Thursday, June 18, 2015

A Pre and Perinatal Psychology Overview

It has been nearly a century since pre and perinatal psychology was introduced by Otto Rank, a student and colleague of Sigmond Freud.  His slim book, The Trauma of Birth, was a gift to his mentor and friend in 1924.  This birthday surprise detailed how Rank thought that difficulty during birth could affect the psyche of the person being born in such a way that it would affect them the rest of their lives.  While first warmly received by Freud, it was rejected and the relationship between teacher and student was forever affected.

Since then, this pattern of considering that babies have experiences that have lifelong implications has taken similar course in the world.  A small cohort of practitioners took on the belief that yes, these early experiences do influence behavior for a lifetime while the medical, scientific and popular communities ignored, disengaged or even repudiated this idea.  Now, in 2012, a confluence of neuroscience, cellular biology, trauma resolution therapies, and human development are indeed supporting the fact that early experiences prenatally, during birth and in the first year of life do indeed have lifelong implications for health and happiness.  These experiences can affect the child in both positive and difficult ways, depending on what happens.  Healing is possible, no matter what difficulties may occur.

After Otto Rank, several influential practitioners took up the thread that these early life experiences were deeply meaningful, yet it was not until the 1960’s after the publication of research articles on how caregivers and babies interact that the vital importance of this early bond received scientific support.  This research detailed how the style of attachment between mother and baby could have lifelong and multi-generational implications.  Then the 1990’s were considered The Decade of the Brain, and many government dollars supported scientific research into embryology, neurology and related fields, especially the human genome project.  It was thought that humans had over 100,000 genes that could be mapped and therefore disease and health could be easily tracked and hopefully manipulated for the greater good.  However only 25,000 genes were discovered and research turned to looking at how the environment influenced gene expression.  This field of study is called “epigentics,” or how the environment and genetics interact.  The nature/nurture fight was forever settled and the era of the “epigenome” was born.

These days, researchers, scientists, therapists, medical doctors and other professionals realize that while the genes tell the body what to do and how to develop, electrochemical information in many forms coming from thoughts, feelings and experiences that a person has will influence how the genes we are born with will function.  In addition, chemicals in the environment around a human will influence how the genes express themselves.  Experiences that grandparents have will influence their grandchildren’s life, as these epigenetic changes can be multigenerational.  Geneticists are now tracking a variety of diseases through the generations.  Professionals can also track how experiences influence the baby in utero, especially high levels of stress.

This is what parents need to know: that how they are with their baby starting preconception can influence their baby’s development and also that of future generations. Mothers, fathers, and families can look at this paradigm and take away what many mothers have asked for over and over: an instruction manual for being with babies and children that will help them help their children find happiness in the world.  Every parent wants the best for their child.
Those of us supporting human development can outline best practices that parents can consider, and also, offer support if life experiences have been difficult.  Life is unpredictable and mostly not in our control but we can do our best to positively influence the outcome.  Metaphorically, we can chart our course like a sailor consulting the starry sky.  Let us consider positive early life experience as a constellation of stars.  Here is a list of the points:
  •   Ancestral lineage- people are  securely attached and there is no disease       (rare)
  •   Dad and Mom “conscious”, prepare for baby
  •   Lovemaking is tender and intentional
  •   Conception and implantation are easy
  •   Uterus is healthy and baby is growing in a good spot
  •   Mother and father lead healthy lives, mild to moderate stress.
  •  Good and regular prenatal care
  •   Birth is optimal, natural, no interruption, not too short, not too long
  •   Baby is not separated, has lots of skin to skin,  “self attaches;” there is no   difficulty breastfeeding
  •   Neonatal period is relaxed and uneventful, completely breastfed until at       least 6 months.
No person or family has an optimal constellation of factors for human development, however, we can change our stars.  That is the good news.  Here is what parents can do:
  • If a woman is considering getting pregnant she can most positively influence healthy gene selection by preparing at least three months in advance.  Bruce Lipton and other cellular biologists show that what a woman experiences then can create an environment that influences which genes are selected, especially if she can avoid high stress or experiences of fear or loss.  Babies conceived during wartime or famine have an entirely difference experience from those conceived in time of plenty.  Women can take vitamins esp. folic acid and eat healthy foods, especially fish oils and other foods that positively influence neurological development.
  • Potential parents can examine how attuned they are to their own emotions and how comfortable they are expressing these emotions with people they love and trust.  Parents can begin to practice talking about their feelings with each others more to increase their own comfort levels with emotional expression. Parents who can do this with ease and help their children express and understand their emotions is one of the best predictors of children’s happiness and ability to self regulate feelings.
  • Mates can create a loving and conscious atmosphere for conception.  Most of us know that not all babies are planned, and even when planning, it can be stressful to conceive if there are patterns of infertility. 
  • Parents can also influence their baby’s development through communication with the baby in utero.  This concept can be a stretch for some parents, but research has shown that babies can experience their parents’ intentions and communication, even if they don’t understand the words. These babies exhibit enhanced visual, auditory, linguistic, and motor development. In general, they sleep better, are more alert, confident, and content than infants who were not who did not receive this level of communcation in utero.  Births in the families where there is prenatal communication are shown to have less intervention and the babies are bigger and stronger.  These families also have more intense bonding and greater coherence.  Parents can talk, read, play games through touch and sing to their unborn.
  • Stress plays an important role in human development.  If it is truly overwhelming or toxic stress, like during war, domestic violence, a huge workload at the office, or adverse circumstances the mother feels she has no control over, then it can program the baby’s nervous system so he or she is hard to settle, negatively affecting sleep, communication, eating and even motor and cognitive development.  However,  occasional moderate stress can support humans to be more resilient.  Not all stress is bad!  But women need to determine how much is too much for them and get support they need.  Therapies such as massage and other forms of bodywork, meditation and relaxation techniques are important resources here, as is exercise, walks in nature or anything that helps a mom feel better and more in charge of her environment.
  • Parents, mothers in particular, can look at their own history and determine how they were parented.  Research has shown that that we parent our own children in the same manner in which we raised with up to 85% accuracy.  The best way to prepare is to make sense of your history and address problems in the presence of a qualified counselor.  It is not what happened to us as children, but how we have come to terms with it.
  • Pregnant moms and their mates can seek out good prenatal care and select minimal intervention during birth.  In addition, birth and postpartum doulas or women who can help with birth and the newborn can really help the new family get off to the best possible start.  Research has shown that the presence of a doula can decrease the need for interventions and even increase the satisfaction of a couple’s relationship.
  • If there has been a difficult birth or separation between mom and baby, then parents can use skin-to-skin practices and therapies to help repair and support bonding.  This is effective even if the baby was adopted.  Breastfeeding is also a best practice for optimal human development, but if that is not well established, parents can still support their children with health practices and play.
  • Research now shows that the first 18 months of life in a human lays down the significant nerve pathways.  The brain develops rapidly until age three when neurons not being used or stimulated will be pruned.  Since a baby’s nervous system goes 10 times slower than an adults, parents and caregivers can slow down and provide appropriate enriching experiences through touch, music, rhythm and communication.  Parents can talk with their babies.  The connecting, attuned experience is vital for all aspects of the babies development!
  • Moms and caregivers need to be encouraged to make themselves a priority.  Babies will entrain off of what a mom is feeling.  If she is exhausted, anxious, depressed, lonely, or nutritionally drained than her baby will feel it.  There is truth to the saying “if mama’s not happy, no one’s happy.”  If mom needs to go back to work, families can select educated and resilient care providers and help for the family to make the transition.
One of our greatest spiritual challenges is living in the real world, and at every turn on the life road, parents can feel blamed.  Every parent wants the best for their child.  Take time for yourself and your baby. Use your resources. Connect with other families and find a balance between function and overwhelm.  Then get help if you need it.  We need a cultural shift around moms and babies, but until then, we can chart our course with these pre and perinatal points in mind to support families.  Parts two and three will further layout how we help families and adults who have had difficulty during the pre and perinatal period.

By Kate White and Myrna Martin

The sole purpose of these blogs is to provide information about the tradition of ayurveda. This information is not intended for use in the diagnosis, prevention or cure of any disease. If you have any serious, acute or chronic health concern, please consult a trained doctor/health professional who can fully assess your needs and address them effectively. If you are seeking the medical advice of a trained Ayurvedic expert, call us or e mail.
Dr Unnati Chavda
(Promoting pregnancy wellness) 

Wednesday, June 3, 2015

When Does Parenting Begin? An Introduction

In our culture, the majority opinion is that parenthood starts after birth. This view has been subtly fostered by medical scientists who think of a baby as physical matter, especially brain matter, which they have long believed is insufficient to register or process memory, learning, trauma, emotion, or any truly human experiences until months after birth. This effectively excludes the period of life in the womb from active parenting. Hence, we tend to think that parenting cannot really begin until a real baby is actually "delivered" to the parents. Considering all we know today about the realities of life before birth, we must appropriately reset the clock on parenthood. The womb is no longer a dark, secret place. We know it is not an isolation tank! What goes on in there for nine months is the ceaseless moulding and shaping of the whole baby--a collaboration between baby and parents. All the new facts of life plead for parental involvement, participation, and cooperation in the powerful matrix of intimate interactions that take place in the womb. Pregnancy is parenting de facto. Parental influence on a child is at its peak during construction in utero. Creating is what parenting is about--creating a physical body and brain, creating emotional foundations for living, and establishing a rich connection with the prenatal self.

1. Creating a Physical Body

Parents provide the immediate physical environment which will determine whether the baby's equipment for living will be poor, average, or optimal. As the foundations for physical life are laid, each new part is built upon the previous one so that both limitations and advantages are preserved. Although some degree of "plasticity" is possible during later development, the original parts remain in place. Parents who wait to think about this until after their child is born will be starting too late--nine months after all the basic equipment has been constructed. In the 20th century, parents began to face compounding hazards of reproduction. These included old and new bacteria and viruses, which seem to emerge when our immune system is weak and vulnerable. In addition, environmental dangers became more challenging with the huge new production of industrial and agricultural chemicals, a swelling tide of stimulants and sedatives such as nicotine, caffein, and alcohol, tempting "street" drugs like opiates and amphetamines, the plethora of new drugs prescribed by physicians, new forms of electromagnetic radiation including the bombardment of ultrasound waves being overused to entertain parents during obstetrical office visits. Because of so much environmental disruption, the safety and sanctity of the womb is threatened as never before. (For specific research addressing womb safety, see our column WombSafe). A mother's diet can innocently invite birth defects. Science has only slowly found the connection between deficiencies of folic acid (one of the B vitamins) and the profound malformations of anencephaly and spina bifida, defects which occur when the neural tube fails to close 18 to 26 days after conception. If construction deficits occur at the top end of the tube, the baby's brain will likely be affected; if at the lower end, the spinal column will likely be affected. Large scale disruptions in the food supply, as in a famine, can create widespread problems of reproduction. Long-term studies of children born to mothers who were starved in early pregnancy show damage to the mechanisms of appetite control and growth regulation, resulting in obesity in the offspring. Famines produce increased rates of diabetes and schizophrenia, partly through zinc deficiency which contributes to both of these diseases. Sub-optimal nutrition, one of the factors behind the plague of low-weight babies, means shortages of essential supplies during brain construction resulting in a sub-optimal brain. In the modern urban environment, estrogenic compounds flow freely and have an impact on human sexual development. Hormonal deficiencies, excesses, and imbalances effect both the genes and the environment that ultimately determine sexual identity and orientation--all this before the baby is born.

2. Creating Emotional Foundations

One of the biggest surprises about life in the womb is the extent of emotional involvement and expression, generally not anticipated in psychology or medicine. Spontaneous and graceful movement that can now be observed from about 10 weeks after conception reveals self-expression and early aspects of self-control, needs and interests. Some behaviors reflect a protest against uncomfortable experiences. By 15 weeks, ultrasound shows babies moving in reaction to something as simple as a mother's laugh or cough. More disturbing are the aggressive actions seen toward the needle during amniocentesis--attacking the needle barrel with a closed fist, suggesting self-protection, self-assertion, fear and anger that was previously thought unreal and impossible. With surprising development of hearing and tasting before 16 weeks gestational age, the way is open for babies to have even more extensive interactions with their mothers and fathers. Ultrasound imaging of twins similarly shows the unexpected scope of their social relationships seen in repeated hitting, kicking, kissing, or playing together. Life in the womb--now that we can observe it--bears little resemblance to the lazy world previously hypothesized in which a baby was a passive passenger virtually deaf, dumb, and blind. In those days, parents themselves thought it was appropriate to be deaf, dumb, and blind. As it is with the establishment of physical settings in utero, the emotional system is also organizing itself in relation to the range and varieties of experiences encountered. A baby surrounded with anger, fear, and anxiety will be adjusting itself to that world and may carry those settings forward unless something changes. Patterns of fearful reaction already visible via ultrasound before birth can be seen after birth. This emotional sensitivity of the fetus is one big reason why adoption cannot be viewed as just a simple experience for the parents. Chances are, an adopted baby has emerged from confusion and conflict, both troubled and conditioned by the turmoil of the birth parents. They have been learning from experience and are likely to arrive feeling at least uncertain, possibly rejected, carrying unconscious baggage of anxiety about its identity and connections. Parents are potent factors in shaping the dynamic world of the unborn.

3. Establishing a Rich Connection with the Prenate

Not long ago we thought it was impossible for prenates to have any truly personal or significant experiences. We didn't see that they could have a working mind. In retrospect, our false beliefs about their brain power obscured the fact that babies in the uterine world were indeed having a range of experiences, establishing patterns of interaction, listening to music and conversation, and as tests ultimately proved, were committing them to memory. Numerous experiments have made it clear that prenates who have the opportunity to hear stories and music repeated to them in utero can demonstrate recognition for this material later in life. Prenates have become familiar with and show a preference for specific lullabies, musical themes like "Peter and the Wolf," "Mary had a little Lamb," and even theme music from television soap operas. Prenates memorize the voices of their mothers and fathers in utero while learning the basic features of their native language, the "mother tongue" as we say. Spectrographic analysis of voice and cry sounds as early as 26 weeks of gestation show how far babies of this age have already progressed in adopting the voice characteristics of the mother. In a recent experiment, mothers repeated a children's rhyme daily for four weeks from week 33 to 37 in utero. Tested at 37 weeks while still inside, the babies reacted with a change of heartbeat to the familiar rhyme, but not to the unfamiliar rhyme. In other research, babies have demonstrated immediately after birth a preference for their mother's voice and their native language. The womb turns out to be a stimulating place and functions as a school. And all babies attend. In the last fifteen years as these facts were gradually becoming known, many books, tapes, and exercises were created to help parents understand and communicate with babies in the womb. All are potentially valuable in helping parents to make a creative and loving attachment (rather than an insensitive or aggressive one), a connection which respects the needs and limitations of the baby and doesn't overwhelm them. Babies are naturally curious and interactive. Taking advantage of this since about the 1980s, organized programs for parents have been developed and tested, revealing the benefits of carefully planned stimulation. (For the scientific details, please see another section in this column featuring best examples of prenatal stimulation.) These studies have proven what few believed decades ago: (1) that babies in the womb are alert, aware, and attentive to activities involving voice, touch, and music; (2) that babies benefit from these activities by forming stronger relationships with their parents and their parents with them, resulting in better attachments and better birthing experiences, and (3) that these babies tend to show precocious development of speech, fine and gross motor performance, better emotional self-regulation, and better cognitive processing. These are the gifts and rewards of active parenting.