and confident about labor and delivery.16
Many hospitals, birthing centers, and local midwives and doulas host classes for this purpose. If there are no classes in your area, you may be able to find one online. Attending one of these classes will give you an opportunity to learn more about what to expect and answer any questions that you may have. This can help you feel more certain about the future and confident moving forward in your pregnancy.
7. Create a To-Do List
Pregnant women often report feeling like they have “so much to do” and “not enough time.” It is true that there are many tasks to complete before the baby arrives, but many women get so overwhelmed with how much they have to do that they struggle to take action. A big challenge is the fact that you don’t know when the baby will arrive, so it’s impossible to know how long you have to get everything done.
Making a to-do list of all the tasks you’d like to complete before the baby comes seems simple, but many women fail to do it. Take some time to jot down everything that you’d like to get done. This can include setting up the nursery, registering for baby gifts, and baby proofing your home, to name a few. Once you have a list prepared, it can help to go through and indicate which tasks are most urgent and which ones can potentially wait until after the baby is born. For example, putting the bassinet together is urgent, but baby proofing could wait if you run out of time.
8. Set Small Goals
Now that your to-do list is prepared and you have an idea of which tasks are urgent and which ones aren’t, it’s time to set goals for yourself. The thought of tackling a long to-do list can be very overwhelming when you’re pregnant and not fully feeling like yourself. That is why it’s important to set small, attainable goals. For example, you may decide to tackle one item on the to-do list each day.
It’s important that you set your goals to be attainable. Remember that what you could accomplish pre-pregnancy is not the same as what you can accomplish while pregnant. Avoid shaming yourself and practice self-compassion. And don’t be afraid to ask for help.
9. Say “No” More Often
Taking on too many responsibilities can lead to stress and burnout. If you’re a people-pleaser, then this is especially true. To help prevent or reduce stress, don’t hesitate to say “no” when a favor is asked of you. This is one way of setting healthy boundaries in relationships.
Setting healthy boundaries is important to start before you give birth. When a baby arrives, there are countless demands placed on you and you will be faced with needing to prioritize what is most important. Getting comfortable saying “no” can help prepare you for this next phase.
10. Create a Maternity Leave Plan
For many pregnant women, work and finances are a source of stress during pregnancy. Figuring out how much time to take off, who will take over your work responsibilities, how to transition back after maternity leave, and how to manage finances can be overwhelming. Once you share your pregnancy news with colleagues, you can start the process of planning your maternity leave. There is no “right” time to tell your supervisor and colleagues, but many women choose to do so around 20 to 24 weeks of pregnancy.
A maternity leave plan has two components: one is how your job will be managed in your absence and the other is how you will personally manage being out of work and your transition back. The first part will be a collaboration with your colleagues. The second part can be developed with the help of your partner, family, and friends. Don’t be afraid to ask other people for advice or feedback on how to plan for maternity leave. Having a good solid plan in place during your pregnancy can help reduce some stress and worry.
When to Call the Doctor About Stress During Pregnancy
If you have attempted to cope with your stress on your own but are continuing to struggle or if your stress is severe and impacting your ability to function, you should consider getting professional help. Treatment for stress during pregnancy may include therapy, medication, or a combination of both. To find out more about these options, speak with your physician, OBGYN, or midwife about how you are feeling and what options may be available to you.
Therapy for Pregnancy Stress
Therapy can be a beneficial treatment option for women dealing with pregnancy stress. Therapy involves meeting with a psychologist, social worker, counselor, or therapist either individually or in a group. It provides you with an opportunity to talk about how you are feeling and learn healthier ways to cope with your emotions.
Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are two types of therapy that are effective for treating depression during pregnancy.17 CBT helps you identify when you are having unhealthy or irrational thoughts and teaches you how to change them. IPT focuses on helping you improve your relationships, which in turn helps you improve your emotional state. Some therapists may also utilize other approaches, like psychodynamic or solution-focused therapy, to help pregnant women better cope with stress.
Medication for Pregnancy Stress
Mental health medications, like antidepressants, anti-anxiety medications, and mood stabilizers, may be prescribed for certain women who are struggling to cope with stress, depression, anxiety, or other emotional challenges during pregnancy.18 Research on taking these medications while pregnant is limited.
Certain medications do carry risks to the unborn fetus, so these medications are generally avoided. If your doctor feels that you may benefit from anxiety medication during pregnancy, they will consider the pros and cons and help you decide whether this is the right option for you. Be sure to consult with a psychiatrist or psychiatric nurse practitioner that specializes in working with perinatal mental health.
For Further Reading
For more information about dealing with stress during pregnancy, see the following organizations: