Prenatal Stress,Poverty, and Child Outcomes

It is well documented that children living in poverty experience disadvantages in virtually every area of health and mental health, development, academic achievement, and other areas, compared to their more well-off peers. Mechanisms behind these disadvantages certainly include the lack of resources of all kinds inherent in poverty, including access to health care, high-quality education, safe housing, nutritious food, and many other resources. Less well recognized is the contribution of prenatal stress to these gaps, as poor children’s disadvantages often start early in fetal life due to high stress experienced by their mothers. Animal research and emerging human research demonstrate that stress during pregnancy affects fetal brain development through the mother’s hypothalamic–pituitary–adrenocortical axis, influencing the developing stress system and other parts of the brain of the fetus. Understanding these relationships among poverty, prenatal stress, and child outcomes is important for social workers, whose policy and service provider roles provide opportunities for amelioration at both micro- and macro-levels. This paper elucidates the consequences of prenatal stress, demonstrating that the physiological stress response operates prior to birth and directly influences infant and child biological, psychological, and social well-being. First, we briefly review the well-documented disadvantages experienced by poor children. Then, we describe the physiology of stress, clarifying the often-confusing definitions and elaborating to explain unique physiological aspects of stress during pregnancy. Finally, we discuss the important role social work may play in addressing this important problem.