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74 m a s s a g e & b o d y wo r k m ay/ j u n e 2 0 2 1 they worry about all the things that could go wrong. Some plan their "ideal" birth and feel anguish over anything that falls short. Some cling to real or imagined promises of painless, risk-free labor through technology and pharmaceuticals to assuage their fears about the upcoming birth; others fear those same interventions. Health problems, not to mention stresses from the rest of life, increase maternal and fetal risks for some women, adding additional layers of apprehension about the pregnancy's outcome. 3 Consequences of Stress for Mother and Baby As we know, stress activates the sympathetic branch of the autonomic nervous system. This increases adrenal production of stress hormones, creating a fight, flight, or freeze response. Such activation is essential for our survival—think of slamming the car brakes to avoid an accident. However, both acute stressors and chronic sympathetic arousal, provoked by ongoing worries and anxieties, can have negative impacts on mother and baby. 4 Today, the topic of stress seems ubiquitous. But amid our ongoing complaints about how stressed we are, or how stressed out we feel, it is useful to consider the very concrete and far-reaching ways stress impacts health. In the rapidly growing fetus, and the rapidly changing mother, the negative manifestations of stress can be many. In one study, elevated amounts of maternal stress (both psychosocial stress and cortisol levels) early in pregnancy were associated with poorer cognitive performance when the baby was a year old. 5 In addition, prenatal depression— which is both caused by various social and physiological stressors and furthers those sources of stress—has been correlated with prematurity and low birth weight. 6 Multiple systematic reviews reveal a litany of consequences emerging from prenatal stress. During pregnancy and birth, there is an association between prenatal stress and: • Preterm labor • Preterm birth • Low birth weight • Restricted fetal growth • Pre-eclampsia • Gestational diabetes 7 Those negative consequences can, in turn, continue into the baby's life, manifesting in: • Hyper-responsiveness to stress • Asthma • Allergies • Temperamental difficulties • Affective disorders • Attachment difficulties 8 This growing body of evidence supports the "fetal origins hypothesis," which argues that what the fetus is exposed to in utero— not just environmental factors, but also psychosocial ones—"can have sustained effects across the lifespan" of the child. 9 Indeed, one review argues that "prenatal stress can have consequences that span generations." 10 What Massage Can Do The potential stressors of pregnancy are numerous. Yet, there is a way to help with all of them: learning how to relax and to focus internally. Relaxation and self-awareness tend to increase well-being for both mother and baby, and the chances for positive birth experiences. Learning relaxation techniques is correlated with a host of benefits: "fewer admissions to the hospital, fewer obstetric complications, longer gestation, reduction of cesarean sections, and fewer postpartum complications." 11 Women REMINDER Increased relaxation facilitates healthy circulation to the uterus, which improves fetal well-being. Possible Benefits of Prenatal Relaxation • Enhanced immunological function • Increased oxytocin production • Reduced maternal blood pressure, heart, and respiratory rate • Increased uterine blood supply to enhance fetal health • Fewer prenatal complications • Reduced fear and anxiety • Reduced labor time and complications