“The foetus can see, hear, experience, taste and, on a primitive level, even learn in utero … Most importantly, he can feel – not with an adult’s sophistication, but feel nonetheless”.– Dr. Thomas Verny, The Secret Life of the Unborn Child, 1981, p. x).
From a bundle of cells to a beautiful human being, this transformation signifies not only the importance of the nine months in a mother’s womb but also the crucial role played by the physical and emotional environment during the pregnancy. This is where the foundation for life is laid. Thus, for a mother to be happy and prepared to take on this responsibility will be the factor that influences to a large extent this phenomenal process. Attachment, a sense of security and a feeling of being wanted, all start here.
Adler placed a strong emphasis on the importance on the first five years of a child’s life and the parenting involved as predictors of a child’s and, later on, of an adult’s adaptive or maladaptive style of life. Adlerian theory (as cited in Ansbacher & Ansbacher, 1956) underscores a striving for belonging in the development of personality and focuses on the influence of the family atmosphere and family dynamics in childhood, and on the values of parenting.
With rapid technological and methodological progress in the fields of neuroscience and neuro-endocrinology, an accumulating body of research-based evidence has mounted, which shows that the groundwork for a new life starts even before an infant’s birth.
For example, Dr. Thomas Verny (2011), known for his pioneering work, states that:
“ … Prenatal and early post-natal stages determine to a very large extent our biological and psychological make-up. That is … all kinds of medical conditions, including heart diseases, diabetes, and many, many other immune diseases, are really the result of some very early stresses in life” (retrieved on internet)
This view challenges the proponents of genetic determinism, who claim that our physiological and behavioural expressions are formed once the genes of the sperm and the egg merge at the time of conception. According to this argument, maternal “nurturing” of the foetus is simply confined to providing metabolic support.
Bruce Lipton (2011), however, puts forward that:
“In contrast to the beliefs of genetic determinacy, it is becoming evident that organismal expression is dynamically and intimately intertwined with environmental cues. Genes in the nucleus do indeed represent blueprints for proteins, the molecules responsible for physical traits and the mechanics underlying behaviour. However, it is now recognized that the regulation of gene expression, that is the switching on and off of genes, is not a property of the genes themselves, but is controlled by environmental signals (Nijhout, 1990). We are also now aware of the fact that organisms under stress are able to actively alter their DNA and create new genes in an effort to accommodate environment challenges” (Thaler, 1994)” (retrieved on internet) (Thaler as cited in Lipton, 2001).
The development of the brain, both structure and function, is shaped by the inference and interaction of four major factors. They include:
- genetic endowment;
- internal or endogenous stimulation and sleep;
- external experiences and stimulation of the sensory organs and
- the environment.
There are four components of the environment that influence foetal, infant and child development. These are the physical, chemical, sensory and social/emotional environments. Events and stimuli from each of the four components of the environment are capable of altering the course and outcome of developmental process. The environment of the foetus, infant and young child can have both positive and negative effects. (Graven &Browne, 2008.
For example, the extensive research conducted into the effect of cigarette smoking on the unborn foetus and the correlation with criminally violent children supports the claims made by Dr. Thomas Verny in the 1980s. By cutting the supply of oxygen available in the maternal blood, the foetus is thrust into a state of chronic uncertainty and fear. Adler had already observed that an early experience of chronic anxiety, even of a struggle to survive, could lead to the development of a view of life as hostile and dangerous. Subsequent compensations could lead, in turn, to feeling weak and threatened, through to instigating violence (Stein, 1999).
Research has also established that, during the course of pregnancy, it is important for the relationships of an expectant mother, especially with her partner, to offer social support and to provide a buffer against the stress and anxiety that accompanies this major life change (Sagrestano, Feldman, Killingsworth-Rini, Woo & Dunkel-Schetter, 1999; Dunkel-Schetter, Gurung, Lobel & Wadhwa, 2000).
Adler (1931) too, with his concept of social interest, implies that, a woman’s partner, in order to face successfully the Life Task of love and intimacy, must have her welfare and feelings of belonging to her social environment enhanced through co-operation:
“We may say that for a full solution of this co-operation of two, each partner must be more interested in the other than in himself [herself]” (as cited in Ansbacher & Ansbacher, 1956, p. 432).
One of the factors that may influence the extent to which relationships in general can be beneficial to pregnant women is their cultural background. Researchers have found that cultural influences on relationship processes may play a role in promoting healthy pregnancies (Dunkel-Schetter, Sagrestano, Feldman & Killingsworth, 1996; Morling, Kitayama & Miyamoto, 2003; Dunkel-Schetter & Rini, 2004.
Dr. George Neeson (2010), a Classical Adlerian Medical Psychotherapist, has highlighted that the feelings of interconnectedness among people are essential not only for living together in society but also for each individual’s development, and cultural values in particular, can offer insights into the expectations and behaviour of pregnant women and their social network.
Even more intriguing is evidence of the impact of the mother’s and father’s attitudes and feelings towards their unborn child. Based on the findings of many other researchers as well as his own experience as a psychoanalyst, Dr. Verny presents evidence that the attitude of the mother towards the pregnancy and the child, and towards her partner, have a profound effect on the psychological development of the child. The mother, by her patterns of feelings and responses, is the main source of the stimuli that will influence the development of the foetus. Similarly, the mother’s attitude towards motherhood has also been shown to be one of the most important factors determining the character of the birth experience: the more traumatic the labour and delivery, the higher the correlation with physiological and psychological problems (as reported by Dougherty, 1990, retrieved on internet). These findings, however, must be qualified in order to take into account that a mother herself is always situated within a social and contextual field that can enhance or hinder her attitude towards motherhood.
Moreover, a mother’s love and acceptance of the unborn child, together with positive thoughts towards it, act as a very strong protection, so that it will continue to thrive even if her own personal situation is a struggle. But if the unborn child’s need for affection and attention are not met, “… [its] spirit and often [its] body, too, begin wilting”(Verny, 1981, p. 27, as cited in Daugherty, 1990, retrieved on internet).
Thus, a mother’s emotions are of the utmost importance for the foetus. From an Adlerian point of view, Rasmussen (2010) expounds extensively on the physiology and the purposefulness of emotions. He holds that emotions are motivational and, from an evolutionary point of view, that they are imperative to survive, to enhance our existence, to adapt to our environment and to reproduce.
Dr. Frank Lake’s (1978) conceptualised that there is a bidirectional flow of blood from mother to foetus as mediated by the placenta through the umbilical cord, which gives rise to various physical “feelings” such as aggression, submission, emptiness, fullness, giving-and-taking that are the basis for subsequent psychological “feelings” (as cited in Moss, 1987, p. 203). Lake picked up on Mott’s (1960) term “umbilical affect” to designate this exchange, defining it as the “feeling state of the foetus as brought about by blood reaching him [or her] through the umbilical vein” (as cited in Moss, 1987, p. 203). As both Mott and Lake defined this exchange, the umbilical vein not only conveys nutritive resources and as such could be experienced as a “life-giving flow, bringing, renewal and restoration” but could also “be the bearer of an aggressive thrust of bad feelings into the foetus if the mother herself [is] distressed and ‘feeling bad’” (as cited in Maret, 1997, p. 51). Having reached these conclusions, it is important to avoid over-emphasising the responsibility of a mother and hence to put her under undue pressure by blaming her through failing to consider appropriately her social embeddedness. For example, consider an expectant mother in an abusive relationship, or an immigrant mother fleeing violence and struggling with poverty, a new country, language, nutrition, etc.
Dr. Bruce H. Lipton (2001), a researcher biologist, in an article on Maternal Emotions and Human Development, writes:
“During pregnancy, parent’s perception of the environment, which is chemically communicated to the foetus through the placenta, the cellular barrier between the maternal and foetal blood. … The parents’ experience help ‘preprogram’ the behaviour of the child, so that it may more effectively deal with environmental exigencies. … In this new perspective, parental nurturing is obviously more than just providing metabolites and a safe haven for development. Nurturing is profoundly more inclusive in that the parent’s attitudes and perceptions help prepare the baby in learning to deal with its new environment. … In utero, the child acquires ‘attitudes’ about life as it decodes the ‘behavioural signals relayed in the blood’.” (retrieved on internet).
It is, however, important to underline that individual events of parental anger and fear during pregnancy do not necessarily affect the “physiology” of the developing child. It is specifically “chronic”, or continuously-held emotions that could be detrimental.
Dr. Verny (2002) remarks that:
“Nothing about the mind is that neat. But the womb is the child’s first world. How he [she] experiences it –friendly or hostile – does create personality and character predisposisions. The womb, in a very real sense, establishes the child’s expectations” (p. 37). (author’s italics)
Not only is the foetus capable of discriminative learning, which indicates some form of feeling awareness but, with the capacity to respond, comes the ability to collect experiences in memory for future use. Recent research (Marquez, 2000) supports the capacity of the unborn child to store very early traumatic experience in the “bodymind” (Pert’s  terminology), translated into psychosomatic conditions.
Risks of psychopathology in childhood and adolescence are associated with a number of prenatal and perinatal factors. For example, major depression in the child can be linked to maternal emotional problems during the pregnancy; anxiety in the child can be related to a history of miscarriage and stillbirth; disruptive behaviour disorder in the child can be predicted by poor maternal emotional health during the pregnancy and birth complications; substance use disorders by the child can be attributed to maternal use of substances during the pregnancy (Allen, Lewinsohn & Seeley, 1998). Depressed maternal emotional health during pregnancy has also been found to be associated with conduct disorder and attention deficit disorder in the child (Downey & Coyne, 1990).
As already quoted early on, Verny (1981) warned us that what the child experiences in the womb creates predispositions, expectations and vulnerabilities rather than specific qualities; it is about susceptibility, rather than predetermination. For example, increases in maternal neuro-hormones, such as adrenaline, noradrenaline and oxytocin, heighten the child’s biological susceptibility to emotional distress. An excess of these maternal hormones has been linked, inter alia, to low birth weight, reading difficulties, behavioural problems, higher heart rates, irritability, poor sleep patterns, gastrointestinal difficulties, hyperactivity, excessive crying, etc. Most traumatic of all is when the mother, due to illness, a severe loss, hostility to the pregnancy, emotional immaturity, guilt, absence of support, withdraws her love and attention from her unborn child. Both parents’ support to the child is critical in the first four years of life. “Next to genetic inheritance, in fact quality of parenting is the single most important factor in shaping the depth and breadth of intellect” ( as cited in Dougherty, 1990, p. 169).
There are some important studies that validate the importance of the prenatal stage. Dr Alessandra Piontelli (1992) carried out a study of foetuses and their behaviours while in utero. She used ultrasonic cameras and correlated behaviours from birth through to the age of four. The parallels she drew in the uterine experiences and early infancy stage formed a solid framework for the understanding of the lifelong implications of the prenatal experience. Through direct observation in the womb and after birth, Dr. Piontelli construed the possible links and continuities between the experience in utero and the neurophysiology of the baby, and concluded that these constituted evidence of memory of the womb experience.
Allan Schore’s (1994, 2003) extensive and seminal work in relation to maternal care, the developing brain and attachment is worth mentioning here in as much as he found a growing body of current evidence that shows that the neural circuitry of the stress system is located in the early developing right brain that is dominant for the control of vital functions and which matures before the left brain does. The early exposure to a chronic stressful environment negatively impacts on the maturation of the stress coping strategies and the processing of emotionally bodily information, leading to attachment disturbances and mental disorders.
The work carried out by Joseph LeDoux (1998) and Antonio Damasio (2000, 2006) emphasised the importance of the role played by two small parts of the limbic system of the brain: two almond-shaped clusters of neurons, the amygdalae, one in each hemisphere, in attaching significant emotional significance to signals of – or stimuli from – stress, threat, alarm, resulting in fear.
It has been established that if the environment becomes stressful, another area of the limbic system, the hippocampus, is responsible for determining how stressful the situation truly is. In this manner, it acts as the fear regulator, ultimately responsible for effective stress regulation. The hippocampus then communicates to the rational area of the brain, the cerebral cortex, and makes the decision whether to calm down, fight, freeze, or flee (Post, 2011).
Although in the development of the structures of the forebrain, the hippocampus is the first to develop and to form gradually – throughout the critical period of infancy – the amygdala achieves its maturity while still in utero. The last structure to develop in the forebrain is the cerebral cortex, which will mature into early adulthood, and is the site of what are considered “higher functions”: learning, language and abstract thought. (Ann McDonald, 2007).
When there is early exposure to traumatic experiences and stressful pressure, especially between conception and three years of age, the hippocampus stagnates and will fail to grow, rendering it unable to provide a potential calming and soothing influence. Ultimately this leads to the amygdala emitting stress and fear uncontrollably and, as the foetus and the infant grow, its emotional system remains under arrest (Post, 2011, internet).
In another relevant study by Entringer, et al. (2008) was undertaken to determine whether or not there was an association between prenatal stress and immune function in human adults. It entailed measuring the level of stimulated production of cytokine in 34 healthy young women whose mothers experienced major negative life events during their pregnancy and that of a female comparison group. The outcome of the study suggested a direct association between prenatal stress exposures and alterations in immune parameters in adult women.
In another study by Sandman, Davis, Buss & Glynn (2011) accumulated evidence shows that exposure to prenatal stress profoundly influences the developing human foetus with consequences that persist into childhood and very likely, as far as the affected individual is concerned, forever. Consider the following methodology: maternal/foetal dyads were assessed at 20, 25, 31 and 36 weeks of gestation; infant assessments began 24 hours after delivery with the collection of cortisol and behavioural responses to the painful stress of the heel-stick procedure and measures of neuromuscular maturity; infant cognitive, neuro-motor development, stress and emotional regulation were evaluated at 3, 6, 12 and 24 months of age; and maternal psychosocial stress and demographic information was collected in parallel with infant assessments. Findings indicated that the mother and her foetus both were influenced by exposure to psycho-social and biological stress. These findings may have important implications for long-term child development and mother-child interactions (ibid., 2011).
(1) Heel stick: A procedure in which a newborn baby’s heel is pricked and then a small amount of the blood is collected, usually with a narrow-gauge (“capillary”) glass tube or a filter paper.
The expansion of our knowledge of the influences that surround the creation of a human life has led William Emerson (2002) to the following conclusion:
“One of the central concepts in this field is the notion that mind pre-exists the nervous system; that there is a level at which the conceptus is aware of essential qualities of feeling present in its inception; and that this awareness records its struggle to survive the hazards of implantation, the history of its gestation and the detailed trauma of its birth at an energetic and cellular level”. (p. 68).
The foundational significance of the prenatal stage has been validated through extensive research, making responsible parenting of utmost importance. The American College of Obstetricians and Gynaecologists published in 2001 a booklet titled Preconception Care: A Guide for Optimizing Pregnancy Outcomes in which they recommend that all health care consultation during a woman’s reproductive years, particularly those that are a part of pre-conception care, should include counselling on appropriate health behaviours to optimise pregnancy outcomes and prevent maternal mortality
Dr. P. Nathanielsz (2001) devised a programme for creating the best possible conditions for an unborn child, from pre-conception through pregnancy, called “The Prenatal Prescription”. For him, all family members and extended family need to make an extra effort to give support and love to a woman during her pregnancy to help her prepare to take on her responsibilities, and also to endeavour to create an environment of low stress around her in order to promote a healthy brain development of the child.
In an Editorial provided for a web site titled “The Importance of Prenatal Care”, Dr. Sharon D. Johnson (2011) writes that:
“Research suggests that women who are more health-conscious are more likely to initiate prenatal care early during pregnancy and make every attempt to make their scheduled prenatal care visits. These same women are more likely to demonstrate other responsible acts such as planning their pregnancies; maintaining a proper nutritional diet; and abstaining from using drugs, tobacco or alcohol. These women also seek out information from healthcare providers about other positive aspects that they can implement during pregnancy”(retrieved on internet).
The above studies and findings are only a very few examples of the multitude of research undertaken over the last 3 to 4 decades regarding the impact of maternal emotions on the foetus. For two keen students of Adler’s Psychology, it is comforting to discover that they scientifically support what Adler intimated, through observation and intuition, almost a century ago.
Adler (1956) indeed believed that human beings in order to develop properly must initially be protected, fed and cared for, which, in his day, was a task usually performed by their mother and without which they would inevitably perish. He states that:
“The mother represents the greatest experience of love and fellowship which the child will ever have. … By a mother’s skill we mean her ability to cooperate with her child and to win the child to cooperate with herself. She can be skilful only if she is interested in her child and occupied in winning his [her] affection and securing his [her] welfare. … The mother gives her baby the first contact with another human being, the first interest in someone other than himself [herself] She is his [her] first bridge to social life (as cited in Ansbacher & Ansbacher, p. 372).
Adler (ibid.), however, stressed that, while the importance of the maternal role is undoubted, he also warns that whatever the experience each individual is self-determined.
“No experience is a cause of success or failure. We do not suffer from the shock of our experiences – the so-called trauma – but we make out of them just what suits our responses. We are self-determined by the meaning we give to our experiences, and there is probably always something of a mistake involved when we take particular experiences as the basis for future life” (as ibid., p. 202). … “It is not the child’s experience which dictates his[her] actions; it is the conclusions which he[she] draws from his[her] experience. (ibid., p. 203).
On pain of falling into a new trap of determinism – this time of the environment – it is important to remember that Adler (1979) saw a child born into the world as a sentient being who processes information to gradually evolving conclusions. Without the benefit yet of a developed logical system, it develops a style of life that is ”ultimately the individual’s own creation, the product of [its] creative power”(p. 6). By the same token, he (1956) considered that the way a human infant perceives and uses its heredity and its environment in the broadest sense will largely determine its relationship to the outside world.
For Adler a maladaptive style of life occurs because of a deficiency in social interest, which he considers as the touchstone of mental health. Once an individual’s “private” conclusions have been identified, they can be challenged and worked upon in order to bring about a different belief system and, hopefully, a changed attitude towards self, others and life.
The on-going studies on the influence of the pre-, peri-, and postnatal stages of pregnancy have substantially improved our knowledge and understanding of the various processes involved, with their concomitant applications.
This new emphasis has led Dr. Thomas Verny (2002) to draw up a set of rules that he introduces under the title of a new concept, that is, “conscious parenting”. Parents need to be made aware that from the first idea of conceiving a baby, their thoughts, attitudes and behaviours will exert a profound influence on their child’s development and health all the way through its pre- and postnatal development.
To put it simply, the more positively the mother and the father approach the pregnancy, thereby providing the best opportunity for the prevention of most medical and psychological disorders, the healthier will be the outcome.
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