Pregnancy and Facial Palsy Risk
Published research shows that Bell's palsy is more common during pregnancy than at other times.
That means facial palsy is about 2.6 times more common in pregnant women. Most cases happen in the third trimester or in the weeks right after birth.
What Might Explain the Link
Doctors don't know the exact cause, but a few things may raise the risk during pregnancy:
- Blood pressure changes — including high blood pressure, preeclampsia, and fluid buildup
- Hormone shifts — especially estrogen and progesterone
- Pregnancy factors — like IVF, carrying twins, or being an older mother
- Other health factors — like gestational diabetes, higher body weight, or jaw joint problems
A Closer Look: What Patients Reported
Jodi Maron Barth also studied people who developed facial palsy during pregnancy. She asked them directly about their experience through a survey. A few things stood out:
- 70% said their facial palsy started in the third trimester
- 24% said theirs started after they gave birth
- 25% had a history of jaw joint (TMJ) problems
- 18% had high blood pressure during pregnancy
It's worth knowing what this kind of survey can tell us, and what it can't. People answered based on memory, not medical records. They found the survey through online support groups, not through a doctor's office. This gives us a real window into patient experience. But it's not the same as a large medical study measuring risk across everyone — like the numbers above.
Can Stress Cause Facial Palsy?
Facial palsy often happens when a sleeping virus wakes up. This can be the cold sore virus (Bell's palsy) or the shingles virus (Ramsay Hunt syndrome). Jodi Maron Barth's research looked at stress levels in the month before facial palsy symptoms started, using a tool called the Perceived Stress Scale.
Most people in her study reported moderate stress before their facial palsy began. A good number reported high stress — including people who had never had mental health concerns before.
This connects to other published research on stress and the shingles virus:
- Studies from Korea, Japan, and Denmark have each linked higher stress to a greater risk of shingles
- Stress raises certain hormones in the body. These hormones can weaken the immune system's ability to keep sleeping viruses under control
- When that control weakens, the virus can wake up in the facial nerve, causing the sudden weakness we know as facial palsy
Not every study agrees on how strong this link is. But it shows up often enough, across different countries, to be worth knowing about.
Facial Palsy Can Affect Your Mood Too
It's not just stress before facial palsy that matters. Facial palsy itself can be hard on your mood after it happens. Research shows higher rates of anxiety, low mood, and pulling away from others. This happens even in mild cases. Your face is a big part of how you connect with people. Changes to it can feel like a real loss.
This is part of why mental health support is becoming a normal part of facial palsy care, not an extra.
What This Means for You
If you're pregnant or just had a baby and notice facial weakness, get checked right away — this is a known higher-risk time, not a coincidence. And if facial palsy is affecting you emotionally, that's common and recognized. You don't have to handle it alone.
This article shares research and findings by Jodi Maron Barth, PT, of The Center for Facial and Functional Recovery, presented at IFNS 2025, along with published literature on Bell's palsy in pregnancy and stress-related viral reactivation. Shared with permission.