Fundación eCare Acompaña - Elisabeth d'Ornano - Evidencias - Madre

the prenatal footprint

The prenatal period is the most important period in our lives.
Thomas Verny, perinatal psychiatrist.

Since the beginning of the 20th century, psychologists have tried to understand when the psychological development of the baby begins, what memory remains of the time we live in the womb and how the type of birth affects intellectual and emotional development.

Otto Rank, Nandor Fodor, Francis J. Mott, Donald Winnicott, Frank Lake, Elizabeth Fehr, Artur Janov, Lloyd de Mause, Stanislav Grof, Anastasios Kafkalides, David Chamberlain, Alessandra Piontelli and Thomas Verny are just some of the pioneers of prenatal psychology. All of them have tried to understand what the foetus goes through in the womb and at birth, as well as the imprint this leaves on a child’s future psychological development. In addition, some of them have specialised in treating the so-called “primal wound”, i.e. any lack of affection or traumatic memories that may have become engraved upon a baby at the time of their birth, in order to prevent this from continuing to cause suffering.

Science has made it increasingly clear that babies perceive their environment from the earliest stages of pregnancy and that everything they experience is recorded in their cellular and physical memory.

All this pioneering work means that we now know that what we experience in the womb and the way we are born play a key role in our entire subsequent development, and may even condition it for life. Babies feel, learn, remember and relate from the earliest stages of pregnancy. As David Chamberlain rightly points out, we should stop calling them “foetuses” or “embryos”.

The sooner the mother recognises the reality of the psychological development of the baby in her womb, the more parents-to-be know about the importance of this imprint, the more and better the baby will be cared for during pregnancy. Understanding how sensitive babies are to the environment in the womb and how well they perceive their mother’s emotions necessarily leads us to try to care of all pregnant women as much as possible, ensuring that their condition is a cause for celebration and joy rather than grief or distress.

When you understand the extent to which babies are conscious from the womb and how they are affected by the way they are born, you understand the importance of facilitating a Birth Without Violence, as described by Leboyer.

Life in the uterus

Leboyer (a French obstetrician and pioneer in fostering birth without violence) called this life in the uterus.
The science of embryology, which studies the development of the baby in the womb, is confirming what mothers have always intuited: the happier, calmer and more confident the mother feels and the sooner she establishes a bond with her baby in the womb, the more harmonious the baby’s growth will be. The love and trust that a woman feels and experiences during pregnancy is translated into hormones and neurotransmitters that end up bathing the baby, making it live what its mother feels and enabling it to grow in the most loving and healthy way possible.

From conception, the first cells of the future baby store memory of the environment in which they develop. This memory is initially cellular, and then becomes physical. As the senses develop, the baby in the womb can smell, hear, taste and feel.

The imprint of what we experience in pregnancy as babies in the making is something we carry with us for life, it is part of our memory. How the emotional state of the pregnant mother affects the development of the baby in the womb has been a concern of humanity since antiquity.

In his Quaderni d’ Anatomia when referring to pregnancy Leonardo da Vinci wrote: “… one and the same soul governs these two bodies…. a thing desired by the mother is often found imprinted on those parts of the infant that have the same qualities in the mother at the time of her desire… A will, her supreme desire, a fear or a mental pain that the mother feels has more power over the child than over her, given that frequently the child loses its life because of it…”.
The Renaissance physician and alchemist Paracelsus also stated: “Woman is the artist of the imagination and her child is the canvas on which she paints her picture” (Paracelsus, 1493-1541).
The more the baby feels loved from conception, the easier it is for it to develop in a harmonious and healthy way.

Several psychotherapists have shown how the emotional environment a baby experiences in the womb can affect it for life.

Increasing evidence shows that conditions in the womb are as important as genes in determining mental and physical development throughout life.
(Peter W. Nathanielsz, Life in the Womb: The Origin of Health and Disease).

The most transcendental social discovery of the last two centuries is the unsuspected impact on adult life of what happened to the baby in its mother’s womb
(Eduard Punset).

The truth is that many of the beliefs we hold about babies are false. They are not simple beings, but complex, ageless creatures with an astonishing number of thoughts.
David Chamberlain (1928-2014) Perinatal Psychologist

The mental health of the child can be primed before conception.
Thomas Verny, perinatal psychiatrist.

the pregnant mother

Nature gives mothers nine months to harbour doubts, fears and ambivalence about the child to come.

The bond with the coming child is not instantaneous but gradual. Pregnancy brings about a very special psychological process.

As the baby grows in the womb, changes also occur in the mother’s brain. It gradually becomes much more sensitive and emotional.

During pregnancy there is a natural, impulsive need to get closer to one’s own mother. In order to prepare herself effectively for motherhood, the pregnant woman has to remember and review her own experiences of being a daughter in order to imagine herself as a mother.

If the woman has no family nearby or has already lost her mother, she may need a “mother figure”: an experienced and close mother to help her in this process. The important thing is that the woman feels listened to and free to express how she imagines herself as a mother.

After birth it is necessary to accept the new-born and get to know and love the child as it is, leaving daydreams behind in order to live motherhood and fatherhood to the full.

respectful professionals

From the beginning of pregnancy many women and their partners are longing to do everything in their power to care for their baby and ensure its healthy and caring arrival into the world. Probably one of the most important decisions in any pregnancy is the choice of professionals, both for the monitoring of the pregnancy and when the time comes for delivery.

When choosing where and with whom to give birth, i.e. which professional team to trust at the time of delivery, it is advisable to obtain the following information:

What is their way of working and their philosophy of care?

Is the team aware of and do its members follow the recommendations of the Ministry of Health in the Strategy for Normal Birth Care?

Do the team encourage women to submit their birth plan?

What indicators do the team or birthing facility follow? For example, what is the percentage of caesarean sections and induced labours?

Is this data accessible to the public? Transparency is an indicator of quality of care.

Apart from an epidural, what other kind of pain relief is offered?

Is the presence of the father or another person allowed during caesarean sections and instrumental deliveries?

Does the team understand the importance of not separating the new-born from the mother in the first two hours of life? If there is a medical reason for separation, do they allow the father or another family member to accompany the new-born?

How does the team support breastfeeding?

Are they accredited as an IHAN (Iniciativa para la Humanización de la Asistencia al Nacimiento y a la Lactancia ≈ The Baby-Friendly Hospital Initiative) hospital or in the process of accreditation?

If the new-born needs to be admitted, does the Neonatal Unit apply developmental and family-centred care?

preparing for childbirth

Childbirth always involves at least two human beings: mother and baby. A journey from one to the other: the first meeting after, ideally, nine months of pregnancy.

Childbirth is instinctive: something the body knows how to do. You don’t have to learn to give birth. The mother’s body does most of the work by gradually opening and pushing the baby downwards during contractions. But it is important to note that the baby also plays its part: positioning itself, turning, resting at times as it gradually moves forward.

The uterus is a muscle: when it contracts it becomes hard. The French obstetrician Leboyer in his book ‘Childbirth, chronicle of a journey’ explained how the uterus in labour can contract in two ways: pleasantly or painfully. In pleasurable contractions, the uterus contracts gently and slowly.

Painful contractions, on the other hand, according to Leboyer, are more like cramp: the whole uterus contracts at the same time and then suddenly releases. This sudden, sharp contraction is what causes pain. For contractions to be pleasurable, it is important to be deeply relaxed and to be able to receive and accompany them as if they were a wave washing through the uterus.

mental health in pregnancy

Not all women feel well during pregnancy, nor do they experience the entire pregnancy in the same way. Some suffer from emotional disorders such as depression and anxiety or live in situations of maximum stress.

In these cases, it is more difficult to bond with the baby and prepare for its arrival.
There are currently several research groups around the world working on understanding how the emotional state of the mother during pregnancy affects the baby.

Care after birth can improve or worsen the effects of prenatal stress on the baby’s development.

Amongst other things a mother’s feelings and thoughts towards her baby can facilitate or hinder the birth and the initial bond with the baby before and after birth.

In addition, nutrition and the environment in which the pregnant woman lives also greatly affect the baby’s neurodevelopment. We know for certain that drinking alcohol during pregnancy, even in small doses, damages brain development.

Avoiding stress during pregnancy is a priority. It has been shown, for example, that maternal stress is one of the main causes of premature birth. For this reason doctors should not wait until the pregnant woman is unwell before offering her sick leave.

Rather than to go through the premature delivery of a very fragile baby it is preferable to be on sick leave during the last three months of pregnancy in order avoid stress and experience this period calmly and peacefully.

a complicated pregnancy

Some pregnancies are complicated. Sometimes from the very beginning, as early as the first three months, a problem is detected that hampers the baby’s development.

Obstetricians, who are experts in the complications that may arise during pregnancy, often admit that they do not know how to deal with the emotional side of complicated or difficult pregnancies. Frequently they unnecessarily encourage hasty decisions in such delicate matters as whether or not to go ahead with a complicated pregnancy. In other instances, professional continuity fails and the woman or couple find they see a different professional at each consultation, with the added suffering that this creates.
These are often very complex emotional situations. It can be difficult to feel both an increasing bond with the baby in the womb and at the same time concern or fear for the baby’s future or for one’s own health.

Some people think it is better “not to get too attached to the baby” or “not to get your hopes up” in case the pregnancy does not end well.

Some mothers who have experienced very difficult pregnancies have told how feeling very connected to the baby growing inside them was what gave them the most strength in very adverse situations. Even mothers who lost their babies have said that, despite everything, they enjoyed the pregnancy, the wonder of feeling their baby inside their womb, and that it was having been able to enjoy that connection fully that helped them through the hidden grief of gestational or perinatal loss.

If the baby is unwell, feeling and knowing that you are loved will always help you to cope with adversity.

It is therefore important to find support and ways to connect with the unborn child even – or especially – when the pregnancy becomes complicated.

In such situations it may help to:

Give yourself plenty of time before making decisions. Haste is invariably a bad idea. Often the rush is brought about more by the fear of the professionals, from their struggle to support in difficult moments than from the clinical situation of the baby.

Focus on the present, on the here and now. Take time to listen to your body and observe the changes produced by pregnancy. Take care of yourself as much as possible. Difficult situations sometimes present us with an opportunity to live unconditional love to the full, even if you have to say goodbye because death comes.

Trust and prepare for the moment you meet your baby who is already so dear to you, even if it will be a time of farewell.

Being pregnant with a baby that is not developing well can be very difficult and painful, but it can also be an opportunity to come to terms with the mystery and fragility of life.

pregnancy loss and bereavement

Some babies do not live outside the womb. They die at some point during pregnancy or childbirth. Death almost always comes suddenly, unexpectedly and inexplicably. The process of grieving and coming to terms with death is particularly difficult.

Often the mother feels guilty. She thinks that the baby has died because of something she did or did not do; she feels that she did not do everything within her power to care for the baby in her womb. Since the mother is obviously not to blame for the baby’s death this thinking is irrational and is actually a reflection of the deep pain of loss. Feeling cared for by health professionals who spend time listening to and accompanying the bereaved parents is very important.

Mourning requires recollection, silence and time and depending on each mother and father often a long time. Sadness must be allowed in a society that prefers not to recognise it. It is not usually easy, even less so if there are other couples in the family or friends giving birth to healthy, full-term babies.