We are keenly aware of the impact stress can have on our physical health. If you’ve ever felt overwhelmed or unable to cope thanks to the myriad pressures life puts on us, you’ll know it can have a serious impact on the body. Disruption to our digestive systems, being more vulnerable to illness, headaches and breakouts can all be physical symptoms of excessive worry and anxiety.

Knowing what stress can do to our bodies, if you’ve had a miscarriage, it’s perfectly natural to wonder whether going through a stressful time or experiencing ongoing anxiety during pregnancy might have played a role. According to baby charity Tommy’s, one in five pregnancies in the UK end in miscarriage, and despite how common they are, we still don’t know definitely what role stress plays in the mix. However, we do know that most early miscarriages (that’s up to 12 weeks) are caused by problems with the baby’s chromosomes – and those happen by chance.

Miscarriage and stress is a topic that was thrown into the spotlight in 2020 when Meghan Markle wrote in a New York Times op-ed that she believed stress had played a contributing factor in her own miscarriage. And plenty of other women speak anecdotally about the link between a stressful patch and their subsequent loss. So, what’s the truth?

There’s no denying that pregnancy, with all its uncertainties, can be a stressful time. “Stress is our body’s response to pressure, and that manifests in many ways. We have very little control over stress in our lives and during pregnancy so it’s natural to feel more anxious or stressed at times,” explains Jyotsna Vohra, director of research, programmes and impact at Tommy’s. “If left unmanaged, stress can develop into chronic stress or even burnout.”

The few studies that have been done exploring whether stress increases the chances of miscarriage tend to conclude that there is a connection. However, many baby loss charities are keen to point out that this research is limited and not always reliable. This is down to a number of factors including the difficulties in actually pinpointing how stress feels for each individual.

“There is little detailed research on the exact relationship between stress and miscarriage. But when researchers at our Tommy’s National Centre for Miscarriage Research reviewed the existing data on stress and miscarriage, they did find evidence of a link between the two,” explains Vohra. “However, there is still no direct evidence that stress causes miscarriage.”

Dr Amit Shah, gynaecologist and co-founder of Harley Street clinic Fertility Plus, explains that cortisol (aka the ‘stress hormone’) may have an effect on pregnancy, especially when present in high levels over a prolonged period: “Cortisol may cross the placenta and potentially affect the developing foetus. Elevated cortisol levels have been associated with preterm labour, low birth weight and developmental issues in the foetus. However, the direct link between cortisol and miscarriage is still an area of ongoing research.

“Stress is typically not seen as the sole cause of miscarriage. Instead, it’s important to recognise the multiple factors that may contribute, with stress being just one part of the overall picture.”

A 2017 study published in the Scientific Reports journal suggested that “the risk of miscarriage was significantly higher in women with a history of exposure to psychological stress” and that “prior psychological stress is harmful to women in early pregnancy”. Despite this, the authors of the study were clear to point out that “stress varies, not only by an individual’s internal resources but also by the social and material support which is available to them” and that results were “difficult to assess as physiological responses to stress vary with its intensity and duration, and are contingent on the genetic vulnerability and life history of the affected individual.” 

The problem with singling out stress as a cause for miscarriage is its inherent inscrutability due to being an emotional response. It can be hard to understand how much an individual’s stress levels might be directly linked to a miscarriage or whether the things people do while feeling stressed, such as drinking or smoking, might increase the risk of miscarriage. And then there’s the fact that, for generations, humans have given birth in a variety of stressful situations.

“More research is needed to understand the exact link and what it could mean, because stress can be related to other factors, like difficult working conditions or poorer health in general,” adds Vohra.

It’s natural for anyone who has experienced a miscarriage or pregnancy loss to question why it has happened and look for answers. “This is completely understandable and why Tommy’s are committed to funding high quality research that will help us to understand why miscarriages happen and how we can prevent them, and ensuring that anyone who has experienced pregnancy loss has support with their emotional and mental wellbeing that is so needed and can often be overlooked under current miscarriage care,” says Vohra. 

So what does this mean practically when dealing with stress in pregnancy? “Telling people ‘not to stress’ for their own emotional and physical health doesn’t usually work,” says Vohra. “It can be counterproductive and cause more guilt and worry, leading to pregnant women and birthing people feeling even more concerned about whether that anxiety or stress is affecting their baby’s growth and development.

“If you’re feeling extremely anxious or are persistently stressed during your pregnancy, it’s important to speak to your healthcare team so they can provide you with additional support.”

Dr Shah has the following advice for anyone who’s experienced or is currently going through miscarriage: prioritise emotional and physical wellbeing.

“Miscarriage can be a deeply emotional experience, so seeking support from loved ones, support groups or counselling can be beneficial. For future pregnancies, focus on maintaining a healthy lifestyle, managing stress and adhering to your doctor’s recommendations. It’s important to remember that miscarriage is often beyond your control, so be kind to yourself during this time.”

Images: Getty