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Self-Care during Pregnancy: Counteracting Negative Impacts of Stress

          Upon learning that you are expecting to welcome a new life into this world, you may be hit with a mixture of emotions; sometimes you are unsure how to feel. One emotion every parent is bound to feel is some degree of stress. Stress, the result of a person feeling incapable of coping with a negative situation, affects people differently, and yet no one is immune to the dangers of too much stress.

With the growing amount of research on adverse childhood experiences, or ACEs, and their long-term effects, it is highly necessary to look at implications of stress on pregnancy. When a person is exposed to stress for a short period with supportive resources, there are little to no negative adverse effects. The more stress a person feels, along with the prolonging of time and lack of support, the body loses the ability to fight off stress’ biological effects. When a threat or stressful event is registered, the brain triggers the body to produce catecholamines, our stress hormones, activating our fight or flight response which prepares a person to address that threat or retreat to safety (Felitti, Anda, Nordenberg, Williamson, Spitz, Edwards, Koss, & Marks, 1998). Cortisol, the stress hormone, becomes toxic when produced in high levels and flooding the body, after registering too many threats. If a person experiences this stress in his/her early years, the stress actually rewires some of the body’s biological connections, with the potential for negative health outcomes later in life (Burke Harris, 2020; Renae Stancil, Hertz-Picciotto, Schramm, & Watt-Morse, 2000). Therefore, it is important to have a way to balance out the potential harmful effects stress can cause, in the form a personalized self-care routine (Skovholt & Trotter-Mathison, 2016).

When a person is expecting, the physiological effects of stress are distributed to the both the gestational parent and the infant. With what we know about stress and how the body is designed to pass information and nutrients from carrier to baby, it is not surprising to see a trend between higher levels of stress and adverse effects on the baby (Prevention, 2020). Living in a stressful community, environment, or city creates circumstances that cause psychological stress and that stress increases when one has to care for a child (Willie, Powell, & Kershaw, 2016). Strain from the pregnant person on the baby is connected to low birth weight, preterm babies, and in the postpartum period, more anxiety, and irritability (Monk, 2001). In the nursing parent, milk supply can dwindle due to exhaustion and sleep deprivation. Babies born to parents experiencing depression are also more likely to show less movement, heartrate variability, and an impaired stress response (Monk, 2001). Symptoms of stress in the postpartum period can be seen in pregnant persons of every race, yet disparities exist across demographic groups (Willie, Powell, & Kershaw, 2016). This is very well likely due to system racial barriers (Renae Stancil et. al, 2000).

Pregnant persons undergo routine prenatal checkups to monitor their progress as well as the baby’s. At these appointments, various physical aspects of both the gestational carrier and baby are examined for developmental milestones, predictions made for how big baby will be, and recommendations for on how to maintain a healthy pregnancy. One aspect that healthcare providers are slowly coming around to adapting is the inclusion of mental health screenings at wellness visits. Adopting this practice means checking in to screen for any signs showing the person not to be in optimal health. However, this practice needs to be accepted on a more widespread basis so that signs of stress are identified much sooner. From there, even though a doctor is not qualified to provide referrals to resources, he/she can give a referral to a practitioner that does. There also needs to be places to offer services; this is not a luxury every community is able to offer.  

One quality tool that every person can keep stored away is stress management. Under that umbrella, a person becomes better able to recognize signs of stress and respond appropriately using reliable methods (Skovholt & Trotter-Mathison, 2016). However, in order for any tool to be most effective, it needs to be relevant to the person and situation (Willie, Powell, & Kershaw, 2016). There are many avenues a person can seek to learn tress-relief techniques, a practice that takes discipline, but is well worth the effort.

There is no validity in saying that taking the time for balance, peace, and/or a reset is selfish. Everybody gets to at least one point where they need a moment, even though what that moment looks like changes person to person. Not taking our time for a mental moment and pushing ourselves beyond our limits has detrimental effects. For anyone unsure of how to develop coping skills, it starts with making of list of your feel-good activities (Skovholt & Trotter-Mathison, 2016). What are your go-to practices if you are not in the best space mentally and need something to boost your spirit?

So then, we ask how we help parents not feel so stressed. Is it possible for a larger group of people to make such a major transition feeling better prepared and not so insecure?  Imagine a person coming in suspecting a pregnancy, getting confirmation of that pregnancy, and then receiving wholesome care that supports both the physical and emotional wellbeing of that person. Imagine people needing family planning assistance and being connected with the resources that will assist them in making responsible, informed decisions. Imagine that this care starts as early in the pregnancy as possible, even preconception, and starts a continuous cycle so that more parents feel supported when needing advice on making the hefty decisions that affect their children. Society needs to change and acknowledge environmental factors contributing to high levels of stress. Communities need funding for initiatives and resources committed to gaining the trust of individuals and providing them comprehensive care. Health care providers need to take the extra few minutes to ask questions that can interrupt the domino effect of stress and encourage their clients to take active roles in their care before it is too late. If these steps are taken, communities will plant seeds promoting positive mental and physical health. That is the type of society I want to live in.







References

Anderson, R. (2005). Stress and pregnancy. The Journal of the Royal Society for the Promotion of Health, 125(5), 215–215.

Harris, N. B. (2020). The Deepest Well: Healing the long-term effects of childhood adversity. BLUEBIRD.

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine. https://www.sciencedirect.com/...ii/S0749379798000178.

Harville, E. W., Gunderson, E. P., Matthews, K. A., Lewis, C. E., & Carnethon, M. (2010). Pre-pregnancy stress reactivity and pregnancy outcome. Paediatric & Perinatal Epidemiology, 24(6), 564–571. https://doi-org.mylibrary.wilm...65-3016.2010.01152.x

Monk, C. (2001). Stress and mood disorders during pregnancy: implications for child development. Psychiatric Quarterly, 72(4), 347–357. https://doi.org/10.1023/A:1010393316106

Renae Stancil, T., Hertz-Picciotto, I., Schramm, M., & Watt-Morse, M. (2000). Stress and pregnancy among African-American women. Paediatric and Perinatal Epidemiology, 14(2), 127–135. https://doi.org/10.1046/j.1365-3016.2000.00257.x

Skovholt, T. M., & Trotter-Mathison, M. (2016). The resilient practitioner: Burnout and Compassion Fatigue Prevention and self-care strategies for the helping professions. Routledge, Taylor & Francis Group.

Stress and Pregnancy. (2020). Prevention, 72(4), 8.

Willie, T. C., Powell, A., & Kershaw, T. (2016). Stress in the city: influence of urban social stress and violence on pregnancy and postpartum quality of life among adolescent and young mothers. Journal of Urban Health : Bulletin of the New York Academy of Medicine, 93(1), 19–35. https://doi.org/10.1007/s11524-015-0021-x

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