Stress Management

Stress is a common term, but the symptoms of stress are truly unique to each and every individual. Defined as "the pattern of specific and nonspecific responses an organism makes to stimulus events that disturb its equilibrium and tax or exceed its ability to cope," stress occurs when the demands placed on an individual exceeds that individual's ability to cope with them, resulting in a disruption of their normal state of homeostasis. As the terms eustress implies, small doses of stress can be beneficial for emotional and intellectual growth and development and in regard to our innate "fight or flight" response that occurs while preparing ourselves for defense. However, an overabundance of stressors or stimuli can be overwhelming and uncontrollable and result in distress – a dangerous contributor of psychological and physiological health problems, with particularly severe implications for pregnant patients.

Pregnancy is an exciting stage in a woman's life, but is often accompanied by unpleasant symptoms and stressors such as physical changes in the body, feeling nauseous or more tired than usual, having constipation, aches and pains, or mood changes, having concerns or worries about labor, delivery, the baby's health, or parenting, and having stress within the relationship. Further, women who were previously pregnant may experience their current pregnancy differently and can therefore be affected by different stressors and symptoms. These emotional, hormonal, and physical changes, in addition to other stresses in life spanning from daily hassles (domestic affairs, financial issues) to major life events or crises (divorce, illness or death to someone close), can result in severe health problems, conditions, and negative birth outcomes. Therefore, techniques and strategies to aid in managing stress are critical to incorporate during prenatal care to improve the health and wellbeing of both mother and baby.

What are the symptoms of stress?

Stress can manifest into numerous physical, mental, and emotional issues. A pregnant patient expressing general symptoms of stress can serve as a cue to action for conversation about stress management and strategies, in order to prevent more severe stress from occurring.

General symptoms:

  • Physical changes (body shape, weight)
  • Hormonal changes (mood swings)
  • Concerns/anxiety about pregnancy, birthing, parenting, relationship Emotional distress (anger, irritability, anxiety)
  • Muscular problems (tension headache, pain)
  • Gastrointestinal issues (heartburn, flatulence, diarrhea, constipation, IBS)
  • Over-arousal (elevation in blood pressure, rapid heartbeat, sweaty palms, heart palpitations, dizziness, shortness of breath, chest pain, persistent tension headaches, migraines, hypertension, heart disease)

What are the benefits of stress management during pregnancy?

Stress management can alleviate symptoms and ultimately lead to a healthier pregnancy. Research suggests that the more life events experienced by a pregnant women, the more they are at risk for preterm birth. And, the more severe an event, the higher the risk becomes. Thus, stress management should be tailored to the individual's lifestyle and the type of stress experienced. Stress management is especially important in pregnant women with family history of hypertension and other forms of heart disease in order to avoid increased severity of symptoms.

General Benefits include:

  • Improving the immune system that is affected by stress.
  • Reducing aging conditions such as frailty, functional decline, cardiovascular disease, osteoporosis, inflammatory arthritis, type 2 diabetes, and certain cancers.
  • Minimizing brain impairment to not block certain toxins and harmful molecules, common to patients with Alzheimer's Disease.
  • Decreasing the possibility of worsening risk factors including hypertension and high cholesterol.
  • Minimizing frequent anger or hostility exhibited by stressed individuals, and thus decreases the associated risk of heart disease and crying fits.
  • Reducing the risk of developing depression accompanied by stress, thus decreasing the associated risks for heart disease, obesity, and kidney dysfunction.
  • Aiding in quicker recovery from serious illness, such as a heart attack. (Source: APA)

Pregnancy-specific benefits:

  • Massage has been shown to reduce both depression during pregnancy and the likelihood of preterm birth or low birth weight.
  • Physical activity has been shown to reduce anxiety symptoms, protect against onset of anxiety and depressive disorders and symptoms, and is associated with reduced feelings of distress and enhanced well-being.
  • Yoga practices, including physical postures, breathing, and meditation, collectively known as the integrated approach of yoga therapy (IAYT) were shown to reduce preterm birth, low birth weight, and complications including isolated intrauterine growth retardation (IUGR) and pregnancy-induced hypertension (PIH).
  • Instructed relaxation therapy focusing on diaphragmatic breathing resulted in reduced preterm birth and low birth weight.
  • Relaxation training has been shown to decrease incidence of low birth weight, reduce anxiety, heart rate, and cortisol levels.
  • Psychosocial stress interventions and assessments have been shown to reduce the risk of preterm birth and low birth weight.