Can Stress Cause Premature Labor?

A pregnant women at her desk, head in hands.

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If you're having a stressful pregnancy, my heart goes out to you. Dealing with the symptoms of pregnancy can be hard enough when life is going well. When life is stressful, it's even more difficult to cope with all that comes with pregnancy.

Although stress can be more challenging to manage during pregnancy, it's important to try to relax. Stress, especially chronic stress, can increase your risk of having a small baby or going into premature labor (also known as preterm labor).

Stress and Preterm Labor

The beginning of labor is a complex process that is not fully understood. Multiple hormones and body systems in both mother and baby are involved, and predicting when labor will start is very difficult. Because labor is complicated and hard to study, scientists can't say for sure that stress causes preterm labor.

However, there is an association. In other words, studies show that mothers who experience more stress are more likely to go into labor early, so stress increases a mother's risk of premature labor. During stressful situations, the body reacts in a number of ways. For instance, heart rate and blood pressure increase, and hormones flood the body.

It's important to realize that stress can be either acute or chronic.

  • With acute stress, the body's reaction is temporary and short-lived. Afterward, the body returns to its normal state.
  • With chronic stress, whatever is bothering you is ongoing or recurs. As a result, the body never returns to its normal state.

Acute stress does not increase the chances that a mother will go into preterm labor. If you have, say, an occasional argument with your baby's father or have trouble paying the bills sometimes, you're not at higher risk. However, the changes that chronic stress makes to the body are what doctors think might contribute to preterm labor.

Chronic stress causes long-term changes in the body's vascular system, hormone levels, and the ability to fight infection. These changes could all potentially influence labor to start before the baby is full-term (at least 37 weeks gestation).

For example, dealing with a divorce, the death of a loved one, long-term unemployment, or anxiety related to your pregnancy could all cause the kind of chronic stress that increases your risk for preterm labor.

Reducing Stress During Pregnancy

There are a few things that you can do to lower stress during pregnancy (and these are also excellent ideas if you're not pregnant). More research needs to be done into exactly which relaxation strategies will help decrease the risk of preterm birth, but anything that reduces chronic stress could possibly increase your chances of having a term baby.

  • Alternative therapies: Massage, aromatherapy, acupuncture, and hypnotherapy have been shown to help to reduce stress. (Though note that no studies have shown whether they reduce the risk of preterm birth, specifically.)
  • Counseling: In one small study, researchers found that mothers with chronic stress who received psychological counseling during their pregnancies were less likely to deliver early.
  • Exercise: Low-impact activities usually recommended during pregnancy include brisk walking, swimming, stationary cycling, and using an elliptical or stair-climber. Yoga has been shown to improve pregnancy outcomes and reduce the risk of preterm birth. Talk to your physician about safe exercise during pregnancy and what to avoid (such as lying on your back or stomach).
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  • Latendresse, G. "The Interaction Between Chronic Stress and Pregnancy: Preterm Birth From a Biobehavioral Perspective." Journal of Midwifery and Women's Health 2009: 54, 8-17.

By Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia.