Fifty years ago “experts” believed that the human fetus was a blank slate, devoid of sensitivity, feeling, and any interactional capability. Over the last 30 years, a wealth of knowledge has been acquired about the fetus, its prenatal environment, and events surrounding the birth experience (perinatal). Pre- and perinatal psychologists, using such modern clinical tools as electronic fetal monitors and ultrasound, have proven that the unborn baby has well-developed senses and reacts to stimuli from mother and the environment. We now have an increased understanding of the physical, emotional, and social influences on the unborn baby. Communication, both physiological and emotional, between parents (particularly the mother) and the fetus can have a significant impact on future health and development.

Over the past 20 years, the new field of “fetal programming” or “fetal origins” has been studying how in utero experiences exert lasting effects on us from infancy into adulthood. A woman’s experiences and lifestyle can change the development of her unborn baby and beyond. The nutrition in the womb, the drugs, infections, and pollutants the fetus is exposed to, the mother’s health, stress level, and state of mind during pregnancy, all affect the fetus and the person later in life. The experience in the womb has been linked to physical and mental health problems later in life, including heart disease, diabetes, cancer, hypertension, allergies, obesity, anxiety, depression, schizophrenia, and autism (Paul 2010).

Pregnancy is a dynamic, interpersonal process. The fetus is attuned to its mother in many ways. It learns about the day-night cycle from the mother’s rhythm of activity and sleep. It knows her voice. It knows her tastes in food by swallowing amniotic fluid tinged with the flavors of the culture. The fetus’s nervous system is shaped by its mother’s emotional states. If a pregnant woman has chronic anxiety due to marital problem, financial difficulties, or other stressors, high levels of the stress hormone cortisol enters the fetus’s brain and body. High cortisol levels can result in anxiety, depression, and emotional dysregulation in childhood and later life. In a British study of thousands of women, those who were highly anxious during pregnancy had children with double the rate of behavioral and emotional problems at 10 years old (Monk, Fitelson, & Werner 2011). Research examined the effects of national grief and trauma. Throughout the United States, a woman’s chance of miscarrying was higher in September 2001 (i.e., the time of the World Trade Center attack) than in the months before and after (Bruckner 2010). Pregnant women with elevated stress hormones are unknowingly preparing their unborn babies for a harsh world, programming their brains and nervous systems to be on high alert for potential threats (Laber-Warren 2009).

Not eating a healthy diet in the first days after conception increases the likelihood of cardiovascular diseases and depression in adulthood. Conversely, women who gain too much weight during pregnancy have children who are 48 percent more likely to be overweight by age seven. Pregnant women who eat a diet low in iron have children who are shyer, fussier, and less sociable. When the mother fails to provide essential nutrients, the fetus is being programmed to adjust its metabolism for deprivation. If a woman gets the flu during her first trimester, her child is seven times more likely to develop schizophrenia. The effects of air pollution on the fetus have been studied for many years, and have been found to lead to a host of adverse outcomes: premature delivery, low birth weight, heart problems, increased cancer risk, cognitive delays, and lower IQ scores. It is well known that consuming alcohol during pregnancy is particularly toxic, damaging the prefrontal cortex in the fetal brain, the region responsible for decision making and impulse control. Fetal Alcohol Syndrome and Fetal Alcohol Effects cause physical, cognitive, and emotional damage throughout life (Paul 2010).

Despite these negative results of stress and trauma during fetal development, a healthy postnatal environment can be healing. Secure attachment, nurturing, and mental stimulation can reverse the effects of a compromised pregnancy. Research shows that when mothers were attuned to their babies, the cortisol levels of these infants returned to normal. Sensitive, responsive, and loving parenting can prevent the development of learning, emotional, physical, and behavioral disorders. Proper exercise and eating habits can halt diabetes and obesity in children and later in life (Laber-Warren 2009).
Prenatal psychologists believe that the core of personality forms in the womb, rather than during the first few years of life. Research and observation have demonstrated the significance of the in utero experience (Verny & Kelly 1981):

• Maternal emotional, as well as physical, messages are transmitted to the fetus.
• Severe maternal stress during pregnancy is associated with prematurity, low birth weight, and infants who are irritable, hyperaroused, and colicky.
• Women who want their babies have easier pregnancies and healthier infants than women who have unwanted pregnancies.
• The 5-month-old fetus can recognize mother’s voice and communicate auditorily with the father.
• Synchrony and bonding being during pregnancy; mother and unborn baby develop reciprocal sleep-activity cycles and styles of reactivity.
• Every sensory system of the baby is capable of functioning prior to birth.

The time of pregnancy offers parents-to-be an opportunity for both physical and psychological preparation. This period of time is truly the dawn of attachment, the time in which mother, father, and baby-to-be begin the process of uniting and connecting. We continue this discussion by examining the physical development of the fetus and the psychological tasks and reactions of the parents that accompany pregnancy.