Promoting Stress Management for Pregnant Women during the Zika Virus Disease Outbreak

A Resource for Healthcare Providers

Depending upon where they live or where they have recently traveled, it is understandable for your patients to be worried about Zika. Zika is an emerging infectious disease and we are learning new information about it every day. There is a lot we don’t know about Zika and the unknowns can be scary for expectant parents.

What we know

Pregnancy can already be a stressful time for women and their partners. In addition to common concerns about becoming a parent, many expectant mothers worry about the health of their pregnancy and the health of their baby. The emergence of Zika virus can be an additional unsettling consideration for those who are pregnant or trying to get pregnant.

Managing stress for women who want to conceive and women who are pregnant is important for promoting healthier pregnancies, healthier births, and better long-term health outcomes for families. Prenatal stress can effect neonatal development and increase the risk for preterm labor, preterm birth, and low birth weight.

As a healthcare provider, concerned patients may ask you questions about the risk of Zika virus to their pregnancy, or you may notice symptoms of stress and anxiety. You have an opportunity to provide accurate information and resources about Zika, and also to provide information about how managing stress is important for the health and wellbeing of the pregnant woman and her fetus.

Communication Tips for Providers

Conduct a risk assessment regarding Zika exposure. Understanding the level of risk and whether women have been infected can help you and patients understand how best to manage some of their concerns about Zika virus. For example, if the patient has not traveled to an area where there is active transmission of Zika, does not live in an area where there is active transmission, or does not have a spouse or partner that has traveled to an area where there is active Zika transmission, then you may be able to reassure the patient that they have a very low risk and help alleviate their concerns. For those with higher risk, follow the CDC clinical guidance and check for updates as new information becomes available.

Show empathy and acknowledge concerns and worries.

Provide reassurance. Reassure your patients that it is normal to have concerns during pregnancy. However, if their worries are significant and affecting their daily life, patients may benefit from seeking support from a mental health professional. Provide stress management guidance and strategies such as the ones described below.

Have a conversation about the concerns and worries. Correct any misinformation and share what you know is accurate. Provide references to legitimate sources of information about Zika for pregnant women. Information for pregnant women is available from the Centers for Disease Control and Prevention at www.cdc.gov/zika/pregnancy. You can also find Zika information, guidance, and resources for health care providers at www.cdc.gov/zika.

Provide a mental health referral, if needed. Provide information about where to seek additional professional mental health support, if needed. This may be a good opportunity to screen for anxiety or depression using one of the tools listed below.

Strategies for Pregnant Women to Manage Stress and Worry

Early support, stress management strategies, and psychosocial interventions should be offered to all pregnant women and their partners, regardless of Zika exposure status. Relaxation during pregnancy may have positive effects on fetal development and neonatal outcomes. Share the following stress management strategies with your patient:

Take a break from hearing or reading about news and media coverage of Zika. Too much information and misinformation can increase anxiety. Suggest that they pick a few trusted sources and times during the week to look for information updates and then refrain from focusing on media coverage of the virus.
Find activities that bring them joy and keep them in the moment. Suggest that they eat a healthy, well-balanced diet, get regular exercise, or try yoga or meditation to ease stress.
Manage stress with online tools. There are many online and mobile apps available for stress management, meditation, and healthy pregnancy tips.
Reach out to family and friends. Having good social support is important for individual resilience and stress management. Suggest that they engage in enjoyable activities with family and friends and identify people to talk with to help alleviate some of the stress.
Be proactive. Consider utilizing CDC’s preventive measures for Zika for the whole family.
For additional information, visit trusted sources such as CDC’s Zika website, Mother to Baby, March of Dimes, and text4baby (Text BABY to 511411). Several of these websites also have materials available in Spanish. The Substance Abuse and Mental Health Services Administration (SAMHSA) has numerous resources including Coping with Stress During Infectious Disease Outbreaks.