Can Stress During Pregnancy Cause Miscarriage?

stressed pregnant woman

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Depending on whom you ask, stress during pregnancy is either a proven 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.

The Role of Stress During Pregnancy and Miscarriage

Old wives' tales have long linked bad moods during pregnancy to strange consequences, but the idea that stress during pregnancy would affect the baby may be rooted in actual science.

Dozens of 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. Basically, everyone feels some level of stress in day to day life. It seems to be a part of the human condition. And every person processes that stress differently. A minor irritation to one person might be the cause of a nervous breakdown 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 and let things happen." This, of course, leads to additional stress in worrying about how to stop worrying.

Theories on Stress and Miscarriage

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 during pregnancy also found that women reporting higher levels of stress seemed to have an 80 percent 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 2006 study found evidence that cortisol levels increased above average for pregnancy meant an increased risk of early miscarriage, such as within the first three weeks after conception. A 2002 study also linked depression as being a risk factor for further miscarriages in women who had recurrent miscarriages.

Looking at preterm birth, which is a risk factor for newborn infant loss, a 2003 study examined 1,962 women and found that those who reported high counts of anxiety were more likely to experience preterm labor and subsequent birth. Other studies had previously 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. A 2003 review found that stress during early pregnancy was most likely to be associated with "shortened gestation."

Cortisol levels are but 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 Link Between Stress and Miscarriage

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.

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

With these studies in mind, one could argue that the exact link between pregnancy stress and miscarriage is not fully understood or accepted.

Where It Stands

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. The truth is that it is possible that anxiety and stress could be linked with miscarriage but the evidence is too unclear to draw conclusions.

It is unlikely that normal everyday stress and worries, such as worrying about your finances or deadlines at work, would have any effect on pregnancy, but it is possible that major levels of stress could cause miscarriage or later pregnancy loss. For example, sudden unexpected unemployment during times of economic downturn from 1995 to 2009 in Denmark was associated with a greater risk of a pregnancy ending in miscarriages.

Regardless of the link with miscarriage, stress during pregnancy may affect the baby in other ways and 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 your anxiety and to get your mind off things.

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 to addressing any anxiety disorders that might be affecting your quality of life.

Stress Management for Pregnant Women

There are some stressors that simply can't be avoided when pregnant, but what we can do is alter the way we "experience" stress. In fact, it appears that in some of the studies mentioned it was "perceived" stress rather than actual stressful events that were associated with pregnancy loss.

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 one of the benefits—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 both emotionally and physically in all other areas of your life as well.

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