Pregnancy is generally a happy parenthesis for the mother-to-be, but it nonetheless remains a period of profound physical and psychological transformations, sometimes sources of stress.

During pregnancy, the potential sources of stress are numerous and of different natures, with of course a different impact depending on the future mothers, their character, their intimate history, their living conditions, the circumstances of the pregnancy, etc. In addition to the current stress of daily life, acute stressful situations (bereavement, divorce or separation, job loss, war situation, etc.), there are various elements inherent in pregnancy:

• the risk of miscarriage, real in the first trimester of pregnancy. This stress of miscarriage will be all the more pronounced if the mother-to-be has already had one during a previous pregnancy, or even several;
• pregnancy ailments (nausea, acid reflux, back pain, discomfort), in addition to the physical inconvenience they cause, can nervously exhaust the mother-to-be;
• pregnancy obtained by ART, often described as “precious”;
• stress at work, the fear of announcing your pregnancy to her boss, of not being able to return to her job when she returns from maternity leave are a reality for many pregnant employed women;
• the mode of transport, especially if it is long, or in difficult conditions (fear of having nausea in public transport, fear of not having a seat, etc.):
• the medical examinations carried out within the framework of prenatal screening, the fear of the discovery of a problem in the baby; the anxiety of waiting when an anomaly is suspected;
• fear of childbirth, fear of not being able to recognize the signs of labor. This fear will be all the more acute if the previous childbirth was difficult, if a cesarean had to be performed, if the survival of the baby was threatened, etc;
• anguish at the prospect of mom’s new role when it comes to a first baby. When it comes to a second, worry about the reaction of the eldest, fear of not having enough time to devote to him, etc. Pregnancy is indeed a period of profound psychological reorganization which allows women to prepare themselves, psychologically, for their future role as mother. But this psychological maturation can re-emerge deeply buried fears and anxieties linked to the intimate history of each woman, to her relationship with her own mother, with her brothers and sisters, and sometimes even traumas experienced in childhood. ‘unconscious had until then “erased”.

These different possible sources of stress, the list of which is far from exhaustive, come to affect a mother-to-be that the hormonal upheavals of pregnancy already make it prone to stress, skin-deep emotions and mood swings. The hormonal imbalance due to the fluctuation and the interaction of the various hormones of pregnancy between them (progesterone, estrogens, prolactin, etc.) indeed promote a certain hyperemotivity in the expectant mother.

More and more studies point to the harmful effects of maternal stress on the good progress of pregnancy and the health of the unborn baby.

The risks for the mother

The role of stress in increasing the risk of preterm birth is one of the most scientifically documented. Several mechanisms are involved. One concerns CRH, a neuropeptide involved in the onset of contractions. However, several studies have shown that maternal stress is associated with an increase in CRH levels. Another possible mechanism: intense stress could also lead to a susceptibility to infection which, itself, will increase the production of cytokines, known to be vectors of premature delivery (1).

The risks for the baby

An Italian study (2) involving more than 3 children showed that the risk of asthma, allergic rhinitis or eczema was significantly higher (800 times) in children exposed to maternal stress in utero (mother who experienced bereavement, separation or divorce, or job loss during pregnancy) than with other children.

A much smaller German study (3) established that in the event of prolonged maternal stress during the second trimester of pregnancy, the placenta secreted, in response to the secretion of cortisol (the stress hormone), corticoliberin. However, this substance could have a harmful effect on the growth and development of the baby. One-time stress would not have this effect.

Above all, it is not a question of making future mothers feel guilty for this stress of which they are the victims more than responsible, but of detecting these stressful situations as early as possible and providing them with support. This is in particular the objective of the prenatal interview of the 4th month. If during this interview, the midwife detects a possible stressful situation (due to working conditions, certain obstetric or psychological history of the mother, the couple’s situation, their financial situation, etc.) or a certain fragility in pregnant women, specific follow-up may be offered. Sometimes speaking and listening can be enough to soothe these stressful situations.

Rest is also essential for better living your pregnancy and managing the various sources of stress. Of course, pregnancy is not an illness, but it remains a period of profound physical and psychological changes, which can give birth to certain anxieties and concerns in the mother. It is important to take the time to settle down, to “ease off”, to refocus on yourself and your baby.

A balanced diet also helps in stress management. The mother-to-be will pay particular attention to her magnesium intake (in Brazil nuts, almonds, cashews, white beans, certain mineralized waters, spinach, lentils, etc.) the anti-stress mineral par excellence. To avoid blood sugar fluctuations, which promote low energy and morale, it is important to focus on foods with a low or medium glycemic index.

The regular practice of a physical activity adapted to pregnancy (walking, swimming, gentle gymnastics) is also essential to clear the mind, and thus take a step back in the face of different stressful situations. On the hormonal level, physical activity triggers the secretion of endorphin, an anti-stress hormone.

Prenatal yoga is particularly suitable for stressed-to-be mothers. The work on the breath (pranayama) associated with the different postures (asanas), it allows a deep bodily relaxation and a mental soothing. Prenatal yoga will also help the mother-to-be to adapt to the various changes in her body, and thus limit certain pregnancy ailments that can be a source of additional stress.

Other relaxation practices are also beneficial in the event of stress: sophrology, hypnosis, mindfulness meditation for example.

Finally, also think of alternative medicine:

• homeopathic remedies usually used against stress, nervousness, sleep disorders can be used during pregnancy. Seek advice from your pharmacist;
• in herbal medicine, from the second trimester of pregnancy, it is possible to take infusions of Roman chamomile, orange tree, lime blossom and / or lemon verbena (4);
• acupuncture may show good results against stress and sleep disturbances during pregnancy. Consult an acupuncture doctor or midwife with an obstetric acupuncture IUD.