Pre- and perinatal psychology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [6]


Prenatal and perinatal psychology is an interdisciplinary study [1] [2] [3] of the foundations of health in body, mind, emotions and in enduring response patterns to life. It explores the psychological and psychophysiological effects and implications of the earliest experiences of the individual, before birth ("prenatal"), as well as during and immediately after childbirth ("perinatal") on the health and learning ability of the individual and on their relationships. As a broad field it has developed a variety of curative and preventive interventions for the unborn, at childbirth, for the new born, infants and adults who are adversely affected by early prenatal and perinatal dysfunction and trauma. Some of these methods have not been without significant controversy, for example homebirth in the West and in earlier days, LSD psychotherapy for resolving birth trauma.


Examples of the diversity of interests in the subject are: in neurobiology where it is understood that "experience can change the mature brain - but experience during the critical periods of early childhood organizes brain systems"[4]; in psychoneuroendocrinology where there is evidence of an "umbilical affect exchange" which influences the immediate and long- term psychology of behavior [5] [6]; in bioengineering where the importance to development as well as growth of the fetomaternal system is increasingly understood [7]; and in clinical maternal-fetal medicine [8] where the unique symbiotic relationship between a mother and her fetus is explored, and where issues such as maternal stress and the development of later psychopathology in the child are considered [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] through hormonal mechanisms particularly the HPA axis [21].

Although theoretical and psychotherapeutic approaches vary in their treatment of the topic, a common thread is the fundamental importance of pre- and perinatal experiences in the shaping of the personality and in future psychological development. Yet somewhat contrary to the evidence [22] [23] [24], this assertion is not widely supported in psychology. There are widespread doubts regarding the extent to which newborn infants are capable of forming memories, the effects of any such memories on their personality, and the possibility of recovering them from an unconscious mind, which itself is the subject of argument in the field. Only a minority of psychologists have had direct experience of the therapeutic modalities that explore these phenomena and many question the validity and even the existence of repressed memories. However, experience and memory are not synomous, and while a fetal infant may not be able to recall his or her experiences, he or she still lived in those moments and possibly had neurological, psychological or physiological responses to them, which may influence the ongoing development of the mind and/or brain structures.

Historical development

The relevance of birth experiences has been recognized since the early days of modern psychology. Although Sigmund Freud touched on the idea briefly before rejecting it in favor of the Oedipus complex, one of his disciples Otto Rank became convinced of the importance of birth trauma in causing anxiety neuroses. Rank developed a process of psychoanalysis based on birth experiences, and authored his seminal work, 'The Trauma of Birth' [25]. Freud's initial agreement and then later volte-face, caused a rift between them, which relegated the study of birth trauma to the fringes of psychology. The subject was taken up again in 1949 by Nandor Fodor [26] a patient of Rank's and teacher of Francis Mott [27] [28]. In addition to birth trauma, Fodor emphasized the significance of prenatal trauma.

Developments in the 1950s included a shift in emphasis towards non-traumatic by Donald Winnicott and to the transpersonal by Maarten Lietaert Peerbolte [29] [30] aspects of pre- and perinatal experience, and brought attention to the relevance of very early gestation, and even the event of conception by Peerbolte. These topics saw later elaboration by Frank Lake as well as Michael Irving, R D Laing, Graham Farrant, Stanislav Grof and others. The expression at a broad social level of basic perinatal feelings, such as "suffering fetus" or "toxic placenta," is part of the narrative in psychohistory, developed by Lloyd deMause. Pre- and perinatal psychology is at the a core of Primal therapy and Primal integration. Professor Stephen Maret has explored these influences in his book, The Prenatal Person [31].

Material emerging from sessions of psychedelic psychotherapy using LSD and other hallucinogenic drugs was the foundation for research into the enduring effects of pre- and perinatal experiences in adult life conducted by Frank Lake, Athanasios Kafkalides and Stanislav Grof. Grof went on to formulate an extensive theoretical framework for the analysis of pre- and perinatal experiences, based on the four constructs he called Basic Perinatal Matrices. Lake and Grof independently developed breathing techniques, following Wilhelm Reich as an alternative to the use of psychedelic drugs, which was subject to considerable legal difficulty from the mid-1960's onwards. A related technique called Rebirthing Breathwork was developed by Leonard Orr; and Core process psychotherapy trainees relive presumed birth trauma as part of their training.

Public attention was drawn to the importance of prenatal experiences by the 1981 book, The Secret Life of the Unborn Child [32], by Thomas R. Verny, who founded the Association for Pre- & Perinatal Psychology and Health (APPPAH). David Chamberlain, who was president of the APPPAH from 1991 to 1999, published a popular book entitled, Babies Remember Birth (1988), outlining new experimental research that supports the existence of pre-natal memories. Further evidence was presented by Ludwig Janus in The Enduring Effects of Prenatal Experience (1997).

Perhaps the first book to effectively convey the importance of trauma-free childbirth to the wider public was Birth Without Violence (1975), by French obstetrician Dr. Frederick Leboyer [33], which helped popularize the practice of placing newly-born infants in a tub of warm water, known as a "Leboyer bath" to simulate the familiar pre-natal environment of warm amniotic fluid. Following on from Leboyer, another French obstetrician, Michel Odent, pioneered the practice of low intervention labour and took the "Leboyer bath" one step further, developing the use of warm-water pools for a water birth.

In 2004, Dr. Wendy Anne McCarty [34] [35], co-founder of the Prenatal and Perinatal Psychology Program at Santa Barbara Graduate Institute, reviewed the 30 years of clinical research in prenatal and perinatal psychology and current mainstream early development models. In her book Welcoming Consciousness, she introduced the Integrated Model of early development that was reflective of the prenatal and perinatal psychology clinical findings. The transcendental and human aspects of awareness documented from the beginning of life became the core thread in this holonomic holographic model.


  1. McCarthy WA Nurturing the Possible: Supporting The Integrated Self from the Beginning of Life retrieved from [1] on May 16, 2007. Quote: "Prenatal and perinatal psychology (PPN) has grown into a multidisciplinary field “dedicated to the in-depth exploration of the psychological dimension of human reproduction and pregnancy and the mental and emotional development of the unborn and newborn child. The heart of the field’s unique contribution is the exploration and understanding of prenatal life, birth and bonding, and infancy from the baby’s point of view."
  2. McCarty, W. A. (2002a). The power of beliefs: What babies are teaching us. Journal of Prenatal & Perinatal Psychology & Health, 16(4). 341-360.
  3. McCarty, W. A. (2004). The CALL to reawaken and deepen our communication with babies: what babies are teaching us. International Doula 12(2), Summer 2004
  4. Perry, BD, Pollard, R, Blakely, T, Baker, W, Vigilante, D (1995): Childhood trauma, the neurobiology of Adaptation, and “Use-dependent” Development of the Brain: How “States” become “Traits”, Infant Mental Health Journal, vol 16, no. 4, Winter
  5. Dorner G (G. Dorner, "Die mogliche Bedeutung der pra unloder perinatalen Ernahrung für die Pathogenese der Obesitas." 107-123, quoted by Dorner, "Significance of Hormone-dependent Brain Development and Pre-and Early Postnatal Psychophysiology for Preventive Medicine," 429). "During the pre and/or early post-natal life. systemic hormones and neurotransmitters are capable of acting as organizers of the brain, which is the controller of the neuro-endocrine-immune system. Thus, the quantity of the systemic hormones and neurotransmitters co-determines during a critical period of brain development, the quality, ie. the responsiveness, of their own central nervous system controllers and hence the functional and tolerance ranges of their own feedback systems throughout life . . . Abnormal levels of systemic hormones and neurotransmitters, which can be induced by abnormal conditions in the psychosocial and/or natural envlronment. can act as teratogens and lead to permanent physiological and/or psychological dysfunctions in later life. Thus many malfunctions of reproduction. metabolism, information processing, and immunity called up to now idiopathic, essential, cryptogenic, primary or genuine can be explained by pre and/or early postnatal psycho-and/or physiological processes."
  6. Fedor-Freybergh and Vogel, "Encounter with the Unborn: Philosophical Impetus behind Prenatal and Perinatal Psychology and Medicine," xix-xx. "Psychoneuroendocrinologists have already elicited useful data from the preliminary theoretical research in recording fetal response to and retention of outside environmental stimuli (touch, sound, and light stimuli for the most part). Various highly specific biochemical structures (hormones, neurotransmitters and other polypeptide structures) are needed, in direct connection with input phenomena, for the transformation and storage of both sensorial and sensible types of information. Crucial to the formation of the primary central nervous system on the hypothalamic-pituitary-adrenal level, some of these functions are detectable in the very beginning of development of the human being. Thus the embryo successively develops a high sensibility and competency for the potential ability for perception"
  8. Clinical Maternal-Fetal Medicine by Hung N. Winn, John C. Hobbins (Eds) Taylor & Francis; 1st edition (June 15, 2000) English ISBN-10: 1850707987 ISBN-13: 978-1850707981
  9. Herrenkohl L R, "The Anxiety-Prone Personality: Effects of Prenatal Stress on the Infant." In Roy J. Mathew, Ed. The Biology of Anxiety. New York: Brunner/Mazel, 1982, pp. 51-86
  10. Antonio J. Ferreira "The Pregnant Woman's Emotional Attitude and Its Reflection on the Newborn." American Journal of Orthopsychiatry 30 (1960): 553-6
  11. Child At Risk: A Report of the Standing Senate Committee on Health, Welfare and Science. Hull: Canadian Government Publishing Center, 1980
  12. Barrett J H W, "Prenatal Influences on Adaptation in the Newborn." In Peter Stratton, Ed. Psychobiology of the Human Newborn. New York: John Wiley S. Sons, 1982, p. 270
  13. Abram Blau, et al., "The Psychogenic Etiology of Premature Births." Psychosomatic Medicine 25 (1963): 201-11
  14. A. J. Ward, "Prenatal stress and childhood pschopathology." Child Psychiatry and Human Development 22 (1991: 97-110
  15. Lars Billing, et al, "The Influence of Environmental Factors on Behavioral Problems in 8 Year-Old Children Exposed to Amphetamine During Fetal Life." Child Abuse & Neglect 18 (1994): 3-9
  16. D. H. Stott, "Follow-up Study from Birth of the Effects of Prenatal Stress." Developmental Medicine and Child Neurology 15 (1973): 770-87
  17. Norman L. Corah, et al, "Effects of Perinatal Anoxia After Seven Years. Psychological Monongraphs 79 (1965): 1-32
  18. Sarnoff A. Mednick, "Birth Defects and Schizophrenia, Psychology Today 4 (1971): 48-50
  19. Sarnoff A. Mednick et al, Eds., Fetal Neural Development and Adult Schizophrenia. New York: Cambridge University Press, 1991
  20. "Delinquents Said To Have Perinatal Injuries," Psychiatric News, September 1, 1978, p. 26
  21. DINGFELDER S 'Programmed for pathology', review of maternal stress research in APA Online's Monitor of Psychology, retrieved from [3] May 15, 2007 "While the general or specific vulnerability to mental illness continues to be a hot topic, most scientists agree that maternal stress affects infants through hormonal mechanisms. One such mechanism, discovered through animal studies, involves the hypothalamic-pituitary-adrenal (HPA) axis. Chronic activation of this system in mothers, says Huizink, may be responsible for HPA dysregulation, their offspring's difficulty controlling stress hormones. HPA dysregulation has been associated with greater emotionality and difficulty calming down after a stressful situation"
  22. David B. Chamberlain, "Prenatal Intelligence." In Thomas Blum, Ed. Prenatal Perception, Learning and Bonding. Berlin: Leonardo Publishers, 1993, pp. 14-21
  23. A. J. Ward, "Prenatal Stress and Childhood Psychopathology." Child Psychiatry and Human Development 22(1991): 97-110
  24. Adrian Raine, The Psychopathology of Crime: Criminal Behavior as a Clinical Disorder. San Diego: Academic Press, 1993
  25. Rank O, The Trauma of Birth. New York: Richard Brunner, 1952; Otto Rank, The Myth of the Birth of the Hero and Other Writings. New York: Random House, 1932
  26. Nandor Fodor, The Search for the Beloved: A Clinical Investigation of the Trauma of Birth and Prenatal Condition. New Hyde Park, N.Y.: University Books, 1949
  27. Leonard J 'The roots of panic' retrieved from [4] May 15, 2007
  28. Francis J. Mott, Mythology of the Prenatal Life. London: Integration Publishing Co., 1960
  29. Maarten Lietaert Peerbolte, "Some Problems Connected Whh Fodor's Birth-Trauma Therapy" Psychiatric Quarterly 26(1952): 294-306
  30. Peerbolte ML Editor, Hermes Trismegistus. Poimandres. Grieks-hermetisch geschrift in het Nederlands vertaald met een transpersonalistische beschouwing. Deventer 1974 Quote: "Lietaert Peerbolte considers the Poimandres in the light of a transpersonal psychology, based on 'peak experiences', a term used to denote various states of expanded consciousness. The translator points out that in the past, these states of heightened consciousness were linked to religious experience. This is clearly demonstrated in Poimandres. The translator hopes that in the coming era there will be a renaissance of the hermetic view of life, stimulated by a transpersonal psychology and a transpersonalist philosophy" retrieved from JR Ritman Library at [5] on May 15, 2007
  31. Maret S The Prenatal Person University Press of America (November 6, 1997) English ISBN-10: 0761807683 ISBN-13: 978-0761807681
  32. T. Verny, The Secret Life of the Unborn Child, 1981; Dell 1982 reprint: ISBN 0-440-50565-8
  33. * F. Leboyer, Birth Without Violence, 1975; 2nd revision 2002: ISBN 0-89281-983-9; also online (see external links)
  34. W. McCarty, "Welcoming Consciousness: Supporting Babies Wholeness from the Beginning of Life–An Integrated Model of Early Development 2004. Santa Barbara, CA:[]
  35. W. McCarty, Supporting babies’ wholeness in the 21st century: An integrated model of early development. Journal of Prenatal & Perinatal Psychology & Health, 20(3), 187-220, 2006 []
  • O. Rank, The Trauma of Birth, 1924; Dover 1994 reprint: ISBN 0-486-27974-X
  • F. Lake, The First Trimester, 1982
  • S. Grof, Beyond the Brain: Birth, Death and Transcendence in Psychotherapy, 1986 ISBN 0-87395-899-3
  • D. Chamberlain, Babies Remember Birth, 1988; 3rd edition (The Mind of Your Newborn Baby) 1998: ISBN 1-55643-264-X
  • L. Janus, The Enduring Effects of Prenatal Experience: Echoes from the Womb, 1997, ISBN 1-56821-853-2
  • M. D. Adzema, Falls From Grace: Spiritual and Philosophical Perspectives of Prenatal and Primal Experience 2004 (online, below)

See also


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