Editor’s note: The following article is part of a partnership between Chambanamoms and Christie Clinic to help create a healthier lifestyle for you and your family.
By Dr. Mildred Nelson, OB/GYN
Pregnancy is a time of profound physical and emotional change. Our hormones are surging. Our bodies are changing. We are anticipating motherhood. That can be both an exciting and scary time. As a consequence there may be a myriad of effects on our sense of well-being and interpersonal relationships. A positive social support system is important to one’s mental and physical health during pregnancy. Conversely, negative social interactions and interpersonal conflicts in one’s personal relationships can be crucial triggers for depression. Up to 47% of pregnant women of low socioeconomic status, for example, suffer depressive symptoms by the second trimester of their pregnancy.
Interpersonal factors of social support and social conflict, defined as behaviors or interactions perceived as harmful, critical and hostile, play a substantial role in the experience of depressive symptoms in pregnancy. A woman may feel let down and unloved by her partner. She may feel tense from arguing. In addition, stress may influence pregnancy outcomes either directly or indirectly through unhealthy lifestyle factors such as smoking or alcohol.
Domestic violence is responsible for more deaths in pregnant women than any single medical complication associated with pregnancy. Every year, 335,000 pregnant women will be victims of assault and result in a myriad of adverse pregnancy outcomes. This is an unacceptable and should not be tolerated. We should support initiatives which eliminate this extreme expression of social conflict for all women.
Another factor creating stress for women during pregnancy are work-related issues. Stress at work has two components; physical and mental. The physical components include lifting, pushing, prolonged standing, and working long irregular hours increases the norepinephrine output. Mental stress includes factors such as decision making with important consequences, problem solving, emotional crises and life changes and increases the secretion of epinephrine. One study found a 58% increase in catecholamine excretion during work in pregnant physicians and ICU nurses. Catecholamine’s decrease uterine blood flow and have been associated with increased adverse pregnancy outcome.
What are the consequences of these stresses for pregnant women? Women with interpersonal conflict are more likely to miscarry, give birth to low birth weight infants and increase their risk of preterm delivery. Women with depressive illness antepartum also experience more somatic pregnancy complications such as premature contractions and back pain. Psychiatric disorders and fear of delivery in pregnant women with conflicted personal lives are more frequent as well. The cost of medical care is greater for pregnant women with stress secondary to increased use of healthcare resources and lost productivity.
In 2010, the American Congress of Obstetrics and Gynecology recommended that Health Care providers routinely screen pregnant women for depression both during and after pregnancy. In spite of this initiative, interpersonal violence and emotional distress often go unrecognized during routine encounters. Furthermore, women may often attribute depressive symptoms to a pregnancy related symptoms.
So, what can one do to prepare themselves for the challenges of pregnancy? First of all, discuss concerns with your provider prior to conception. Consider counseling, yoga, meditation among other complementary and alternative medicine therapies. During pregnancy, be sure to share your concerns with your provider as they develop. Be aware of your inner emotions and seek advice and help often.
Looking to try prenatal yoga? Try chambanamoms.com sponsor Amara Yoga and Arts.