A mixture of emotions run through our minds as I give my wife and two daughters a hug before departing again for another combat deployment. I had only been home with my family for a few months after finishing my first twelve-month deployment to Iraq, and now I was headed back again. My two youngest daughters do not yet understand why as they watch their father leaving again. As a father, I have become a stranger who visits home from time to time, leaving them alone to survive with their mother again. Luckily, I’m blessed with a resourceful spouse who quickly learns to be self-reliant because for her, there is no other option. My wife has already endured being alone with one deployment and multiple training events, and she understands the trauma and level of anxiety that she’s about to endure. But this time, things are different. Within my wife’s womb, our third daughter is developing and preparing to enter this world. This time, it’s not just my wife who endures the physiological changes influenced by this deployment, but the tiny fetus within her womb is also experiencing it (Munck, Guyre & Holbrook, 1984). This newborn will enter into a world that she didn’t choose, surrounded by adversity as a military child. Her future comes with experiencing a lack of a father figure as more training events and deployments loom; she will join her sisters and experience what they have already experienced. However, she will already be at a disadvantage. She will enter this world already possessing negative cogntive and psychological traits even before the military stressors have a chance to wreak havoc on her childhood development. And this is because everything my wife will experience during this deployment is in one form or the other experienced by the fetus developing in her womb.
Fast forward to 10 years later, this beautiful daughter of mine, who was born with Neurofibromatosis Type 1, dyslexia, and minor learning disabilities, suffers from anxiety, depression, and episodes of suicidal ideation. Her first three years of life exposed her to two more combat deployments and multiple military training exercises. These young childhood developmental experiences influenced the problems she faces today; however, what she experienced during fetal development set the stage in the womb to be more predisposed to these psychological traits.
When they find out they are pregnant, most mothers are greatly concerned for the welfare of the child growing in their womb. They watch their diet avoid anything that could harm the development of their child. I was amazed how my wife who suffered from kidney stones during some of her pregnancies, would endure the pain of passing a kidney stone rather than taking a pain pill.
During the pregnancies of my five daughters, we were taught to primarily focus on the mother’s diet, the effects of what the mother breaths, and the importance of exercise. There was minimal focus on mental health. If there was any focus, it was toward the mother’s mental health. It never focused on the important fact that high levels of stress and trauma left uncontrolled would also impact fetal development. In almost all cases, this is not the blame of the mother. We can not control the adversity and trauma that enters our lives, especially in military life. The problem lies in the lack of training and awareness provided to young parents to help them truly understand the impact the mother’s mental health and wellness plays on the development of their child in the womb. In our society, there lies a lack of knowledge within the area of prenatal mental health. I wish I knew then what I know now. There is a lack of understanding that the level of stress that the mother senses impacts their child’s brain development, leading to illnesses and diseases that the child will be born with as they enter into this world. Change can only happen through awareness and education. And that is my goal with this article; I hope to influence change.
The Human Biology of Stress
“Recent studies in humans suggest that alterations in the activity of the neuroendocrine system mediate the effects of psychosocial stress on fetal development and birth outcome” (Weinstock, 2005).
To understand this, we must understand what happens inside the mind and body of the mother when she experiences high levels of stress. But I can’t stress enough that it’s not the mother who is to blame. The number of mental health issues today tells us about the extreme difficulty of stress management. We are faced daily with unavoidable stressors. However, we can learn to control the automatic emotional responses triggered by these stressors and control the release of stress hormones that impact fetal development.
I will primarily focus on the stress hormone cortisol and it’s impact on fetal development even though there are various factors influencing fetal development. When we experience any level of stress or threat, the fight or flight response activates. This automatic reaction occurs with the slightest worry, such as wondering if your child will eat their lunch at school to a near-death experience. The Sympathetic Nervous System (SNS) activates under any level of stress. The SNS is part of the Autonomic Nervous System (ANS) which also consists of the Parasympathetic Nervous System (PNS). When a threat is perceived, the SNS activates; when the danger is no longer perceived the body restores normalcy through the PNS.
When the SNS activates, this results in increased heart rate and shallow breathing. The digestive system shuts off, and the Hypothalamus Pituitary Adrenal (HPA) axis in the brain triggers a stress response. This reaction stimulates the adrenal gland located above the kidney, influencing cortisol’s release throughout the entire body; to include the developing fetus.
“Many independent prospective studies have now shown that if a mother is stressed, anxious or depressed while pregnant, her child is at increased risk for having a range of problems, including emotional problems, ADHD, conduct disorder and impaired cognitive development”. – Vivette Glover, MA, PhD, Imperial College London
Impacts of Stress on Fetal Development
“The brain is the first organ to begin developing at 18 days of fertilization” (Sangganjanavanich & Reynolds, pg 54, 2015). During weeks 28 and 30, the brain is noticeable, and by this time, the frontal lobes of the brain, particularly the areas responsible for emotions, have been developed. In a YouTube video titled: Associations Between Prenatal Maternal Cortisol Levels and the Developing Human Brain posted on the Society of Biological Psychiatry channel, Carly Lenniger explains how cortisol impacts fetal development. She explains that cortisol is released in higher quantities when the mother is experiencing abnormal levels of stress, leading to a child born with higher sensitivity to environmental factors that influence stress. The increase in maternal cortisol affects the development of a child born with anxiety, ADHD, depression, cognitive issues, and other diseases (Weinstock, 2005, Muck, 1984).
A study conducted out of the University of California Irvine found that elevated levels of maternal stress during pregnancy are associated with poorer cognitive functioning at one year of age based on the analysis of 125 different pregnancies where stress levels were examined (Davis & Sandman, 2010). Enzymes in the womb are designed to protect the fetus from normal cortisol levels, yet the protective capability cannot maintain its defense against abnormal levels of maternal cortisol. Additionally, by the third trimester, this active defense has weakened, and maternal cortisol impacts fetal development at a higher rate (Munck & Guyre, 2005).
Understanding the effects of maternal cortisol is the most critical aspect a mother can know when she is pregnant. This is a national epidemic. Our goal is to have healthy children who become loving, productive members of society, and when they are born with preexisting adversity, achieving this can become more difficult. The world seems like a mad place sometimes. From political division, diversity equity and inclusion issues, crime, and now the adversity of COVID-19. When one enters the world with preexisting cognitive and mental difficulties, they are less likely to overcome the unavoidable stressors of this world.
I hope everyone who reads this shares it with everyone they know. I hope that those planning on having children or who are pregnant now seek mental health counseling. We must change the stigma of perceived mental health counseling as only used for those with current issues and see it as a preventive approach to prepare the mind to control the automatic stress responses. Anyone can do this through the evidence-based stress management techniques that are available to all of us. Talking with a counselor during the pregnancy won’t only provide emotional support from a trained professional but a counselor can provide awareness of the resources and techniques that can best help the mother and help guide them through this process.
Those of you who may be in a similar situation as my wife and I. Do not fret. Regardless of the level of mental health issues you or your children may be facing. There is hope, the brain is malleable and can be taught to relearn to respond in a positive way to the automatic thoughts that trigger anxiety and depression. And please do not feel bad if you are a mother who was under a lot of stress during their pregnancy. It’s not until we learn stress management techniques and strive to become proficient through the daily application we can learn to reduce the stress responses in our body. As mothers remember you can not avoid the adversity and trauma that rips into our lives like a North Carolina hurricane. But we can choose to respond in a way that is healthy for ourselves and those around us. Once you learn and master stress management, it’s a magnificent joy. You feel as if you have unlocked the superpower within!
Check out the informative videos below to learn more about the effects of stress on fetal development.
What We Learn Before We’re Born
Associations Between Prenatal Maternal Cortisol Levels and the Developing Human Brain
InBrief: Early Childhood Mental Health
Infant Mental Health | Amy Huffer | TEDxOStateU
References
Munck A, Guyre PM, Holbrook NJ. Physiological functions of glucocorticoids in stress and their relation to pharmacological actions. Endocrine Reviews 1984;5(1):25–44.
Sangganjanavanich, V. F., & Reynolds, C. A. (2015). Introduction to Professional Counseling (Counseling and Professional Identity) (1st ed.). SAGE Publications, Inc.
Associations Between Prenatal Maternal Cortisol Levels and the Developing Human Brain. (2020, June 3). [Video]. YouTube. https://www.youtube.com/watch?v=JuLKzEEoxq4&t=248s
Weinstock, M. (2005). The potential influence of maternal stress hormones on development and mental health of the offspring. Brain, Behavior, and Immunity, 19(4), 296–308. https://doi.org/10.1016/j.bbi.2004.09.006
Glover, V. (2009). Antenatal Stress and Anxiety, Effects on Behavioural and Cognitive Outcomes for the Child, and the Role of the HPA Axis. European Psychiatry, 24(S1), 1. https://doi.org/10.1016/s0924-9338(09)70535-8
Davis, E. P., & Sandman, C. A. (2010). The Timing of Prenatal Exposure to Maternal Cortisol and Psychosocial Stress Is Associated With Human Infant Cognitive Development. Child Development, 81(1), 131–148. https://doi.org/10.1111/j.1467-8624.2009.01385.x