The Importance of Reducing Stress During Pregnancy: Part II

Stress reduction practices support health in parents-to-be and developing babies

Posted Jun 28, 2017

The effects of maternal prenatal stress and traumatic stress on the health, development and behavior of offspring in the womb and over their life span add to the array of concerns faced by parents-to-be in the preconception, prenatal and early parenting periods.

Why are stress reduction practices important for parents-to-be and their developing babies?

As discussed in Part I of this series, chronic and high levels of maternal prenatal stress and traumatic stress have negative impacts on the nervous, endocrine, immune and cardiovascular systems of mothers-to-be (1). Maternal prenatal stress and traumatic stress are associated with an increased incidence of low birth weight offspring and pre-term birth (2), as well as dysregulations in offsprings’ metabolic, immune, endocrine and cognitive functions (3)(4).

A woman’s or girl’s exposure to chronic stress and/or traumatic stress during pregnancy may also influence the programming of her developing baby’s stress response system and the stress reactivity of her child over their life span (5). Studies suggest that stress reactivity can be passed from one generation to another. When a woman or girl who was exposed to stress or traumatic stress during gestation in her own mother’s womb, then becomes pregnant herself, her reactivity to stress programmed during her mother’s pregnancy with her, shapes the stress reactivity of the baby now developing in her womb (6)(7).

What are the signs of an activated stress response system?

Parents-to-be who experience chronic stress or traumatic stress can develop an awareness of how they are affected physically, emotionally, cognitively and in relationships with others when their stress response systems are activated. Brown and Gerbarg (8)(9) explain some of the most common signs of an activated stress response system. These include: feeling tense under pressure; feeling anxious and noticing your heart pounding or beating fast; feeling pain, tightness or tension in your stomach, neck, shoulders and back; having tension headaches; feeling irritable; overreacting to people, or when something goes wrong; startling easily to loud noises; and taking rapid shallow breaths or holding your breath.

Chronic activation of the stress response system may lead to persistent feelings and behaviors that are signs of how our nervous and endocrine systems are affected over time. These include: always feeling like you need to be in complete control; feeling overwhelmed and not able to get things done; having a tendency to imagine the worst; not being able to adjust well to change; yelling frequently and saying things you regret; having a weak short-term memory; and getting sick often.

How do stress reduction practices affect our stress response system?

Our central nervous system has two subsystems, the autonomic and somatic. Our stress response system is part of the autonomic nervous system, which becomes unbalanced or dysregulated when we experience chronic stress or traumatic stress. The autonomic nervous system has both activating and deactivating functions. The activating branch of the autonomic subsystem is the sympathetic branch, which acts like an accelerator, speeding up processes. It is usually activated in experiences of stress and both positive and negative states that require effort.

The deactivating branch is the parasympathetic branch, which acts like a brake, slowing down processes. It is usually activated in states of rest and relaxation. It is also activated in experiences of trauma when there is no escape, or when fight and flight responses are ineffective and freeze/shutdown responses are triggered.

The autonomic nervous system is continually responding to the needs of the body and functions in a rhythmic, cyclical manner. When it functions in an optimally stable fashion, we are in a state of “homeostasis” (10). The intentional use of stress reduction practices can help individuals maintain and restore smooth, rhythmic cycling between the sympathetic and parasympathetic branches of their autonomic nervous system, and thus reduce activation of their stress response system.

What can we do to intentionally support the optimal, stable functioning of our autonomic nervous system?

The autonomic nervous system controls automatic functions that affect our organs, glands and internal processes including circulation, digestion, metabolism, endocrine function, and breathing. The somatic subsystem allows us to have conscious control over skeletal muscles and body movements (11). Some functions are dual controlled by both autonomic and somatic subsystems. These include breathing, chewing, blinking, swallowing and excretory control. 

For the most part, we have no direct conscious access to the autonomic nervous system, except through the points of dual control, for example, breathing. Dual control points act as bridges between the autonomic and somatic subsystems and provide us with opportunities to consciously influence the state of our autonomic nervous system, including our stress response system.

Most of the time, our autonomic nervous system controls our breathing. When we become aware of our breathing, we can consciously change the frequency and depth of our breathing and by doing so reduce feelings of stress and anxiety (12). An increase in the frequency of breathing increases the sympathetic influence of the autonomic nervous system.  A decrease in the frequency AND increase in the depth of breathing, increase the parasympathetic influence of the autonomic nervous system.

Research has demonstrated that coherent breathing, a simple slow breath practice based on paced yoga breath practices can be effective in balancing the autonomic nervous system and reducing activation of the stress response system (9)(11). Coherent breathing is one stress reduction tool that can be used anywhere and anytime when an individual becomes aware that their stress response system is activated.

Why is it important to consider how stress reduction practices affect mothers as well as babies before birth?

It is crucial to consider the effects of stress reduction practices on both mothers and developing babies during pregnancy because they share a bi-directional reciprocal relationship. This means that physiological changes and adaptations that occur in the mother, the fetus or the placenta will influence physiological processes in the other two parts of the maternal-fetal-placental unit (6). Physiological changes that are associated with stress reduction practices may have positive impacts on the mother, the placenta and the developing baby. When stress reduction skills are learned and used by parents-to-be in the preconception period, they can support health and well-being throughout the transition to parenting.

How may stress reduction practices affect the stress response systems of pregnant trauma survivors and their developing babies?

It is important to note that for some people, especially trauma survivors, stress reduction practices may activate rather than balance their stress response systems (13). Parents-to-be who are trauma survivors would benefit from learning these skills from experienced practitioners familiar with the psychophysiology of trauma who can adapt these practices in ways that will support regulation of their stress response systems.

In Part III, I will discuss some of the stress reduction practices that have been shown to be effective specifically with pregnant women and some of the research on the neurobehavioral responses of their babies to the use of those practices before and after birth. I will also discuss why trauma survivors may need adaptations in the instruction of stress reduction practices.

References

(1) Seng, J. S., Oakley, D. J., Sampselle, C. M., Killion, C., Graham-Bermann, S., & Liberzon, I. (2001). Posttraumatic stress disorder and pregnancy complications. Obstetrics and Gynecology, 97(1), 17-22.

(2) Staneva, A., Bognossian, F., Pritchard, M., & Wittkowski, A. (2015). The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review. Women and Birth. http://dx.doi.org/j.wombi.2015.02.003

(3) Entringer, S., Buss, C., & Wadhwa, P. D. (2010). Prenatal stress and developmental programming of human health and disease risk: Concepts and integration of empirical findings. Current Opinions in Endocrinology, Diabetes and Obesity, 176, 507-516.

(4) Kinsella, M. T., & Monk, C. (2009). Impact of maternal stress, depression and anxiety on fetal neurobehavioral development. Clinical Obstetrics  and Gynecology 52(3), 425-440. https://www.ncbi.nim.gov/pmc/articles/PMCC3710585/

(5) Davis, E. P., Glynn, L. M., Waffarn, F., & Sandman, C. A. (2011). Prenatal maternal stress programs infant stress regulation. Journal of Child Psychology and Psychiatry, 52(2), 119-129.

(6) Wadhwa, P.,  Entringer, S., Buss, C., & Lu, M. C. (2011). The contribution of maternal stress to preterm birth: Issues and considerations. Clinical Perinatology, 38(3), 351-384.

(7) Seng, J. & Taylor, J. (2015). Trauma informed care in the perinatal period. London: Dunedin Academic Press.

(8) Brown, R. P., & Gerbarg, P. L. (2004). The rhodiola revolution. New York: Rodale.

(9) Brown, R. P., & Gerbarg, P. L. (2012). The healing power of the breath. Boston: Shambala Publications.

(10) Scaer, R. C. (2012). 8 keys to brain-body balance. New York: W.W. Norton.

(11) Elliot, S., & Edmonson, D. (2006). The new science of the breath: Coherent breathing for autonomic nervous system balance, health and well-being. Allen, Texas: Coherence Press.

(12) Brown, R., Gerbarg, P., & Muench, F. (2013). Breath practices for treatment of psychiatric and stress related medical conditions. Psychiatric Clinics of North America 36, 121-140.

(13) van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body healing of trauma. New York: Viking.