Many of us imagine pregnancy as a wonderful phenomenon, blissful and carefree, and while it’s mostly true, there are also some realities we cannot avoid such as stress during pregnancy.
Your Hardworking Body
During pregnancy, your body undergoes very drastic changes. The total volume of blood in your body increases by up to 2 litres. This translates into your heart having to pump 2 full large soda bottles worth of extra fluid around your body.
In addition, as your uterus grows to accommodate your baby, your organs start to work twice as hard in half the space after they get displaced.
For example, your lungs are pushed higher due to the larger uterus but you still need to have enough oxygen in your blood for both you and your child, hence many pregnant ladies find they have to breathe harder as they progress through the pregnancy.
And as if making your heart and lungs work overtime for nine months is not stressful enough, your hormones also get drastically altered during pregnancy.
Human chorionic gonadotropin, a hormone essential for maintaining the early embryo, and also the hormone which increased levels are linked to nausea and vomiting in early pregnancy, is zero in non-pregnant ladies and increases to a peak of up to 100,000 units around Week 10 of your pregnancy.
Stress During Pregnancy
These physiological changes alone are enough to make most women stressed. Adding on environmental pressures like squabbles with the partner and deadlines from work, pregnancy for the modern woman can be nerve-wracking.
A large study from the USA on 2,000 pregnant women in 2010 reported only 16 per cent of all the women saying they had no stress during the pregnancy, while 78 per cent reporting low to moderate amounts of stress and up to 6 per cent reporting high amounts of stress.
Such statistics mean that if you were in the doctors’ waiting room with other pregnant ladies, you are 5 times more likely to meet a pregnant lady who is stressed than one who is stress-free.
Stress in and of itself is not bad. In fact, stress is a survival tool that our body has retained as we evolved as a species. The stress reaction, as it is formally known as, is a mechanism by which the body responds to impending danger. By releasing chemical mediators such as adrenaline and cortisol, the body primes us for “fight or flight” situations like spotting a lion charging towards us and starting to run.
Negative Effects of Stress During Pregnancy
Yet as with most things, too much of a good thing can be bad. Research shows that repeated activation of the stress reaction puts a significant amount of strain on our body.
Adrenaline, for example, is meant to increase the overall function of our heart, good when you need to make a quick escape but prolonged stimulation of the heart cells with adrenaline has been shown to lead to hypertension and cardiovascular disease.
Similarly, cortisol increases our metabolism to breakdown fat for energy but can lead to chronic conditions such as diabetes when secreted in excessive amounts.
The American College of Obstetricians and Gynecologists recognises that stress is an independent risk factor for pre-term birth. Data from large hospitals have found that pregnant ladies who are more stressed were 4 times as likely to have pre-term labour.
Further studies have also drawn causal links between prolonged stress to other major complications such as:
- maternal hypertension
- low birth weight
- delayed neuropsychological development in the child later on in life
Major theories posit that excess cortisol released during stress increases the frequency of contractions leading to pre-term labour while excess adrenaline increases maternal blood pressure by narrowing blood vessels in the body including those in the placenta, eventually decreasing blood supply to the fetus leading to low birth weights and potentially other long time developmental issues.
Moreover, studies showed that higher levels of cortisol in mothers were linked to structural changes in the baby’s amygdala, an area of the brain involved in a child’s emotional and social development.
It found that children whose mothers had high levels of stress during pregnancy were more likely to have emotional issues growing up. Learn more about that here.
It doesn’t take an expert to know that excessive stress during pregnancy is harmful to both the mother and her unborn baby. Numerous studies have proven it. So what can you do to prevent this?
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Dealing With Stress and Anxiety While Pregnant
It is important for pregnant women to learn how to manage their stress levels for their own well-being and that of their baby’s. Here are some things you can do to minimise stress while you’re pregnant:
1. Identify when you are stressed.
There is a range of verified tests specific to pregnant patients to help doctors assess the level of anxiety and stress in a patient such as the Pregnancy Stress Rating Scale. However, no test can replace the patients’ insight into her own situation.
Recognising that you are stressed enables you to seek help. Good social support is essential in reducing stress, especially during pregnancy. You are going through a drastic change in your life and should not hesitate to reach out to friends or relatives.
2. Rationalising your outlook towards pregnancy.
Rationalising your outlook to one that truly represents how you feel can reduce the stress of performing to expectations we impose on ourselves.
Social media tends to ingrain in us an idealised version of pregnancy, I have noticed that this leads to several of my pregnant patients saying that they feel guilty if they do not “enjoy” the pregnancy more and if they “complain” about how difficult it is. Pregnancy is amazing but it is also challenging. There is no shame in saying it is tough.
3. Choose activities to help yourself relax.
Relaxation can be thought of in 2 categories, active and passive. Exercise is an example of active relaxation, low-intensity exercise such as walking is a good activity to maintain throughout the pregnancy.
Passive relaxation is another means of de-stressing, particularly when you are tired from a long day at work and do not really feel like exercising. Passive relaxation focuses more on decreasing the mental aspect of your stress, meditation and deep breathing techniques are some of the ways to achieve this.
In conclusion, pregnancy is a physically demanding process that without complications already places a great demand on the woman. Stress from the environment precipitates in a stress reaction that in the long term can be detrimental to our health particularly if in a pregnant woman. Therefore, the identification of stressors and early intervention is key to ensure a healthy and smooth pregnancy.
This article was written by Dr Matthew Tan, a resident doctor at DTAP Clinic. He is an avid advocate for the accessibility and inclusivity of health care and firmly believes that every person should be given the chance to understand their medical conditions and work together with their doctors to achieve their health goals.
Updates by Camille Eusebio
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