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Miscarriage, or the death of a fetus in the womb before the 20th week of pregnancy, is the most common reason for losing a baby during pregnancy. It affects 10 to 15 percent of all known pregnancies, or roughly 1 million pregnancies a year.

And yet, as often as miscarriage occurs, there is a lot of stigma, silence, and shame felt by those who lose their baby. This is often because the pregnant parent feels responsible for the loss in some way. Some people may even wonder if it was their stress level that led to the miscarriage.

Unfortunately, this shame isn’t helped by the lack of information about miscarriages in general. Even when there is information, though, that information is sometimes contradictory or confusing — especially when it comes to the role that stress might play.

Unfortunately, the evidence isn’t clear on the role of stress in causing or putting someone at risk for a miscarriage.

Most major medical organizations, including the World Health Organization (WHO), the March of Dimes, the UK’s National Health Services (NHS), and the National Institute of Child Health and Development, do not consider stress a direct cause of miscarriages.

This is likely because several large studies have found no direct causal link.

For example, a 2018 study of 344 women found no link between miscarriage and stress, and a 2013 study didn’t find any evidence that stress impacts uterine or umbilical cord blood flow, suggesting that stress doesn’t affect a fetus directly.

However, there has been some research to suggest that there is at least an indirect link between stress and miscarriage, which could make it a risk factor.

For example, a 2016 Danish study suggested that social stressors could play a role because it found an increase in miscarriages one month after an economic downturn.

A 2017 review of research since 1978, meanwhile, also suggested that psychological stress could increase the risk of miscarriage by as much as 42 percent. While study authors aren’t exactly sure what the connection is, they theorize that it could have something to do with how stress affects hormones important to pregnancy.

For example, cortisol might affect the placenta, while prolactin and progesterone (two hormones essential for pregnancy) could both be suppressed by stress.

Other studies have suggested stress could be a risk factor because it affects the pregnant person’s mental health and behavior. For example, stress might trigger depression, which could, in turn, cause the parent to be more likely to use harmful substances like alcohol and drugs or smoke tobacco.

It could also raise the risk for adverse pregnancy outcomes because it endangers your physical health during pregnancy. For example, stress could increase your blood pressure — research has found a link between poverty and high blood pressure — and high blood pressure is a risk factor for early pregnancy loss and preeclampsia.

Stress could also cause you to forget to eat, which will impact your growing fetus’s ability to get the nutrients it needs and raising the risk of preterm birth or low birth weight. Or stress might lead you to eat too much, causing you to gain weight too quickly, raising your risk for gestational diabetes.

Still, these are indirect links. Most doctors and researchers agree that stress alone likely doesn’t cause a miscarriage directly. Even the 2017 review that found a link suggests that other factors are more likely to cause miscarriage.

Chromosomal abnormalities

About half of all miscarriages result from a chromosomal abnormality, which means that the embryo gets the wrong number of chromosomes or is affected by translocation, which is when one part of a chromosome moves onto another.

Chromosomal abnormalities could cause an embryo to implant, but never develop, which is called a blighted ovum. Or they could cause the fetus to stop developing in the womb, which is called intrauterine fetal demise.

Sometimes they lead to a molar pregnancy, which is when the embryo forms into a tumor.

Chromosomal abnormalities are never anyone’s fault and there is nothing that any doctor — or you — can do to prevent them from happening.

Other causes

Miscarriages can also occur due to:

Other risk factors can include:

  • being over the age of 35
  • having obesity (BMI of 30 or more)
  • having certain autoimmune diseases, such as antiphospholipid antibody (APA) syndrome or systemic lupus erythematosus

First of all, you may be wondering if your miscarriage was caused by something you did. In all likelihood, no.

Most miscarriages are not preventable. You might not even have any warning signs that it’s happening until it does — and even if you did, it’s unlikely that medical intervention could stop it.

In addition, mild stress or even work stress is unlikely to cause a miscarriage on its own. Extreme stress (think: the loss of a loved one, severe trauma) might come with a higher risk — but even then, the link is not well established. And remember: This stress isn’t likely your fault, either.

Miscarriage isn’t your fault. It can happen for a number of reasons, and you have nothing to be ashamed of if it happens to you. As a result, there’s no clear way to make sure you don’t experience one.

The best thing you can do is just focus on taking care of yourself, mentally and physically. This can include:

  • taking prenatal vitamins
  • getting good prenatal care (i.e. regular checkups with your OB-GYN)
  • eating nutritious food
  • avoiding foods that pose a risk to your pregnancy
  • quitting alcohol and drugs
  • asking your doctor about any existing prescription medications you’re taking
  • decreasing your caffeine intake

It’s very human to feel stress sometimes — especially when you’re pregnant. After all, a lot is changing all at once, so it’s normal to feel some anxiety.

Odds are, work stress or even family stress is unlikely to cause a miscarriage on its own. But stress isn’t necessarily good for you either, which is why there’s no downside to prioritizing self-care and relaxation while you’re pregnant.

What this self-care looks like depends on what you find relaxing, but it could include:

  • carving out time for regular exercise (even if that’s just a walk around the park every day)
  • getting some rest time in
  • asking friends and family for help
  • joining a pregnancy support group
  • meditating
  • practicing pregnancy yoga
  • making time for an activity you enjoy

If you’ve experienced miscarriage or pregnancy loss before, you might find it more challenging than most to not worry about miscarriage, but try to remind yourself that stressing about your stress levels doesn’t help anything.

If you find it difficult to stop worrying, you might also find it helpful to talk to a therapist or to join a miscarriage support group.

You might find it helpful to seek therapy if you experience a high-stress event during your pregnancy, such as the loss of a loved one, a layoff from your job, or another unexpected trauma.

While the connection between stress and miscarriage isn’t clear, experts generally agree that higher stress from trauma is more likely to impact your health and pregnancy. But with treatment, you’re more likely to be able to mitigate this stress and get the help you need to take care of yourself during this time.

Miscarriages are much more common than people think. But remember, even if you experience one, it’s almost certainly not your fault, even if you’re experiencing high levels of stress. The best thing you can do is prioritize taking care of yourself during these 9 months.