When it comes to preterm birth, stress matters

In 2005, there was a devastating earthquake in Chile. Years later, a researcher asked whether or not the earthquake impacted preterm birth rates in that community. Some women saw a greater risk; others did not. What made the difference? Women closest to the center of the quake AND in their 1st trimester during the quake had significantly higher preterm birth rates, but not those exposed later in pregnancy or further from the quake. This suggests that intense stress early in pregnancy may be a risk factor for preterm birth.Stress during pregnancy is associated with a variety of poor outcomes, including preterm labor, low birthweight babies and pregnancy-induced hypertension. Evidence suggests women experiencing particularly high levels of stress during pregnancy are at a 25-60% greater risk for preterm birth as compared to women reporting low levels of stress.A variety of factors can cause stress during pregnancy, including anxiety, depression, perceived racism, health behaviors, trauma, a lack of coping resources, the community in which one lives and/or works, social expectations, socioeconomic level, level of education and quality of relationships. This issue is inherently complex, and we do not expect to eliminate stressors for moms. However, we believe that increasing social support can buffer the effects of stress. What can this look like?

• Group Prenatal Care. There is power in knowing you aren’t alone. During group prenatal care, 10 women who are at similar stages in their pregnancies go through their prenatal care experience as a group. In this setting, women are able to form important social connections with their peers that can help reduce stress. CenteringPregnancy, a model of group prenatal care, is currently offered by TriHealth, Christ Hospital, WinMed Health Services and UC Health.  In partnership with Ohio Department of Medicaid, we are currently expanding the model in Hamilton County.
• Community Health Workers and Home Visitors. Sometimes, we could all use a bit of judgement-free support. Community health workers and home visitors across multiple agencies serve and advocate for pregnant women and moms. They help with issues related to housing, transportation, food and employment that can be stressful for women to deal with during and after pregnancy. Women can get connected to these services simply by calling 211.
• Non-heath partners who impact health. It turns out that stress related to housing, income, transportation and education play an important role in our health. For this reason, Cradle Cincinnati has recently formed new partnerships with organizations like Cincinnati Public Schools, Cincinnati Metropolitan Housing Authority, and Hamilton County Jobs and Family Services to work on new ways to lessen the impact of stress on local pregnancies.

Together, we can help Cincinnati have less stressful and healthier pregnancies. Join us as we recognize November as Preterm Birth Awareness Month by highlighting the important role that stress plays on this issue.