Can Stress During Pregnancy Cause Miscarriage?

stressed pregnant woman

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Depending on whom you ask, stress during pregnancy is either a risk factor for miscarriage and stillbirth or it's an outright myth that stress has any relation to pregnancy loss. The truth is somewhere in the middle.

Stress and Miscarriage

Old wives' tales have long linked bad moods during pregnancy to strange consequences, but the idea that stress during pregnancy could affect the baby may be rooted in actual science. Studies have found a link between high levels of stress during pregnancy and risk for outcomes ranging from miscarriage to health and learning problems in the child, but researchers don't quite agree on what the results mean.

It's very hard to study and evaluate stress as a factor in pregnancy loss. Everyone feels some level of stress in day-to-day life. And everyone processes that stress differently. A minor irritation to one person might be the cause of a panic attack in another.

In pregnancy, this is also true. Every pregnant woman worries at least a little bit during the pregnancy, whether it's about the pregnancy or about other life factors. Some worry a lot. This has most likely been going on since the beginning of time, and yet the majority of pregnant women give birth to healthy babies.

When you start talking about stress as a factor in pregnancy loss, it's easy to look back and conclude that you had a miscarriage because you were too stressed out—which can lead to self-blame, especially in unexplained miscarriages. It's even easier for other people to do this and to imply that you would never have miscarried you had just remembered to "relax." This, of course, leads to additional stress in worrying about how to stop worrying.

Theories on the Role of Stress

Theories vary on exactly why stress during pregnancy would affect the baby, but some center around a hormone called cortisol. Cortisol tends to be elevated in people feeling stressed. Some elevation is normal during pregnancy, but above-average elevations could be linked with miscarriage. Some scientists believe that this elevated cortisol could cross the placenta and interfere with development.

In a 2008 study, researchers administered the 12-item General Health Questionnaire (GHQ) about stress to nearly 20,000 women, and found that those reporting higher levels of stress had a higher risk of stillbirth when compared to women with intermediate levels of stress. Adjustment with a variety of other factors, such as mother's age or health risk factors, did not change the results.

In addition, a 2013 study found connections between levels of the enzymes that help the body regulate stress and increased risk of miscarriage. Meanwhile, other studies have looked into the connection between depression and recurrent pregnancy loss. For instance, a 2015 study also found both depression and "psychological stress" were more common in women who had recurrent miscarriages.

Looking at preterm birth, which is a risk factor for newborn infant loss, a 2015 research review (an analysis of 39 previous studies) found links between mothers experiencing depression, anxiety and stress and preterm labor and subsequent birth. It's important to note that the effects of pregnancy distress were only associated with spontaneous preterm birth. Other studies had similar findings showing stress as a risk factor for preterm birth and low birth weight, with outcomes varying by the level of stress and timing of the stressful events.

Cortisol levels are only one method by which stress could have a role in miscarriages. Others include the effect of stress on the function of the immune system, while others may consider the levels of neurotransmitters in the brain.

Evidence Against a Connection

Not every study looking at stress during pregnancy has found evidence of a link with miscarriage. A 1998 study found no increased risk in women who had elevated cortisol and other hormonal markers associated with stress. In this study, there was very little association between psychological scores and stress hormone concentrations.

Meanwhile, a follow-up 2014 review study looking at cortisol levels and in vitro fertilization outcomes, including miscarriage, showed mixed results.

Another study found that women under stress were more likely to use drugs like cigarettes and marijuana, which might be risk factors for miscarriage independently.​But, in this 2003 study, researchers also found that women reporting high stress in early pregnancy did not have a higher risk of miscarriage when looking at stress as the only factor.


Currently, no one is able to say conclusively that "stress causes miscarriages," but it also doesn't seem accurate to say that it's a myth that stress can cause pregnancy loss.

It is unlikely that normal everyday stress and worries, such as worrying about your finances or deadlines at work, would have an effect on pregnancy, but it is possible that major levels of stress could cause miscarriage or later pregnancy loss. For example, one study showed that sudden unexpected unemployment during times of economic downturn was associated with greater numbers of pregnancies ending in miscarriage.

Regardless of the link with miscarriage, stress during pregnancy may affect the baby in other ways, It's always a good idea to make stress management a priority in your life. Stress may be unavoidable for many people, especially if you're dealing with something like infertility or recurrent miscarriages, but it might be a good idea to look into doing whatever you can to alleviate anxiety. In doing so, you might improve your odds for a healthy pregnancy as well as your overall health.

Simply put, there is no downside to incorporating more relaxation and stress management into your life.

Stress Management

There are some stressors that simply can't be avoided when pregnant, but what we can do is alter the way we experience stress. The art of looking at a situation in a new light so that it is experienced in a different way is referred to as "cognitive reframing." Cognitive reframing is essentially a way of consciously looking at the glass a half full rather than half empty.

For example, you may picture two different women going through chemotherapy with drugs that cause hair loss. One woman may find it incredibly stressful to lose the hair on her head. Another, through reframing, may focus on something she sees as a benefit, such as not needing to shave her legs for several months.

Reframing takes effort, and sometimes you have to "fake it until you make it”—meaning that you may need to intellectually look at the positives even though your feelings still point out the negatives. Take some time to learn techniques for stress management, methods that may not only help you lessen any risk of stress upon pregnancy but can help you live healthier in all other areas of your life as well.

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