Stress has long been suspected as a possible cause of miscarriage, with several studies indicating an increased risk among women reporting high levels of emotional or physical turmoil in their early months of pregnancy or just before conception. But while a relationship has been noted, researchers didn’t know exactly how a woman’s stress could cause miscarriage.
In the final episode of their six-part docu-series on Netflix, Prince Harry and Meghan Markle opened up about how the duchess experienced a miscarriage in July 2020. Harry says he believes the stress Meghan had been experiencing from a lawsuit, and the countless sleepless nights that led to, contributed to the miscarriage.
Many studies have linked chronic stress to higher rates of miscarriage, but, it’s unclear how, exactly, stress can increase the risk of pregnancy loss.
Experts say that the impact of stress on a person’s pregnancy is unique to the individual, as everyone responds to stressors differently. Very high levels of stress can lead to concerning symptoms, such as changes in food intake or high blood pressure, which could have a possible negative impact on a pregnancy.
Miscarriage, or early pregnancy loss, occurs in about 10% of known pregnancies. However, some estimates suggest that number is higher since many pregnancies end before people realize they’re pregnant.
Though there are several things that could increase a woman’s risk of experiencing a miscarriage, including chromosomal abnormalities, maternal age, obesity, and alcohol or cigarette use, stress is believed to be a major contributing factor.
An analysis published in 2017 found that the risk of miscarriage was significantly higher in women who experienced intense psychological stress.
However, most major medical organizations, including the World Health Organization (WHO), the March of Dimes, the UK’s National Health Services (NHS), and the National Institute of Child Health and Development, do not consider stress a direct cause of miscarriages.
This is likely because several large studies have found no direct causal link.
How does stress affect pregnancy?
A 2018 large-scale study in the journal Human Reproduction found no link between maternal stress and early pregnancy loss.
Another study found that maternal distress does not impact the uterine blood flow or umbilical cord blood flow, which means that stress has no effect on the fetus’s access to nutrients or normal growth and development.
However, it has been seen that stress may worsen the more common causes of miscarriages.
For example, a 2017 study in Scientific Reports found that while chromosomal abnormalities are often the cause of a miscarriage, psychological factors like stress can increase this risk by about 42%. Pilliod says that miscarriage correlates with more chronic versions of stress, such as the stress caused by poverty.
Researchers say that the stronger associations are in sort of lifelong chronic stress and disparities in terms of socio-economic status, racial disparities, and things of that nature.
Researchers hypothesize that the connection of stress to miscarriage could have to do with the hormonal implications of stress on the body. For instance, increased cortisol affects the placenta and it impacts how other hormones behave. Prolactin, for example, which stimulates the production of progesterone, is decreased by stress, which means both hormones may be suppressed by stress.
Several studies on pregnant women have found that stress is associated with a higher risk of miscarriage. Stress may be caused by financial problems, unemployment, high work demands, marital or relationship conflict, divorce, physical or emotional abuse, or death of a loved one.
Women can also experience stress directly related to their pregnancies, like fear of childbirth (called tokophobia) or anxiety about prenatal testing or the baby’s health. People may perceive different life events to be stressful. A woman’s perception of stress is more important than the actual number of stressors in her life.
The link between stress and miscarriage in humans is not fully understood, but there is biological evidence to suggest that stress and miscarriage are related. Stress activates the hypothalamic-pituitary-adrenal (HPA) axis, which is the body’s stress response system. Studies on rodents have found that when the HPA axis is activated by stress, it affects production of progesterone, a reproductive hormone that is involved in conception and maintenance of a healthy pregnancy. This is believed to put females at higher risk of miscarriage.
Other ways stress can affect pregnancy
Stress can have negative effects on pregnancy and an infant’s health. When women experience stress during pregnancy, the brain produces stress hormones and stimulates the immune system response. Prenatal stress, anxiety, and depression are linked to pregnancy complications like preterm labor and delivery, low birth weight, shorter birth length, preeclampsia, and gestational diabetes. Women who experience stress during pregnancy are also more prone to infection and illness. Women under stress may be less likely to prioritize self-care, which can also increase the risk of illness and infection.
One study found that of the participants who experienced high stress, 54% had preterm births.
Stress can result in inflammatory and chronic medical conditions, such as cardiovascular diseases. Should a mother have one of those conditions, it could affect placental function and growth restriction.
Most common causes of miscarriage
Miscarriages are unfortunately pretty common. Approximately 10% of pregnancies will end in a miscarriage during the first 3 months of pregnancy. But in the majority of cases, it is due to problems that are out of a person’s control.
The most common cause for an early miscarriage is a problem with the baby’s chromosomes. Chromosomes carry the genes that a baby gets from its parents. A developing baby gets one set of chromosomes from each biological parent. But sometimes this process is flawed and the baby gets too many, or not enough, chromosomes. If this happens, it often leads to a miscarriage.
Certain factors can make you more likely to miscarry. These include:
- Being over 35 years old
- Having a body mass index (BMI) over 30
- Having medical conditions like diabetes or high blood pressure
Miscarriages can also occur due to:
- uterine fibroids and scars
- cervical issues, such as cervical insufficiency
- sexually transmitted infections, such as gonorrhea and syphilis
- food poisoning, such as listeriosis
- exposure to harmful substances, such as tobacco, alcohol, drugs, and environmental toxins
The American College of Obstetricians and Gynecologists and other authorities agree that stress is not a cause of early miscarriage. However, this doesn’t mean that stress can’t have some negative impact on your pregnancy.
We know that ongoing stress can affect both mental and physical health. These effects during pregnancy can then lead to complications that create a higher risk of miscarriage.
How to lower stress during pregnancy
It’s very human to feel stress sometimes — especially when you’re pregnant. After all, a lot is changing all at once, so it’s normal to feel some anxiety.
Odds are, work stress or even family stress is unlikely to cause a miscarriage on its own. But stress isn’t necessarily good for you either, which is why there’s no downside to prioritizing self-care and relaxation while you’re pregnant.
What this self-care looks like depends on what you find relaxing, but it could include:
- carving out time for regular exercise (even if that’s just a walk around the park every day)
- getting some rest time in
- asking friends and family for help
- joining a pregnancy support group
- practicing pregnancy yoga
- making time for an activity you enjoy
If you’ve experienced miscarriage or pregnancy loss before, you might find it more challenging than most to not worry about miscarriage, but try to remind yourself that stressing about your stress levels doesn’t help anything.
If you find it difficult to stop worrying, you might also find it helpful to talk to a therapist or to join a miscarriage support group.
While the connection between stress and miscarriage isn’t clear, experts generally agree that higher stress from trauma is more likely to impact your health and pregnancy.
Most miscarriages are not preventable. You might not even have any warning signs that it’s happening until it does — and even if you did, it’s unlikely that medical intervention could stop it.
In addition, mild stress or even work stress is unlikely to cause a miscarriage on its own.
Miscarriage isn’t your fault. It can happen for a number of reasons, and you have nothing to be ashamed of if it happens to you. As a result, there’s no clear way to make sure you don’t experience one.
The best thing you can do is just focus on taking care of yourself, mentally and physically. This can include:
- taking prenatal vitamins
- getting good prenatal care (i.e. regular checkups with your OB-GYN)
- eating nutritious food
- avoiding foods that pose a risk to your pregnancy
- quitting alcohol and drugs
- asking your doctor about any existing prescription medications you’re taking
- decreasing your caffeine intake
NOTE: The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.