How Does Stress Affect Pregnancy?

Everyone has stress – even when you’re pregnant.

“Experiencing the whole range of human emotions while pregnant is to be expected,” says Elizabeth Werner, PhD, a researcher and assistant professor of behavioral medicine in obstetrics and gynecology and psychiatry at Columbia University Medical Center. “That’s normal and healthy, and what we should be doing.”

Don’t worry that everyday pressures, like working and taking care of other kids, will hurt your baby or your pregnancy, she says.

“There is no expectation that anyone lives a stress-free life,” Werner says. “That’s just not possible. Some stress in our lives, which we all have, is totally to be expected, and we’re not concerned about it being seriously detrimental to the fetal environment.”

Stress can describe many things, from daily worries to traumatic events like floods and earthquakes, or the complex impact of living in poverty, says Christine Dunkel Schetter, PhD, a researcher and professor of psychology and psychiatry at UCLA. Different types of stress will have different effects. 

“When you take stress in that context, there is no one answer,” Dunkel Schetter says. “There is considerable evidence that some forms of stress pose risk for the mother and the baby and the birth itself.”

What Does the Research Say?

Studies have shown that anxiety during pregnancy is a risk factor for earlier birth. A 2022 study led by Dunkel Schetter found that pregnant people who said they were anxious about their pregnancy, their baby, and giving birth were more likely to have shorter pregnancies. These results show anxiety is physiologically important and can affect when a person gives birth, she says.

Other studies have found that a birthing parent with serious anxiety during pregnancy can increase the risk of problems for the child later on – such as developmental delays, emotional reactivity, or behavior issues.

The takeaway: It’s important to get help to reduce anxiety, Dunkel Schetter says.

“What I want is for [pregnant people] to consider at the beginning of their pregnancy whether they might be anxious, or predisposed to anxiety, or worried about this particular pregnancy, and if any of those are true, seek the advice of their provider and look for online resources,” she says.

Discrimination and racism cause major stress for people of color. That stress can impact pregnancy – a 2008 study found that African American pregnant women who experienced more racism in their lives and their families’ lives were more likely to have babies with low birth weight.

Serious emotional distress and the impact it has on your lifestyle – like nutrition and sleep – can change the environment in your uterus, Werner says. Those changes are complicated and still being studied, but distress can alter how the placenta works, and affect your hormones that respond to stress.

“We’re seeing hints, but we have a long way to go to really understanding mechanistically the complex relationship with how all those things happen, also keeping in mind that the postpartum environment is hugely important, and the brain is tremendously plastic, especially the infant brain,” Werner says.

Even if a baby’s parent had extreme stress during pregnancy, later problems aren’t inevitable. “You may be more at risk, but a really healthy and nurturing postpartum environment can really change that,” Werner says.

When to Get Help for Stress

Taking care of your mental health during pregnancy is a positive step for you and your future baby.

“If you are really struggling with anxiety or with a mood disorder, it’s a really great time to engage in treatment,” Werner says. “Maybe you’ve felt really overwhelmed by it, or it’s been something you’re avoiding. Sometimes this can be a great period where you feel motivated in a new way.”

Though having worries is normal, if it feels like they are stopping you from living a full life, think about getting treatment, she says.

“The degree to which it’s influencing your ability to do other things is probably a good indicator,” Werner says. “If you’re just so consumed with worry all the time that it’s really getting in the way of other things, that’s probably a really good time to reach out and get help.”

Many OB/GYN offices screen all pregnant patients for anxiety and depression with a questionnaire about how you’re feeling; ask your doctor to be screened if you haven’t been.

If your anxiety is making it hard for you to leave the house, or if you feel unable to get out of bed, find help. Pay attention to changes in your eating and your moods, Werner says. Friends, family, or your partner might also notice changes in your mental health.

“There are a variety of ways that anxiety and depression manifest, in both the way we’re thinking and our behavior,” Werner says. “Sometimes we think it’s just part of life, this level of suffering, but sometimes there are ways in which mental health professionals can help to reduce that and lead to a life that feels less painful.”

How to Find Help

Talk therapy can be very helpful for dealing with stress and anxiety during pregnancy, Werner says. Ask your OB/GYN or regular doctor if they can recommend mental health professionals in your area. You can also check with your insurance company to find services.

It can take work to find a therapist, so keep looking if you run into problems finding someone available and affordable, Werner says.

Cognitive behavioral therapy, which teaches techniques to manage anxiety, can be effective for coping with prenatal anxiety, Dunkel Schetter says. Mindfulness meditation can also help you live in the present and let go of distressing feelings, she says.

Everyday ways of taking care of yourself can relieve some stress, too. Find social support from friends and family, Dunkel Schetter says. Exercise – moderately, as your doctor recommends – and eat nourishing foods.

“All these things are part of a healthy pregnancy and can be helpful for stress management,” she says.