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Severe stress is associated with a higher risk of miscarriages, preterm labour and lower birth weight. It may also be associated with changes in babies' behaviour. Long-term studies, such as the Avon study in England which monitored a large group of babies as they grew over a twenty-year-period, indicate that higher rates of emotional and behavioural problems occur in children whose mothers were exposed to extreme stress in pregnancy.
How does this happen?
One explanation relates to a hormone called cortisol - the "stress" hormone of the body. When we are stressed, cortisol levels surge in the bloodstream. In pregnant women, the placenta blocks most of the cortisol from entering the baby's circulation. Some cortisol, however, does get through. In a woman who is severely stressed, excessive amounts may well reach the baby. It is thought that cortisol alters brain development in the child.
Unborn babies are also finely tuned to their mothers' states. With stress, a woman's heart will rise. Studies in the US have shown that when women are mentally stressed, the rise in their babies' heart rate mirrors that of their own.
SA research
The MRC Anxiety Disorders Unit at the University of Stellenbosch is doing further redsearch in this field. They are following a group of pregnant women from the beginning of pregnancy, and are looking at detailed ultrasounds of brain development, monitoring foetal heart rate and then following the babies' development. In doing so, they hope to understand more about how maternal stress affects babies.
When to worry
A certain degree of stress in pregnancy is normal. Pregnancy is a time of great change - there are physical changes, hormone levels rise dramatically and it's normal to feel anxious about the impending birth. Relationships are also changed by the prospect of a new child and financial pressures increase.
Bouts of weepiness and sudden urges to murder your partner, because he left his dirty socks on the bedroom floor, are probably within the bounds of normality. However, persistent low mood, irritability, marked anxiety and feelings of not coping are definitely causes for concern. Pregnant women who experience these feelings should seek help. A gynae, family doctor or clinic sister are good people to turn to for help. The Post Natal Depression Support Association of South Africa also has help lines and their staff members are always ready to provide support and help.
Even if a pregnant woman is not feeling severely stressed, it's a good idea to look at ways of reducing and coping with stress. Support from others is one of the best ways of doing this and may well buffer the negative effects of even severe stress.
Tips to combat stress
The MRC Research Unit of Anxiety and Stress Disorders offer the following advice to pregnant women:
- Get support from others – the partner, friends and family
- Join an antenatal class to meet other pregnant mums who may share your concerns.
- Pamper yourself a little - even an extra five minutes to yourself every day can make a world of difference.
- Gentle exercise (with your doctor's permission) is also an excellent stress reliever.
World Health Day 2005 focuses on the inter-dependence of good mental and physical health at every stage of life. One could start doing that even before children are born by taking care of both the physical and mental health of pregnant women.
Useful numbers
- PNDSA - (021) 797 4498
- Life Line - (021) 461 1111 or (011) 728 1347
- La Leche League - (021) 976 8537 for Durbanville, (021) 393 1634 for Strandfontein.
- The Sister Lilian Centre - (012) 804 4418 or (012) 804 0909
- Dr Alison Sampson - (031) 201 0835
- Mother's Line - (031) 265 9790
- Single parents of Young Kids (SPYK) - Justine Saunders - 084 421 2224
For more information on World Mental Health Day, please contact Winnie De Roover at the Mental Health Information Centre, Tel: 021 938 9229, Fax: 021 931 4172, winnie@sun.ac.za.
- Source: Dr Bavi Vythilingum, Fellow of College of Psychiatrists MRC Research Unit on Anxiety and Stress Disorders
