Emotional and life changes

• Pregnancy brings all sorts of emotional and life changes.
• Stress and depression are common feelings in pregnancy.
• Stay healthy and safe if you’re working during pregnancy.

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Pregnancy is a time of many changes. Your body, your emotions and the life of your family are changing. You may welcome these changes, but they can add new stresses to your life.

Feeling stressed is common during pregnancy. But too much stress can make you uncomfortable. Stress can make you have trouble sleeping, have headaches, lose your appetite or overeat.

High levels of stress that continue for a long time may cause health problems, like high blood pressure and heart disease. When you’re pregnant, this type of stress can increase the chances of having a premature baby (born before 37 completed weeks of pregnancy) or a low-birthweight baby (weighing less than 5½ pounds). 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 here are some common causes during pregnancy:

• You may be dealing with the discomforts of pregnancy, like nausea, constipation, being tired or having a backache. 
• Your hormones are changing, which can cause your mood to change. Mood swings can make it harder to handle stress. 
• You may be 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 responsibilities and prepare your employer for time away from your job. 
• Life is busy and it sometimes takes unexpected turns. That doesn’t stop just because you’re pregnant.

What types of stress can cause pregnancy problems?
Stress is not all bad. When you handle it right, a little stress can help you take on new challenges. Regular stress during pregnancy, such as work deadlines and sitting in traffic, probably don’t add to pregnancy problems.

However, serious types of stress during pregnancy may increase your chances of certain problems, like premature birth. Most women who have serious stress during pregnancy can have healthy babies. But be careful if you experience serious kinds of stress, like:

• Negative life events. These are things like divorce, serious illness or death in the family, or losing a job or home. 
• Catastrophic events. These are things like earthquakes, hurricanes or terrorist attacks. 
• Long-lasting stress. This type of stress can be caused by having financial problems, being abused, having serious health problems or being depressed. Depression is medical condition where strong feelings of sadness last for long periods of time and prevent a person from leading a normal life. 
• Racism. Some women may face stress from racism during their lives. This may help explain why African-American women in the United States are more likely to have premature and low-birthweight babies than women from other racial or ethnic groups. 
• Pregnancy-related stress. Some women may feel serious stress about pregnancy. They may be worried about miscarriage, 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.

Does post-traumatic stress disorder affect pregnancy?
Post-traumatic stress disorder (PTSD) is when you have problems after seeing or experiencing a terrible event, such as 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

As many as 8 in 100 women (8 percent) may have PTSD during pregnancy. Women who have PTSD may be more likely than women without it to have a premature or low-birthweight baby. They also are more likely than other women to have risky health behaviors, such as smoking cigarettes, drinking alcohol or taking street drugs. Doing these things can increase the chances of having pregnancy problems. If you think you may have PTSD, talk to your provider or a mental health professional.

How does stress cause pregnancy problems?
We don’t completely understand the effects of stress on pregnancy. But 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 the chances of getting an infection of the uterus. This type of infection can cause premature birth.

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 pregnancy problems.

Can high levels of stress in pregnancy hurt your baby later in life?
Some studies show that high levels of stress in pregnancy may cause certain problems during childhood, like having trouble paying attention or being afraid. It’s possible that stress may also affect your baby’s brain development or immune system.

How can you reduce stress during pregnancy?
Here are some ways to reduce stress:

• Figure out what’s making you stressed and talk to your partner, a friend or your health care provider about it. 
• Know that the discomforts of pregnancy are only temporary. Ask your provider 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. 
• Have a good support network, including your partner, family and friends. Ask your provider about resources in the community that may be able to help. 
• Ask for help from people you trust. Accept help when they offer. For example, you may need help cleaning the house, or you may want someone to go with you to your prenatal visits. 
• Try relaxation activities, like prenatal yoga or meditation. 
• Take a childbirth education class so you know what to expect during pregnancy and when your baby arrives. Practice the breathing and relaxation techniques 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. 
• If you think you may be depressed, talk to your provider right away. There are many ways to deal with depression. Getting treatment and counseling early may help.

Last reviewed January 2012