Pregnancy is often spoken of as a magical time, full of happy anticipation and feel-good hormones. So it's ironic that the period right before pregnancy – the months, and sometimes years, when you are trying to conceive – can be extremely stressful.

For many women, conception takes time, and the waiting period is full of worry.1

The worry itself can be a source of stress, because many women fear that not being "relaxed" enough will hurt their chances of conceiving,2 although research doesn't back up that common belief. Average stress levels don't reduce fertility nor do they decrease the odds that fertility treatments will work.2,3 

Still, there are good reasons to pay attention to your stress level when you are trying to have a baby. Individuals under high stress take poorer care of themselves and are more likely to smoke or abuse other substances.2 And when you do conceive, the hormones that flood your body when you are highly stressed can cause problems for the baby, including an increased risk of premature birth and low birth weight.

Significant stress during pregnancy also increases a child's long-term risk of having a learning difficulty, a mood disorder, or an immune system problem.4-7

Although most women won't experience these risks, any woman can benefit from taking steps to reduce stress and build resilience. Nurturing your well-being will always help you and your baby. The best time to start is right now – while you're preparing your body and spirit for a baby.

Building resilience for the journey

Stressful events are a fact of life, and you can't avoid them. But you can start making changes that will help you manage how these events affect you. Consider these approaches, each supported by stacks of scientific research:8-14

1. Get active

Virtually every form of physical activity acts as a stress reliever, even if you're not an athlete or you're out of shape. Exercise pumps up your body's feel-good neurotransmitters – called endorphins – which boost your mood while reducing stress, anxiety, and depression.11

2. Eat a healthy diet

Focus on fruits, vegetables, and whole grains, which will help your body run strong and avoid illness. Avoid simple sugars, starches, and too much caffeine, which spikes your blood sugar and triggers stress hormones.12,13

3. Embrace relaxation

Try yoga, practice deep breathing, get a massage, learn to meditate.8,9

4. Take time for hobbies

Read a book, listen to music, catch up on your favorite podcast.8,9

5. Laugh

Even if you force a fake laugh, the act of laughing fires up and then cools down your stress response. Read a humorous story, tell some jokes, watch a comedy, hang out with a funny friend.10,11

6. Connect with others

Social contact is a powerful stress reliever. Take time for a walk with a friend, call a relative, visit your place of worship. Focus on real-world socializing. Studies show that while social media makes it easier to stay in touch with your friends, connecting online doesn't offer the same supportive benefits as time spent in person.14 

7. Practice saying “No”

There's never been a better time to put your needs first. Saying “yes” might keep the peace, but it can lead to stress, anger, and resentment.8,9

8. Protect healthy sleep

Prioritize having a quiet and relaxing bedtime routine. Turn off all your electronic screens and listen to soothing music, take a bath, read a book. And stick to a consistent sleep schedule.8,9

Do you carry other worries or grief on top of trying to conceive? Some of the most stressful life events include the death of a loved one, losing a job, and moving.10 In these tough times, you might need extra support.

When fertility issues cause the stress

Infertility is a common source of stress.1 As months pass without a successful pregnancy, depression, anxiety, sexual problems, and low self-esteem can set in. You might find yourself fighting with your partner more often. For many couples facing fertility issues, different coping styles can leave both people feeling isolated and angry.15

Try these ideas to cope with the ups and downs of infertility testing and treatments:3,15

1. Become informed

Ask your health-care practitioner to explain the steps involved in your treatment plan. Keep asking questions until you're sure you understand.

2. Accept your feelings

It's completely normal to feel stress, anger, sadness, and other emotions during this process.

3. Seek support

Reach out to your partner, family members, friends, a professional for support. If you and your partner are experiencing frequent conflict, then seek the help of a couple's counselor. Work on open communication and take timeouts from talking about infertility.

4. Guard your heart

It's okay to decline invitations to baby showers, birthday parties, and other events that can make you feel too emotional. Your own well-being is your first priority.

5. Keep a journal

Writing down your thoughts and feelings is a good release. Don't think about what to write – just let it flow.

When stress comes with company: Anxiety and depression

The signs and symptoms of anxiety and depression often look a lot like stress – and they certainly make stress worse. These mental health conditions can also cause problems when you are trying to conceive. Poorly managed or untreated depression or anxiety can reduce your chances of becoming pregnant.15,16 

If you take a medication for depression or anxiety, then don't stop using it without first talking to your health-care practitioner. Going off these medications can cause more severe symptoms and fertility issues.15

If you're taking, or considering taking, an antidepressant or an anti-anxiety medication, then talk with your health-care practitioner about your options before you become pregnant. Together you can discuss the risks and benefits of making a change – or sticking with what works.

There might be other approaches with fewer side effects or problems for the baby should you become pregnant. Fish oil supplements might help ease pregnancy symptoms. Some studies in adults suggest that omega-3 fatty acids can help in treating mild-to-moderate depression.16 Talk to your health-care professional before starting any new nutritional supplement regimen.


References

  1. Hornstein M, Gibbons W, Schenken R. Optimizing natural fertility in couples planning pregnancy. https://www.uptodate.com/contents/search. [Accessed Jan. 2, 2018]
  2. Latendresse G, Wong B, Dyer J, et al. Duration of maternal stress and depression: Predictors of newborn admission to neonatal intensive care unit and postpartum depression. Nurs Res 2015;64(5):331-341.
  3. Witt W, Park H, Wisk L, et al. Neighborhood disadvantage, preconception stressful life events, and infant birth weight. Am J Pub Health 2015;105(5):1044-1052.
  4. Vaiserman A, Koliada A. Early-life adversity and long-term neurobehavioral outcomes: epigenome as a bridge? Hum Genomics 2017;11(1):34.
  5. Barrett E, Swan S. Stress and androgen activity during fetal development. Endocrinology 2015;156(10):3435-3441.
  6. Stress management: Stress basics. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/basics/stress-basics/hlv-20049495. [Accessed Jan. 2, 2018]
  7. Stress relievers: Tips to tame stress. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relievers/art-20047257. [Accessed Jan. 2, 2018]
  8. Stress and your health. Office on Women's Health, U.S. Department of Health and Human Services. https://www.womenshealth.gov/a-z-topics/stress-and-your-health. [Accessed Jan. 2, 2018]
  9. Peterson D. The benefits and risks of exercise. https://www.uptodate.com/contents/search. [Accessed April 24, 2018]
  10. Reduce stress with diet and exercise. National Women's Health Resource Center. http://www.healthywomen.org/content/article/reduce-stress-diet-and-exercise. [Accessed Jan. 2, 2018]
  11. Pregnancy nutrition: Foods to avoid during pregnancy. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20043844. [Accessed April 24, 2018]
  12. Trying to conceive, pregnancy, and mental health. Office on Women's Health, U.S. Department of Health and Human Services. https://www.womenshealth.gov/a-z-topics/stress-and-your-health. [Accessed Jan. 2, 2018]
  13. Nillni Y, Wesselink A, Gradus J, et al. Depression, anxiety, and psychotropic medication use and fecundability. Am J Obstet Gynecol 2016;215:453e1-8.
  14. Fish oil supplements: Can they treat depression? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/fish-oil-supplements/faq-20058143. [Accessevd Jan. 2, 2018]
  15. Nicoloro-SantaBarbara J, Busso C, Moyer A, et al. Just relax and you'll get pregnant? Meta-analysis examining women's emotional distress and the outcome of assisted reproductive technology. Soc Sci Med 2018;213:54-62.
  16. Galst J. The elusive connection between stress and infertility: a research review with clinical implications. J Psychother Integr 2018;28(1):1-13.