Stress and pregnancy

How can stress affect your pregnancy?

Feeling stressed is common during pregnancy because pregnancy is a time of many changes. Your family life, your body and your emotions are changing. You may welcome these changes, but they can add new stresses to your life.

High levels of stress that continue for a long time may cause health problems, like high blood pressure and heart disease. During pregnancy, stress can increase the chances of having a baby who is preterm (born before 37 weeks of pregnancy) or a low-birthweight baby (weighing less than 5 pounds, 8 ounces). Babies born too soon or too small are at increased risk for health problems.

What causes stress during pregnancy?

The causes of stress are different for every woman, but some common causes include:

• Dealing with the discomforts of pregnancy, like morning sickness, constipation, being tired or having a backache.
• Changes in your hormones, which can cause your mood to change. Mood swings can make it harder to handle stress.
• Feeling worried about what to expect during labor and birth or how to take care of your baby. If you work, you may have to manage job tasks and prepare your team for when you take maternity leave.
• Problems with your partner or your family, or feeling as if you do not having enough support.

What types of stress can cause pregnancy problems?

Talk with your health care provider if you have these types of stress:

• Negative life events. These are things like divorce, serious illness or death in the family, or losing a job or home.
• Catastrophic events. These include earthquakes, hurricanes or terrorist attacks. 
• Long-lasting stress. This type of stress, also called chronic stress, can be caused by stressful things you experience for a long time. Exposure to racism, especially life-long racism, causes increased stress levels. Other things that cause this type of stress include, having problems with money, having an abusive partner, living in an unsafe or unstable environment and having serious health problems.
• Depression or anxiety. Depression is a medical condition that causes feelings of sadness and a loss of interest in things you like to do. It can affect how you feel, think and act and can interfere with your daily life. Anxiety is a feeling of worry or fear of things that may happen. Both conditions may make it hard to take care of yourself and your baby. Depression and anxiety are common and treatable so talk to your provider if you feel depressed or anxious. If you have these conditions before pregnancy, talk to your provider before you stop or start taking medications. Stopping suddenly can cause serious problems for you and your baby. If you need to stop taking medicine or switch medicines, your health care provider can help you make changes safely.
• Pregnancy-related stress. Some parents may feel serious stress about pregnancy. They may be worried about pregnancy loss, the health of their baby or about how they’ll cope with labor and birth or becoming a parent. If you feel this way, talk to your health care provider.

Health Disparities and Racism

Some pregnancy complications happen more often in some groups compared with others. We call this a health disparity (difference). To understand why some groups are at a higher risk of having a complication, we need to look at social factors that affect them. These are referred to as social determinants of health. They are the conditions in which you are born, grow, work, and live. These conditions affect your health throughout your life. In many cases, social determinants of health and health disparities are related to racism.

Racism refers to the false belief that certain groups of people are born with qualities that make them better than other groups of people.

Racism isn’t limited to personal attacks such as ethnic slurs, bullying, or physical assault. In a racist culture, one group of people has more power than other groups. People in the dominant racial or ethnic group make important decisions that affects everyone’s lives. For example, they have a lot of control over the way that schools, health care, housing, laws and law enforcement work. This control means that people in the dominant group are more likely to:

• Have better education and job opportunities
• Live in safer environmental conditions
• Be shown in a positive light by media, such as television shows, movies, and news programs.
• Be treated with respect by law enforcement
• Have better access to health care

In contrast, people from racial or ethnic minority groups who live in a racist culture are more likely to:

• Experience chronic stress
• Live in an unsafe neighborhood
• Live in areas that have higher amounts of environmental toxins, such as air, water, and soil pollution
• Go to a low-performing school
• Have limited access to healthy foods
• Have little or no access to health insurance and quality medical care
• Have less access to well-paying jobs

The role of chronic stress

Studies have shown that the chronic stress caused by living in a racist culture is a factor in many health conditions, including having a preterm or low-birthweight baby. While some studies and statistics mention race as a risk factor for these conditions, we can’t say that race itself the cause. More research is needed to understand the connections between racism, stress, and health problems.

How does stress cause pregnancy problems?

We don’t completely understand how stress affects pregnancy. Certain stress-related hormones may play a role in causing certain pregnancy complications. Serious or long-lasting stress may affect your immune system, which protects you from infection. This can increase your risk for infections, and certain infections can increase the risk of preterm birth. 

Other ways stress can cause pregnancy problems include:

• Normal pregnancy discomforts, like trouble sleeping, body aches and morning sickness may feel even worse with stress
• You may have problems eating, like not eating enough or eating too much. This can make you underweight or cause you to gain too much weight during pregnancy. It also may increase your risk of having gestational diabetes and preterm labor.
• Stress may lead to high blood pressure during pregnancy. This puts you at risk of a serious high blood pressure condition called preeclampsia, preterm birth and having a low-birthweight infant.
• Stress also may affect how you respond to certain situations. Some women deal with stress by smoking cigarettes, drinking alcohol or taking street drugs, which can lead to serious health problems in you and you baby.

Many parents worry that stress may lead to miscarriage, which is the death of a baby before the 20th week of pregnancy. More research is needed to understand how stress may contribute to miscarriage.

How can post-traumatic stress disorder affect pregnancy?

Post-traumatic stress disorder (also called PTSD) is a disorder that develops when you have problems after you experience a shocking, scary or dangerous event. These events may include rape, abuse, a natural disaster, a terrorist attack or the death of a loved one. People with PTSD may have:

• Serious anxiety
• Flashbacks of the event
• Nightmares
• Physical responses (like a racing heartbeat or sweating) when reminded of the event

Parents who have PTSD may be more likely than those who don’t have it to have a preterm or low-birthweight baby. They also are more likely to smoke, drink alcohol, or have a substance use disorder. These things can increase the risk of problems during pregnancy. If you think you may have PTSD, talk with your provider or a mental health professional. Treatments for PTSD include medications and therapy.

Can high levels of stress in pregnancy affect your baby’s health later in life?

Some studies have shown that high levels of stress in pregnancy may cause certain problems during childhood, such as trouble paying attention or other mental health conditions. It’s possible that stress also may affect your baby’s brain development or immune system.

How can you reduce stress during pregnancy?

Here are some ways to help you reduce stress:

• Know that the discomforts of pregnancy are only temporary. Ask your provider about how to handle these discomforts.
• Stay healthy and fit. Eat healthy foods, get plenty of sleep and exercise (with your provider’s OK). Exercise can help reduce stress and also helps prevent common pregnancy discomforts.
• Cut back on activities you don’t need to do. For example, ask your partner to help with  chores around the house. 
• Try relaxation activities, like prenatal yoga or meditation. They can help you manage stress and prepare for labor and birth.
• Take a childbirth education class so you know what to expect during pregnancy and when your baby arrives. Practice the breathing and relaxation methods you learn in your class.
• If you’re working, plan ahead to help you and your employer get ready for your time away from work. Use any time off you may have to get extra time to relax.
• With economic problems or other situation related problems a consultation with a social worker may help find solutions.

The people around you may help with stress relief too. Here are some ways to reduce stress with the help of others:

• Have a good support network, which may include your partner, family and friends. Or ask your provider about resources in the community that may be helpful.
• If you think you may have depression or anxiety, talk with your provider right away. Getting treatment early is safe in pregnancy and important for your health and your baby’s health.
• Ask for help from people you trust. Accept help when they offer. For example, you may need help cleaning the house, caring for other children or you may want someone to go with you to your prenatal visits.

Last reviewed: February 2023