Birth Psychology, A Brief History

by Jeane Rhodes

This paper will attempt to trace the roots of birth psychology, also known as pre- and perinatal psychology and health, and place it in the context of current theoretical perspectives in the wider field of psychology. The incorporation of the biological component was a development of the second half of the 20th century. The study of somatic (body) psychology began to spread on the foundation laid by Wilhelm Reich (Boadella, 1985; Reich 1949). The reuniting of body and mind has proven to be key to a greater understanding of ourselves as human beings. Therefore, it is important to note that we are discussing the field of Pre- and Perinatal Psychology and Health. This reintegration of specialty areas has been an important development in psychology and particularly important for pre- and perinatal psychology.
      Biblical acknowledgment of the awareness of the babe in the womb can be found in these words from the book of Luke, "and when Elizabeth heard the greeting of Mary the babe leaped in her womb." This is one of many references from ancient scriptures attesting to a realization of the importance of prenatal life. It is interesting to note that one of the pioneering theorists in Birth Psychology, William Emerson (1996), states that, in his experience, the second trimester is primarily devoted to psychic and spiritual development for the unborn child. In the above quoted biblical passage, Elizabeth is stated to be in the sixth month of her pregnancy.
      From the east comes this insight from the Caraka Samhita, reported to be around 4,000 years old.

                      When a man with unimpaired sperm and a woman with unafflicted
                      genital tract, ovum, and uterine bed cohabit during the period of 
                      fertilization, the Jiva (Soul) along with the mind descends into the
                      zygote (combined form of the sperm and ovum) lodged inside the
                      uterus. This results in the formation of the embryo. (Dash, p. 366)

      The surprising thing about this quote is that this knowledge and wisdom was available in the east years before the development of western medicine. As late as 1695 AD, the spermist’s theory maintained that a miniscule human being, referred to as a homunculus, was in the sperm and only needed to be placed into the womb of a female in order to begin developing into a full human being (Hill, 1985). 
      That human beings have long been fascinated with birth and origins of life should not be surprising. Who among us has not gazed into the heavens on a starlit night and wondered about the birth of the universe? And who hasn't been stimulated by the sight of a newly born baby to marvel at the unseen events within the womb of the mother that have led to the birth of such a perfect creation? What is surprising is that we have long discounted awareness (consciousness) during the process of becoming human because of our limited understanding of the process and, as a result, placed the beginning of awareness at some point in the process that we thought we could explain.
      A fascinating part of the study of prenatal and perinatal psychology is observation of the movement of this point over time. Consciousness and awareness were attributed only to adults until well into the 19th century. Then, in the early 20th century, children who had become verbal were recognized as possessing these mental capabilities. Only in more recent years are we daring to explore and speak about the possibility that these abilities might not require verbal capacity and, in fact, might transcend the body entirely.The new frontier is exploring consciousness that does not depend upon physiological structures.
      The second half of the twentieth century brought new ways to learn about the first nine months of human physical development with the advent of technologies such as ultrasound, fetal heart monitoring, and inter-uterine photography. Previous to these technologies, direct observation of the living unborn human was not possible. Our scientific bias discounted information about prenatal sentience despite centuries of intuitive experience of midwives and individual expectant mothers. Much of the research in recent decades reinforced what these individuals have long intuited; for example, that the unborn hears and responds to external sounds. We now know that the unborn child's ear is fully developed at 4-1/2 months in utero. Even this may not account for the earliest fetal responses to sound. Another pioneer in Birth Psychology, Dr. David Chamberlain (1994), suggested that prenates "begin listening and responding in the 16th week, long before the ear is formed at 24 weeks, using the vestibular system and the skin, which functions as an external nervous system absorbing sound and vibration.” (p.190)
      This new data about the sentience of unborn babies, however, is still the subject of intense debate when it comes to attributing awareness or consciousness to the unborn baby. One ancestor of Birth Psychology, the behaviorist perspective in psychology, is ready to accept evidence of classical conditioning as shown in numerous experiments from Peiper in 1925 to DeCasper & Spence in 1982, but this is not considered to be evidence of consciousness to strict behaviorists nor to neurologists. The behaviorists' position is not surprising in light of their adherence to the tenet that only observable behavior is worthy of scientific study. To neurologists, consciousness itself is only a manifestation of neurological functioning, so the debate with neurologists involves establishing that structures are in place to account for consciousness. This begs the question, what stimulates creation of the structures? The biological perspective would point to genetic programming, but the answer is turning out to be much more complex. There is evidence that the development of fetal organs, structures, and systems are coincident to use. Liley, in 1972, stated, "development of structure and development of function go hand in hand” (p. 104). It could just be that intent precedes both, and that the whole question of which comes first, structure or function, with regard to organs and systems within the human body is irrelevant, as one requires the other in a circular fashion. 
      Work in DNA analysis has shown that cells hold long term memory of ancestral and phylogenetic information within strings of complex memory. The new field of epigenetics (Lipton, 2005; Lipton & Baehrman, 2009) has added even more complexity, with research showing that DNA itself is altered by the environment, including the environment of the womb. Integration of knowledge from many fields has never been more important.  Internet communications is facilitating just such integration, as information spreads quickly and dialog between disciplines is becoming more and more common.
      We turn now to the literature of psychoanalytic thought for the contributions of another ancestor. A review of the literature in the period since Freud's pioneering work reveals much in the way of substantiation for the imprinting of birth and prenatal experiences in the unconscious. Freud himself viewed birth as the prototype for later anxiety. In a footnote added to the second edition of The Interpretation of Dreams (1900/1965), he stated, "Moreover, the act of birth is the first experience of anxiety, and thus the source and prototype of the affect of anxiety." Interestingly, in light of later events, this footnote was deleted from subsequent editions. These later events include rejection of the work of his protegee, Otto Rank. Rank's (1929) Trauma of Birth, although researched and written at the behest of Freud, created a split between them upon its completion and was totally rejected by Freud. Whether this can be attributed to fear that Freud’s work would be diminished by the importance attached to the trauma of birth, as Frank Lake (1981) suggests, or to disbelief in the primacy of prenatal and birth experience in the development of the psyche, we can only speculate. Whatever the reason, the psychoanalytic community rejected Rank's work, relegating it to the background for many decades. Although Rank's work is now seen by those in prenatal and perinatal psychology as seminal, some aspects are disputed in light of new knowledge. For example, he and many of his followers viewed the prenatal period as a totally pleasurable and even blissful primal state. We now have evidence that the prenatal period is not always blissful and that the months preceding birth can contain traumatic experiences (Emerson, 1996). A wealth of data from psychoanalytic literature, from Piper (1925) through Ferenczi in 1938 and Winnecott in 1958, has addressed the impact of prenatal experience. Winnecott (1958) in The Maturational Processes and the Facilitating Environment, states specifically that the personal birth experience is significant, and is held as memory material.  Psychoanalytic theorists have begun to take another look at this issue, for example in recent publications from Nora Swan-Foster (2012) and Helga Blazy (2012).
      The field of Prenatal and Perinatal Psychology and Health, as a distinct specialty, was first defined in Europe with the organization in 1971 of the International Study Group for Prenatal Psychology, which later became the International Society of Prenatal and Perinatal Psychology and Medicine, acknowledging the multidisciplinary nature of its members' work. Its twin in North America emerged in 1983 as the Pre- and Perinatal Psychology Association of North America. It too has now acknowledged its multidisciplinary nature by changing its name to the Association for Prenatal and Perinatal Psychology and Health. The two organizations, while sharing a common vision, emerged independently of each other and remain so, although there is common sharing of research contributions in their respective journals.
      Because the implications of the research emerging from this field have far reaching consequences for the human race, perhaps proponents can be forgiven for unusual zeal in promoting their theories. As the field matures, we are seeing more well-grounded research and the release of some early ideas that have not stood the test of time. As more individuals, researchers, academics, and parents, become aware of the importance of the first nine months of life, the field is emerging from the fringes of psychology and coming into its own as an essential field of study. On the level of application in the real world, impacting the way in which babies are birthed, patience with the slowness of change is sometimes difficult. Although the physiological impacts are now fairly widely accepted, i.e. smoking by an expectant mother has an effect on the fetus (first researched by Sontag in 1941), the psychological impacts are more difficult to quantify.
      The integration of health (or medicine) into prenatal and perinatal psychology has proven to be very important. As in the wider field of psychology, we know we cannot separate mind and body. And, as we have begun to conceive of the development of the body as a result of consciousness, we are gaining new insights and understanding of the body and of consciousness. Perhaps the wisdom of the soul is there in the beginning. Our challenge is maintaining contact with this wisdom while developing a means of communicating with others on this material level of existence. This seems as true for individuals as it is for revolutionary theories.


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