Everyone gets stressed. But based on where you are in your life and what your family-building goals are, too much stress can be detrimental to your health and your ability to create the family you choose.
There are few arenas in life in which the mind-body connection is more real and more important.
So, while stress starts in your mind, it very much manifests in your body. And, if you become pregnant, that can not only affect you but also your unborn child.
Here are the ways we'll discuss how stress can influence your TTC and pregnancy journey:
Warning: this is a review of the research in this area but may be triggering or cause additional stress.
NOTE: we believe in people's right to determine their gender. We use inclusive language as much as possible. Sometimes we may use binary terms like "women" or "man" when we are quoting from research that specifically uses those terms, for accuracy.
1. Stress can make it harder to get pregnant
Surely you’ve heard some version of the story about the person who was trying to get pregnant for years and then the moment they stopped trying, they got pregnant.
There isn’t a guarantee that stress is the only thing preventing a pregnancy from happening but it’s not a coincidence either.
In fact, stress is thought to be a major contributor to today's high levels of infertility.
When looking at studies focused on people undergoing In-vitro fertilization (IVF), high-stress levels are associated with fewer eggs retrieved, fewer eggs successfully fertilized into embryos, fewer successful embryo transfers, a lower rate of live births, and lower birth weight.
Inversely, in one study, people assigned female at birth (AFAB) who ranked highest on the positive mood meter were 93% more likely to have a live birth than those who ranked lowest.
Why does this happen? The effect of stress on reproduction is thought to be a factor in human evolution.
That is, stress-induced infertility is likely our body’s way of preventing new births during times of perceived danger.
Researchers believe that when stress hormones like adrenaline and cortisol reach a certain threshold, our bodies read this as a sign to flip the switch from reproduction to survival mode.
NOTE: This does not mean that high stress will make conception impossible - babies are still born during war times and during famine.
The TLDR on this is that stress is a hormonal process that can inhibit and interfere with the delicate and hormonal process of conception.
The science behind stress and conception:
The process to mature quality eggs requires both hormonal balance (needed to signal to the ovaries to move into the next phase of egg maturation) and sufficient energy (needed to power the highly energetic process of chromosomal processing).
Chronic stress inhibits both of these things to occur.
Firstly, when your body switches into survival mode, key reproductive hormones are halted and your eggs cannot receive the hormonal signals needed to mature.
In particular, research shows that stress both suppresses and inhibits the production of something called gonadotropin releasing hormone (GnRH).
GnRH is responsible for the secretion of gonadotropins, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), which regulate the maturation of your eggs through a process called folliculogenesis.
The other unfortunate news is that the effects of chronic stress on fertility, specifically for women, persist long after the stress is gone.
This is because a hormone that suppresses fertility, gonadotropin inhibitory hormone (GnIH), remains high even after stress hormone levels return to normal.
And, while the research is still limited, scientists have been studying the role of GnRH as a way to help enhance egg quality for women going through all kinds of assistive reproductive procedures.
2. Stress during pregnancy can increase your odds of preeclampsia, preterm birth, and low birth weight
Stress during pregnancy is common. However, stress can quickly escalate to what’s considered a ‘maternal anxiety disorder,’ especially within the few weeks before and after the child is born (with prevalence rates of between 11% - 17%).
There are a variety of reasons people get stressed at this important time of lifelong change. Feelings around this time can include:
Fear of childbirth
Financial pressures of a growing family
Identity shifts around family and parenthood
Relationships challenges and changes
Managing work-life balance
Physical discomfort from morning sickness, backaches, and loss of sleep
Stress levels during pregnancy also tend to be higher for people that have struggled to get and stay pregnant in the past.
So, whether you’ve experienced pregnancy loss, reproductive health issues, or have undergone fertility treatment, you may be experiencing greater levels of stress based on the fact that the road to get you there has been presented with more challenges than others.
As much as these stressors are expected, they need to be taken seriously because they can have a number of implications on you and your baby’s health.
Stress and pre-eclampsia
Pre-eclampsia is a pregnancy complication that affects your blood pressure and organs and could lead to early delivery of your baby and in some cases, severe complications for you or your baby.
Although the exact cause of pre-eclampsia is not known, it's thought to occur when there's a problem with the placenta, the organ that links the baby's blood supply to the mother's.
Early signs of pre-eclampsia include high blood pressure (hypertension).
Not only can stress increase your blood pressure but one finding indicates that high psychosocial stress and chronic hypertension can act in combination to increase the risk of pre-eclampsia up to 20-fold.
Stress and preterm births
Stress during pregnancy can increase the chances of having a premature baby - a baby born before 37 weeks of pregnancy.
Babies born prematurely are more likely to have developmental delays, learning disorders, and other chronic health problems.
While stress may not be the only reason a baby is born prematurely, it has been identified as a common thread among those women who did experience preterm birth.
For example, in one study, of those who experienced stress during pregnancy, 54% gave birth preterm with stress as an attributable risk factor. When looking at the average across all participants, the percentage was only 23%.
Stress and low birthweight babies
A baby who weighs less than 5 ½ pounds at birth may have trouble eating, gaining weight, and fighting off infections. And, some may have long-term health problems.
In a similar way that stress can impact premature birth, it’s thought that the same hormonal disruption can influence the birth weight of a baby.
One study found a high correlation between women that measured very high on the Perceived Stress Score (PSS-10) at various stages of pregnancy and the likelihood of a low birth weight baby.
3. Stress during pregnancy can affect the child’s future metabolic, cognitive, and emotional development
A growing amount of research is shedding light on the fact that even milder forms of maternal stress during pregnancy can have lasting effects on the child in the future - both in infancy and early childhood development.
Studies indicate that prenatal maternal stress and anxiety can have an effect on the following:
Higher reaction intensity in children (citation)
higher negative emotionality (citation)
Significant higher rates of behavioral problems
lower prosocial behavior in 5-year-old children independent of concurrent maternal mood (citation)
Poorer working memory at 8 years of age (citation).
4. Stress is a risk factor for postpartum depression
Postpartum depression is a debilitating mental disorder that affects approximately 10–15% of adult mothers yearly.
The disease manifests as sleep disorders, mood swings, changes in appetite, fear of injury, serious concerns about the baby, much sadness and crying, sense of doubt, difficulty in concentrating, lack of interest in daily activities, thoughts of death, and even suicide.
Postpartum depression is so debilitating that it is responsible for 20% of maternal deaths postpartum.
For someone struggling with this disorder, they may experience fear of harming the baby (36%), weak attachment to the baby (34%), and even, in extreme cases, child suicide attempts have been reported.
While stress is one aspect, here are some of the risk factors that are associated with postpartum depression:
A history of depression
Experiencing stressful life events during pregnancy
Negative cognitive attributional style (this means that if something bad happens, you believe it was because of you).
Low social support
A history of miscarriage
A history of pregnancy termination
A history of childhood sexual abuse
The other thing we do know is that pregnancy and childbirth alone can be considered stressful life events that are associated with hormones such as epinephrine and cortisol.
For example, these stress hormones by 500% during labor!
Then there’s the aftermath of birth, which is often filled with physical stressors, especially for those that have experienced a c-section or traumatic birth.
Things like perineal pain, torn tissues, backaches, and urinary tract problems can all cause significant distress.
Stress as a risk factor for the 'baby blues'
While postpartum depression is on the extreme end of the scale, a very common issue is called the “baby blues,” which are estimated to affect 33%-80% of postpartum women.
The baby blues are characterized by feelings of sadness, anxiety, and mood swings.
In one small study, stress, yet again, was a risk factor in whether or not someone experienced the baby blues.
More specifically, the intensity of the baby blues as a liability vs. someone just feeling sad, was higher when the new mother had low self-esteem and high levels of stress in relation to the care of the baby.
5. Stress as a risk factor for childbirth trauma and post-traumatic stress
Despite so many innovations in healthcare, childbirth can be deeply traumatic and even dangerous.
Of course, some women proclaim that it is a magical experience but more and more women are coming out and being candid about their own, often very difficult, issues in their birthing experience.
No one plans to have a complicated or traumatic birth but nevertheless, it could happen to anyone.
Complications or no complications, the process of birth and becoming a new parent or expanding your family may have additional effects on your emotional or mental health.
UK-based, reality TV show celebrity, Louise Thomson, shares her honest feelings about the process of childbirth and the emotional toll is has taken in the months following the birth.
If I could use a few words to describe the past month they would be: SCARED, CONFUSED, PARALYSED, AND TOTALLY OUT OF CONTROL.
My brain 🧠 keeps deleting memories in order to try and protect itself and it’s so scary. Trauma and fear have no understanding of time. I remember a therapist told me that a few months ago and I didn't understand what she meant. Now I do.
Extremely scary circumstances get trapped in your brain as a fight or flight response and they don't get processed like other memories. They don't leave with time. They get trapped in your subconscious.
This caution might seem unwarranted if you have access to excellent medical care. But living in a high-tech society is no guarantee you won’t have a traumatic childbirth. Mothers – and fathers too – may experience helplessness and fear. When deliveries are difficult or medical staff disrespectful, negative memories of birth can cast a shadow over the postnatal period.
For example, in one Australian study tracking healthy women before and after giving birth, 29% of them felt threatened and 14% said their feelings at the time were intense fear, helplessness, or horror.
For many, these feelings of trauma will subside, but for 8-9% of birthing mothers in the US and Canada, this can develop post-traumatic stress disorder (PTSD), a condition characterized by flashbacks, anxiety, and nightmares.
Not unlike PTSD experienced by people who have been through a war, childbirth PTSD symptoms include playbacks that incite feelings of fear, horror, or helplessness and may interfere with daily life.
Childbirth PTSD can also pose issues to the infant. For example, some women may avoid doctors and hospitals for routine check-ups because it reminds them of the experience.
It can also lead to feelings of social isolation, loneliness, anger, depression, etc. which can make it difficult to form a bond with the baby.
Some people with childbirth PTSD also show signs of living in constant fear that their baby could die.
Childbirth PTSD can also impact their intimate relationship with their partner and can impede their future family-building goals.
Put simply, they endure sex in order to prevent future pregnancies that may cause more trauma.
Are some people at higher risk for childbirth PTSD?
Yes, they are.
Some factors may not come as a surprise. Things like having a difficult delivery (e.g. using forceps), having an emergency c-section, or having a traumatic history that may include past sexual assault, miscarriages, or premature births.
But, the biggest risk factors for childbirth PTSD were both mental and social.
For example, women were at higher risk if they were feeling a lack of control (slightly ironic as the feeling of being out of control is also within your control if managed properly!).
And, the odds of PTSD increased more than 4-fold if the birthing mother reported “interpersonal difficulties.”
Managing stress and getting support is the key to reducing childbirth PTSD
Whether it’s a doula or an ELANZA Conception Coach the research is clear that when a gestational parent receives emotional support, they have a better childbirth experience.
What’s more, is that these benefits seem to carry on six weeks postpartum. In several studies, those who received emotional support experienced the following benefits:
Lower rates of depression
Lower anxiety levels
Increased rates of breastfeeding
More time spent with their infants
More positive feelings about their families
Now, there's finally a solution for reducing toxic stress, for good.
For the first time ever, there is a solution that goes far beyond a meditation app.
ELANZA has developed the first personalized wellness program specifically focused on managing the deep-rooted stress that can improve your likelihood to conceive and your ability to have a healthy pregnancy, from start to finish.
This evidence-based program is built upon the best research around neuroscience, positive psychology, and behavioral health sciences to ensure that the mental and biological impact of stress will not impede your journey to create the life you choose.
And it WORKS. Studies have shown that ELANZA is able to reduce stress by 17% over the course of 10 weeks, without medical intervention or therapy.
We've developed the closest thing there is to a pill for stress. You have to try it to believe it.