Premature birth is on the rise despite many public health campaigns to reverse the upward trend and prevent premature births1. Though modern medical technology means many preemies survive and even thrive, no family wants to watch their child suffer and struggle when he or she is born too soon.
We often hear that we don't know the cause of prematurity. As always, that may be true in some cases. But, as is often also true, we're not actually clueless about this. We know many things we can do to prevent prematurity and help mamas carry their babies to term. It's important for you to know how to prevent premature birth.
In this series I'll look at steps you can take to stay health, help your baby grow, and ensure that your baby makes it full term and fully developed. In Part 1 you'll discover nurturing mamas is an important part of preventing prematurity – and how you can make sure that happens in your pregnancy.
The Power of Stress
I've been teaching an online birthing class for years now, and I tend to get the same questions over and over again. Surprisingly, many of these questions have nothing to do with birth, but with pregnancy. Of course I get diet and exercise questions – but one of the top questions is always stress.
“How do I handle stress?”
“What can I do if I can't get away from stressful situations during my pregnancy?”
“It's so hard to deal with the stress right now. It was tough before but now everyone has advice I don't want and nobody agrees with my choices.”
Stress is a chronic problem for so very many of us, and it has many powerful physical effects on our body. Those effects are magnified during your pregnancy. Your baby feels everything that you feel and experiences everything that you experience.
When financial worries feel like they're crushing you, that translates to baby. When you can feel your blood pressure rising and your pulse raising from the stress of trying to deal with uncooperative people, those effects are happening to your baby. Stress is physically exhausting – it saps away your energy and perhaps your very life force, leaving you drained. Literally.
In a journal article entitled “Prematurity and Perinatal Neglect,” midwife Sister MorningStar notes “there is never enough food for a stressed mother.”2 What Sister MorningStar, a midwife with wisdom that comes only from a lifetime of serving mamas and babies, is saying is that it doesn't matter how well nourished you are. If stress is chronic it taxes the body above and beyond what food (even great food) can compensate for.
I don't share this to make you feel guilty – I have had plenty of stress in my own pregnancies – even knowing the incredibly negative effects that it can have. In reality, some stress is actually good for your baby. I talk about this in detail in my podcast on what your baby experiences during pregnancy: experiencing some stress, then experiencing how you effectively handle stress once the acute situation has passed, actually programs your baby to handle stress in healthy ways.
But chronic stress is dangerous for mothers and babies. If you cannot relieve the stress, it puts intense physical, chemical, and hormonal pressures on your body, which is already working very hard to care for your baby and keep itself in good condition.
The Wisdom of the Body
Sister MorningStar also points out that a mother's body has incredible amounts of wisdom. When baby is not being adequately cared for in the womb, for whatever reason, the body makes the decision that baby is better off outside. Premature labor and birth result.
There are many factors that could contribute to your body thinking baby is better off on the outside – we'll cover more of them in upcoming parts of this series because stress isn't the only factor. Yet chronic stress has very real effects: it puts pressure on the heart, which is already pumping more blood than usual in pregnancy; it causes blood pressure problems; skin problems can begin or be exacerbated; you're more susceptible to infection; it may be linked with diabetes; and, of course, it is linked with prematurity.3, 4
The key takeaway here is that it's important to nurture your body throughout pregnancy – caring for yourself creates the best environment for your baby.
Taking Fight or Flight Offline
Stress starts a chain of events you probably know as the “fight or flight” system. Adrenaline (epinephrin) and cortisol are released when your body senses some type of threat. That could be a tiger, it could be fear of the electricity being shut off, or fear of how your mother-in-law is stressing you out about your birth choices.
Take a look at the infographic5 to the right to see just how many effects a stressful situation has (and imagine those effects happening much, most, or all of the time) – you can click the image to open a large version in a new tab.
You want to take this system offline – mostly – to enjoy a healthier pregnancy. Remember, as I shared above, some stress here and there is beneficial for your baby. He or she will certainly experience stress in life, so you can program your baby to have healthy stress responses now. I'll tell you how to do that in a just a minute.
Right now, I want you to seriously consider what you can do to take chronic “fight or flight” offline. You've probably heard that this adrenaline response can slow or even stall labor out completely, which is true. But I want you to consider it even now.
What stress can you root out of your life? Are there steps you can take to remove some of the stress, or lessen it? I'm a big proponent of asking for help during a pregnancy – we'll talk about the very personal aspects of assembling a “village” in a minute. But there are personal choices you can make to reduce stress. Some examples are:
- Reduce hours at work (it is better to have less income and a healthy baby than earning a preemie by overwork)
- Delegate work and/or develop systems to streamline it
- Evaluate relationships for stress and set boundaries (or even cut off toxic relationships for the time being)
- Talk through issues with your partner. Get counseling if you need it
- Accept financial assistance (through your government, church, synagogue, local charities, utility company program etc.) – I think pregnancy is a time to accept assistance and lower stress because your baby's health depends on it
- Make a plan to handle issues that cause recurrent stress – especially financial stress. You may not want to depend on charity forever (who does?) – and creating a plan will immediately relieve stress because you can see how to create a better life for yourself. If finances are the issue, I recommend [raw]
Dave Ramsey's Baby Steps[/raw] – a proven roadmap to hope 🙂
- Make a plan to handle anything stressing you out – upcoming layoffs, upcoming moves, etc. Those things may still be scary and may still cause some stress. But having a plan will help. And it helps your baby.
- Plan your meals out and clean up as soon as you are done with something (dishes, books, toys, whatever)
- Close off rooms you don't use, pack up toys your kids don't play with, and cart a box of stuff to Goodwill or the Salvation Army store every week. Simplify.
- Don't be afraid to say “no” to commitments that are really more than you should take on right now
- Don't feel guilty for saying “no,” packing up toys, giving away gifts you never liked anyways, etc.
- Ask wise, experienced parents for help on parenting issues with your children (in your community, online, or in books – look for families with values similar to yours who have raised happy, healthy, and successful adults)
- Get older children to help – it's good for them
I could continue on with more ideas, but I think you get the picture. Look at areas of your life that are causing you stress and see what you can do to reduce or even remove it. It may take some planning and some courage initially, but the end results are more than worth it for you – and for your unborn baby.
(NOTE: Trying to balance your pregnancy, life, and getting ready for baby? Use my checklist pack stay healthy (naturally), organized, and confident throughout your pregnancy! Get them here.)
Bringing Calm and Connection Online
I used to think the only step in this process was to remove stress, but that's not actually the case. Proactively removing stress is vitally important, but don't stop there.
There's another system, called “The Calm and Connection System6” which is actually opposite of the fight or flight system. You want to have this system “online” as much as possible, and you defintely want to activate it once an acutely stressful situation has passed. Activating this system is what I mentioned helps program your baby for a healthy stress response: “I experience stress and that's tough, but then I handle it and start to calm down, and then I'm calm and I start to feel better and enjoy my day again.”
You want your little one to think that the calm and connection system is the “default” system instead of living in a chronic state of fight or flight. Check out the chart contrasting the effects the two systems have on your body7. Which would you prefer for your babe?
Oxytocin is the primary hormone of the calm and connection system. I've discussed oxytocin quite a bit: how it impacts your birth (and when your labor begins) in “Will the Real Oxytocin Please Stand Up?” and in the podcast I already mentioned: “Your Baby's Experience of Pregnancy.” The podcast is especially relevant for you in pregnancy, because it covers in detail how to get the calm and connection system online – which prevents pregnancy complications and prematurity.
In her Newborn Breath workshop8, Karen Strange discusses how babies experience stress and how to handle a stressful situation. She recommends that once the acute situation has passed, you should take calming breaths and notice where your body is in space. This is essentially, literally, grounding yourself. Feel your feet on the floor or your bum in a chair. This helps you calm down completely. Then you think about something pleasant. For instance, ice cream 😉
You probably smiled when I mentioned ice cream – that activates pleasant memories and helps get oxytocin flowing. Now the calm and connection system can take over.
Don't just jump-start oxytocin after an acutely stressful situation, though. You need to build calm and connection into your day – every day! When I'm working with mamas struggling with fertility issues, I encourage them to make oxytocin a habit, since stress also has a powerful effect on fertility. Pregnancy is a natural extension – once you get pregnant, you want to stay pregnant for the full 40 weeks!
Make Relaxation a Habit
In addition to the stress reducers above, I recommend you plan regular points in your day to focus on relaxation activities that jump-start your calm and connection system. This could be something that's already part of your routine – for instance, many mamas find a daily shower very relaxing. Put on some music and take 10-15 minutes to pamper yourself. You might add a homemade sugar scrub or something else fun every few days.
It's hard to say exactly what will work for you – look at what really relaxes you during your day. I find that having a morning quiet time, where I can read my Bible and pray (before my kids get up) is really essential to me starting the day on a (mostly) peaceful foot. Singing while I do routine chores, like packing Scott's lunch, making dinner, and straightening up really helps. I take a long bath with Epsom salts once a week or so – that really helps me feel better physically and mentally. Here are some suggestions for boosting oxytocin:
- Give hugs!
- Or cuddling if you're worried about contractions from lovemaking
- Playing with or snuggling with your kids
- Playing with or snuggling with your pet
- Enjoying a good meal
- Reading a nice fiction book or watching a funny/warm & fuzzy movie
- Seeing pictures of babies
- Seeing pictures of animal babies
- Work on a creative project (coloring, handicrafts, etc.)
- Do something good for someone else (volunteer on a casual basis, say a prayer, make a gift, etc.)
These suggestions are all based very much on who you and what makes you feel calm, centered, happy, etc. Your list could end up being totally different from what I've suggested. I recommend that you spend a little time brainstorming what makes you feel good – what gives you that little smile and feeling of peace/happiness/satisfaction. It doesn't have to be pure pleasure – vacuuming a room and then looking at a clean floor gets my oxytocin flowing (feel free to laugh).
You can have some habits that take awhile, like my bath. But I recommend you plan smaller things that don't take up a lot of time, or even that could be repeated over and over again (like hugs!). These are small habits you build into your day. They counteract the daily stresses of life and keep you feeling content and peaceful.
That keeps your baby bathed in feelings of peace and contentment throughout much of the day, which is a great way for your baby to grow. Contrary to past beliefs, babies are extremely sensitive in the womb and really benefit from a mama who is feeling centered (and even pampered) during her pregnancy. Go back and review that chart above, too – the positive physical effects of calm and connection offer built-in, renewable protection against prematurity. I recommend reading [raw]
It Takes a Village
Thus far we've focused on steps you can personally take to reduce the amount of stress in your life and build relaxation and calm into your days. But we as mothers, even as humans, cannot be an island. Families need support. You've probably heard the saying (I believe it's an African proverb) that “it takes a village to raise a child” – really, it takes a village to support a mother.
Pregnant women deserve to be supported and pampered. This doesn't mean lying around letting everyone else do things for you – I'd go crazy doing “nothing.” Bed rest is a commonly prescribed course of action when premature labor threatens. It's hotly debated because care providers, doctors and midwives alike, cannot agree on if it helps or hurts! I think it's always up to you as the mama, but the moral of the story is that doing “nothing” all day may not really help.
Support from a village is what really makes the difference. I mentioned a journal piece by Sister MorningStar early in this article. She shares the story of a mother who delivered her second son prematurely – and while she was trying to balance an older baby, a preemie, and her own recovery, help flocked to her. The profound challenge Sister MorningStar issues is this – would that baby have been born prematurely if all that help had been there for her during pregnancy.
Why do we wait until after the tragedy of premature birth has already happened to offer help?
Here's the key takeaway: you can only do so much yourself. Sometimes you need the support of others, outside of yourself. Truly this is a problem that our culture and society needs to look at, because it is a cultural issue. We've long given up supporting mothers and babies, instead expecting mothers to be supermom and determining that a minimum-wage worker is as good as a mom when it comes to raising our infants. The cause of such chronic devaluation of our mamas and our children is not a topic I can cover today – but this problem is part of the barrier for reducing the rate of premature birth in our world.
Lets move back to ways that you can more proactively make a difference, however, rather than dwelling on what we can't (yet) change.
How to Make Your Village
Having support doesn't just have to come from somebody physically helping you with meals, housework, and older children (but if you can get that help, please don't turn it down). Much of it comes from creating a supportive environment, what many call a “tribe.”
If you have had premature labor with a previous pregnancy or the threat of it with this pregnancy, I would reach out as much as possible to get hands-on, physical help. Work to mitigate stress (seek financial help, remove toxic relationships, etc. as I outlined above) – and get real help. Can you hire someone to come in and clean? Can somebody come and watch the kids while you get extra naps a few days a week? Can someone help with meals? Reach out to local churches or synagogues if you need help with meals. Ask your local librarians what organizations are in your area; often there are women's groups with someone able to organize meal trains or cleaning. Getting help to keep your baby inside is invaluable and you should not feel guilty about asking for it.
Lets move back to creating a supportive environment – sometimes emotional support is a critical piece of the puzzle, maybe even more so than physical.
Ideally your care provider is someone you can support and trust. A midwife excels at this, and many obstetricians now have CNM's (certified nurse-midwives) on staff. Find a care provider who will really listen to your concerns – and is willing to discuss issues with an open mind.
In my fifth pregnancy I really needed someone to listen with a non-judgmental ear, to be there for me as I struggled with depression and other problems. Of course my midwife also gave me excellent advice to improve my health and grow my baby (who came at term and very healthy) – but her ability to listen was really critical to my well-being. I would love to know you've found a provider like that. Check out my podcast on choosing and working with a care provider for more on finding the right person for you.
It's also good to know that your spouse is on board and is helpful. This can really vary depending on the expectations your spouse has, what his mother did, etc. I generally recommend trying to streamline things like housework and meals as much as possible, then ask for real help on top of that. And ask what he can help with.
For instance, Scott supervises laundry in our house (now that we have older children helping – when all children were little he did all the laundry). He also sends me to the library for a few hours one day a week so I can recharge and have some uninterrupted time (very rare in our home). And he goes to work every day to provide for our family, which is a considerable burden and I'm grateful he assumes it. But your man may be different. Laundry could be an alien concept to him. Talk things over with him and find out what he's able to help with 🙂 And if things are really tough let him know you need him to step up to the plate and take over in some areas – his baby is depending on him.
Build That Tribe
You should also find a source for some mama advice. Ideally this is from other mamas right in your community. You may be able to reach out and find other parents who have children at the same ages as yours. Natural birthing classes or prenatal exercise classes can help you find other pregnant women. A La Leche League meeting, playgroup, or other mommy gathering can help you meet like-minded moms, too. I'd also encourage you to reach out to experienced moms in your circle of friends. There's benefit in having friends who are in the trenches with you, and those who can give you wise advice from their own experience.
What if you can't find a “tribe?” You can still build a support system for yourself. One solution is to go virtual. Virtual due date clubs and online forums abound. A big benefit of the internet is the ability to find women who share your values, hopes, and dreams. Wanting a more natural focus for your pregnancy, birth, and parenting journey? You can find other women who are working towards the same thing. Sometimes the internet comes with drama, but often it's a valuable source of finding mamas who are going through the same things as you… and those who've been there and can give you great advice.
Books are another helpful source of support. Books often contain wisdom that's really beneficial, and experienced mamas have written books on everything from streamlining your home routines to handling those crazy baby days. I'm a big believer in books and the benefits you can reap from putting somebody else's trial and error results into your life.
Nurturing Your Baby Starts with Nurturing You
I've covered a lot of information on what stress is and why chronic stress is really bad news for your baby. Today's relentless stress and lack of support are one of the reasons prematurity rates are so high. As I've shown you, some of that is an issue with society at large – change needs to happen to support mamas and babies. I believe it's something that won't start on a national level, however. It starts with mothering the mothers right in our own community – and being willing to do it before they have their baby.
But aside from a global change that needs to start on a grassroots level, I've shared many ideas to help you control your own stress levels. More importantly, I've covered how you can build relaxation, calm, and connection into your days – all of which raise positive hormone levels and bathe your baby in a pleasant and protective cocktail of health and well-being.
(NOTE: Trying to balance your pregnancy, life, and getting ready for baby? Use my checklist pack stay healthy (naturally), organized, and confident throughout your pregnancy! Get them here.)
Taking these steps may feel selfish, but I hope I've convinced you that it's vitally important to the health of your baby. Taking care of yourself is taking care of your baby – and he or she is counting on you, every day 🙂
The Premature Birth Prevention Series
- How to Prevent Premature Birth: Part 1
- How to Prevent Prematurity: Part 2
- How to Prevent Premature Labor and Birth: Part 3
2. MorningStar, S. (2014) Prematurity and Perinatal Neglect. Midwifery Today (111), 9-13.
3. See HM1 reference to maternal changes to the cardiovascular system
4. http://psychcentral.com/lib/the-physical-effects-of-long-term-stress/000935/2 (accessed 12/12/14)
5. http://commons.wikimedia.org/wiki/File:The_Fight_or_Flight_Response.jpg (accessed 12/14/14)
7. p. 23 The Chemistry of Connection
8. Strange, Karen. Newborn Breath and NRP Workshop, February 2014