South Asian pregnant women are often revered in their families and communities. Elaborate baby showers are planned, the mother-to-be is encouraged to rest, relax and not take on too many duties, and she is fed sweets and other rich food to help her gain weight to maintain a healthy pregnancy. Many of the customs surrounding the treatment of South Asian pregnant women come from hundreds of years ago when prenatal care was not available and it was the community and family’s responsibility to help the mother carry a child to term.
Currently, prenatal care in South Asian countries, as well as abroad, is readily available to most women and still the culture demands that the pregnant woman remain calm, happy and unstressed the entire pregnancy. While the rates of miscarriage have significantly dropped thanks to modern medicine, research is supporting this widely held cultural value by pointing to realistic effects on the fetus if the mother is stressed or anxious during pregnancy.
Examples of stress can include a death in the family, famine, natural disasters, loss of a job, marital tension, etc. Anxiety can come from such situations or can be caused by the mother’s natural disposition. Mothers whose temperament and personality are highly anxious rarely identify themselves as being anxious because they have grown accustom to feeling on edge and highly aroused. Learning to identify and manage that anxiety can significantly help deter from the following effects it has on the fetus.
Research states that prenatal stress and anxiety is associated with a higher incidence of preterm birth, lower birth weight and length and an increased risk of miscarriage. In addition, children born to mothers who were stressed or anxious during pregnancy are more likely to be fussy and more difficult to soothe. As infants and children, they can have problems with attention and tend to react more emotionally to new situations than babies born to non-anxious mothers. Prenatal stress and anxiety is also associated with higher incidence of hyperactivity in boys and lower mood in both genders as they grow. A longitudinal study found that adults with severe depression were much more likely to have been born to highly stressed and/or anxious mothers than adults without severe depression.
A study published in 2008 at the Harvard Medical School was the first of its kind to identify a link between prenatal stress and anxiety and future allergy and asthma risk in human infants. Researchers at Harvard suggest that even with low levels of allergen exposure in the home, if the mother was stressed or anxious during pregnancy, the fetus’ immune system became compromised and increased the risk of developing allergies and asthma after birth.
Infants of mothers who were stressed and/or anxious during pregnancy are also more likely to show behavioral inhibition (e.g. preferring familiar faces, places and toys over anything new), more likely to be shy and are usually less social. As adults, babies who experience stress in utero, are more likely to experience chronic health issues such as heart disease, high blood pressure, and diabetes.
So what is the connection between the mother’s anxious disposition and fetal stress? Most research points to the effects of cortisol (the stress hormone) and adrenaline. High levels of these hormones are found in anxious or stressed mothers and then are transferred to the fetus, causing it to develop with a stress baseline that is higher than fetuses of less anxious mothers.
In addition, researchers at the University of California at Irvine and at UCLA have identified that stressful situations occurring during the first trimester are most crucial in determining early labor. Stressors at this stage trigger an early rise of corticotropin-releasing hormone (CRH), which regulates the duration of pregnancy and fetal maturation. An increase of CRH in the first trimester can trigger an early delivery.
While they are still working on understanding the exact causal relationship, what they do know is that if you are a generally anxious woman, your chances for early delivery and having an infant with the abovementioned temperament and risk factors is much higher.
So how can you increase your chance of a healthy pregnancy? Here are some tips on how to reduce your stress and anxiety:
- 1. Increase your awareness about how anxious of a person you truly are. By being honest with yourself and not minimizing or denying the truth, you will be helping yourself and your future child live a healthy life. A mental health professional can help you successfully identify your strengths and weaknesses.
- 2. Surround yourself with a strong support system. Find local women’s groups, stay in touch with close friends and family members to help you manage your stress and anxiety.
- 3. Engage in guided imagery or yoga to help yourself distress. Many gyms are now offering prenatal yoga classes that are customized for pregnant women.
- 4. Regular light exercise can help the body produce endorphins and counter the effects of stress and anxiety. Always check with your doctor before starting an exercise program, especially if you are pregnant.
- 5. Be sure to take enough rest and eat healthy foods.
- 6. Avoid situations that cause stress or raise your anxiety levels.
Here is a list designed by Dr. Calvin Hobel, director of maternal-fetal medicine at Cedars Sinai Medical Center in Los Angeles designed to assess your stress level during pregnancy. For each question, answer “yes,” “sometimes” or “no.” According to Dr. Hobel, if you answer “sometimes” or “yes” to three or more questions you may have sufficient stress to warrant counseling to help you learn how to manage stress more effectively.
- I feel tense.
- I feel nervous.
- I feel worried.
- I feel frightened.
- I have trouble dealing with problems.
- Things are not going well.
- I cannot control things in my life.
- I am worried that my baby is abnormal.
- I am concerned that I may lose my baby.
- I am concerned that I will have a difficult delivery.
- I am concerned that I will be unable to pay my bills.
- I live apart from my partner or spouse.
- I have extra-heavy homework.
- I have problems at work.
- Have you and your partner or spouse had any problems?
- Have you been threatened with physical harm?
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