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by Valorie Akuffo, Certified BWI Birth Doula & BWI Lifetime Member

People’s age should always be considered as an exact number plus 9! The nine months in-utero are a miraculous period when hormone fluctuations are rapidly changing. It is an important time to pay attention to mother’s well-being and health. What she does impacts a baby’s physical and mental development. Also - the onset of pregnancy often begins while the mother-to-be is still unaware of conception (she might not even realize she’s pregnant yet).

Mom-Baby Connection

Evidence-based research shows that the pregnant mother’s experience also impacts the unborn baby! A woman’s status during the perinatal period can bring on anxiety if she has cause for concern in regard to her activities and behaviors. A state of panic might ensue if she realizes critical time has already passed and an immediate change is necessary to improve birth outcomes. For example, she may read that eating two or more servings of meat/fish may lead to a reset of fetal development of the Hypothalamic-Pituitary-Adrenal (HPA) axis possibly causing lifelong elevated stress hormone levels in the newborn (see Or she may read from the Center for Disease Control (CDC) that there is no known safe amount of alcohol use during pregnancy before conception and that all wines and beer are equally harmful to the fetus. A mother wants the very best for baby, and now she fears her diet may already have caused harm. So, she reads this and simultaneously stress increases and cortisol spikes.

This is hard in general, but for people who deal with physical or mental illnesses or “living on the edge”, it can add another layer of stress. There already might be serious health concerns for the fetus, infant, or mother that are exacerbated by  their work, or family and health stresses. Decisions about the pregnancy sometimes have to be made urgently, given varied priorities. Clearly, these challenges are key areas of concern. Further understanding to support pregnant mothers and new parents is intensely needed. Understanding the impact of stress (good and bad) and how it relates to the interactions of hormones is important.

Cortisol - The Stress Hormone

Beneficial Effects

Cortisol is the main stress hormone produced by the two adrenal glands, which are located on top of each kidney. It has many beneficial effects. The pituitary gland and hypothalamus in the brain regulates cortisol production. Cortisol plays an important role in the stress response, as its level is part of what controls mood, motivation, and fear. It manages how our body uses what we eat, inflammation response, regulation of blood pressure, and even controls the cycle of sleeping and waking. Cortisol increases sugar, also called glucose, in the bloodstream, enhances the brain's use of glucose and increases the availability of substances in the body that repair tissues.

Maintaining an adequate balance of cortisol is essential for health. The right amount of cortisol boosts our energy to help handle stressful moments and restore us to balance afterwards. The key word here is balance.  

Harmful Effects

All pregnant women are exposed to higher levels of cortisol during these nine months – because of the everyday life experiences AND additionally worries such as labor, being a working mom or not, becoming a parent, etc. Extended durations of elevated cortisol in the body are harmful to the mother and baby. Take the woman in her last trimester who bursts into tears saying, “I’m so afraid of labor and just want an epidural to get me through it!” She is experiencing an extended period of stress and this is also felt by her baby, because she has probably thought this for months. Chronic stress negatively impacts the body’s functions and impacts health issues like anxiety, depression, headaches, focus, digestion and weight control. High cortisol can negatively affect blood pressure, weight, mood, skin and muscle. And remember that whatever affects the mother also affects the baby in-utero.

Empowering Birthing Parents - Especially the Most Vulnerable

Pregnant women (and all new parents) need to stress less! Medical professionals suggest that a significant increase in cortisol should be limited in duration during pregnancy. Women of child bearing age need to be better educated about life decisions and choices – in order to avoid triggering chronic negative stress responses. They need to thoroughly understand female and pregnancy hormones and how they affect their bodies.

If we look deeply, those most deeply impacted are often pregnant teens. The teen years are especially vulnerable – so this is an important time to start educating them about birth. We can also look for ways to reach communities that are more vulnerable due to societal inequities. Given 50% of pregnancies are unwanted, [UNFA report NEW YORK, 30 March 2022]and many of those are teens, we can educate and help them. This calls for the critical need for pre-education… before young women, especially teens, get pregnant.

Knowledge is power. Knowing what to expect and anticipate as much as possible brings a feeling of safety. Let’s call it, “Preconception Childbirth Education.” This is an area where birthing communities can perform better. Pre-conception and early childbirth education, ideally in the first trimester is key. New parents need real ways to work through life challenges, be empowered with positive lifestyle tips, and receive comprehensive and practical labor and childbirth preparation. 

Childbirth education (not just hospital classes about policies and procedures with a hospital tour) is sorely needed. Using excellent childbirth education classes as a way to get all pre-parents and pregnant parents, especially those with less support or less advantages, into support groups, community groups, peer groups and breastfeeding education classes is key. It is a time in life when social support reaps many immediate and lifelong benefits to the health of mother and baby.

We can give these future mothers an informed opportunity to make their pregnancies the best they can be from the onset of the +9 months. As Michel Odent, MD says, “Let the first hormones the fetus feels be ones of joy.” Learn more about BWI’s parent offerings and BirthPrep for Parents! Or find a BWI professional near you.