Prenatal and Perinatal Psychology: Why it Matters

Maine Association for Infant Mental Health

Prenatal and Perinatal Psychology: Why it Matters
Pam Caron, MSN, LSW, IBCLC, PPNE

I have spent most of my life speaking for little ones. Putting words to their actions, behaviors, and feelings is simply what I love to do and what I help others do. When my granddaughter comes home from a long day at school and falls apart, I know she’s worked hard to hold it together for 7 hours, and now she’s made it to her safe place. I use my words to articulate her feelings and to help her and her parents understand her behavior. I do the same for the preschool students in my classroom and the babies in our parent/infant program. Watching their actions, making sense of their behaviors, and empathizing with their feelings, is second nature. Is it any wonder that I would do the same for prenates? These little ones also communicate through their actions, behaviors, and feelings. They too have a lot to share, what are they telling us?

This is what the field of prenatal and perinatal psychology has been exploring for decades. Dr. Thomas Verney wrote The Secret Life of the Unborn Child in 1981 telling us that “the unborn child is a feeling, remembering, aware being and because he is, what happens to him – what happens to all of us – in the months between conception and birth molds and shapes our personality, drives, and ambitions, in very important ways (p. 15). Dr. Verney founded what is now known as the Association for Prenatal and Perinatal Psychology and Health in 1983. It has been described by Dr. David Chamberlain as “the mother that nourishes us all”. Certainly, the association has gestated theories, given birth to new ideas, and provided a nurturing environment for the “language” of prenates to be heard and understood. This matters to me… it’s my why, why I do what I do and how I do it.

I am a mom, and it matters: My daughter is pregnant, and I take pride in the way she and her spouse connect with their baby girl. They know she hears and feels them, and I am blessed to witness these exchanges. I am a mom, and it matters: My granddaughter speaks of her time in the womb, and I believe her recollections. I am a woman, and it matters: I see birth as a beautiful and natural process that both mom and baby were created to participate in, and I strive to minimize the medicalization surrounding this journey. I am a maternal child nurse, and it matters: I want families to be empowered in the birthing process and I encourage writing birth plans that focus on intentions and feelings and creating pictures of ideal birth scenarios as a perfect place to start. I am a teacher of early child development, and it matters: When I consider development, “zero” begins at conception, not birth. Growth happens from the very beginning and so does our exploration. We marvel at the wonders in the womb and the incredible talents of the developing baby. I am a prenatal yoga instructor, and it matters: When a mom is happy and at peace, so too is her baby. As we practice grounding and balancing physical postures, we also bring forth an emotional grounding and balancing as well. I am a lactation consultant, and it matters: Promoting undisturbed birth and honoring the sacred hour after birth is vital. The newborn is capable of crawling to mama’s breast and initiating a pattern of connection that has lifelong implications. I cherish making this happen. I am a therapist, and it matters: Research tells me the physical, emotional, cognitive, and spiritual destiny of babies relies significantly on the quality of the interactions with their mothers from the beginning of life. Attachment is essential and I have an incredible responsibility and honor to educate, nurture, and support this newly formed dyad from conception, through birth, and beyond. Perhaps you do too.

Ultimately if you are someone who recognizes that what happens to us when we are small impacts who we become when we are big, then this may matter to you as well. The goal then becomes for the mother and those around her to create an environment that allows for the blossoming of this little bud of humanity. We become the dedicated nurturers of this period before birth and immediately after birth. This, I believe, is what prenatal and perinatal psychology is about and why it matters.

Additional Resources for Prenatal and Perinatal Psychology

Book Review: Parenting for Peace: Raising the Next Generation of Peacemeakers
By Pam Caron MSN, LSW, IBCLC, PPNE

Parenting for PeaceI am a fan of acrostic poems. Over two decades ago I wrote such a poem regarding attachment. This poem became the back of a bookmark that was shared with the Maine Association of Infant Mental Health and is still used today. Though time has passed, the words, that were put to paper then, still hold true.

I began a special journey a decade ago, one that I continue to cherish. Exploring the field of prenatal and perinatal psychology spoke to my heart as did infant mental health. Honoring the relationship between parent and baby from the very beginning, from conception, has always made such perfect sense to me and this field had allowed me to do just that. Seeing prenates as sentient beings with incredible capabilities gives opportunity for parents to connect with their little ones, truly before they even conceive. Viewing the role of parenting in this light prompts me to see it as a blessing.

Marcey Axeness, author of Parenting for Peace, chooses to discuss principles of parenting using pneumonic assistance (as she describes it). I loved this book, not only because I love acrostic poems but because it is beautifully written. I appreciate her rationale for using principles “unlike rigid rules, principles encompass individual differences, where rules are static, principles give room to breathe, to discover, to inhabit, where rules constrain principles offer an endless palette of application” (p. 3).

I also love that this author considers the parenting journey from preconception and takes the reader through pregnancy, birth, the first seven years, and the next seven years. Her principles spell the word PARENTS; Presence, Awareness, Rhythm, Example, Nurturance, Trust, and Simplicity (p. 4). They are taken from a parent’s perspective and visited in each chapter. Axeness applies these principles and gives parents tools to practice along the way. The notion of visiting the same principles throughout her book with different age groups, is brilliant. Nuggets of information and things to do are threaded beautifully from one age to the next. This predictability is reassuring to the reader/parent as I’m sure it is reassuring to the child. In doing with us (cultivating peace) as she would have parents do with children is a beautiful way of paralleling the process. For instance, she explains,

Our children’s healthy development calls us to pursue our own development and presence practice is a rich way to do so. We can attune ourselves more deeply to what we are engaged in: gestures can become prayers, thoughts can become meditations, comments can become blessings” (p. 287).

I have read this book twice now and I keep revisiting different pieces. It truly is a work meant to be savored, I wish I was embarking on my parenting journey now and had this remarkable guide by my side.

 

IN TOILET TRAINING, A PREMIUM ON PATIENCE

NEW YORK TIMES COLUMN: FAMILIES TODAY:
IN TOILET TRAINING, A PREMIUM ON PATIENCE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Problems in toilet training nearly always arise because of an imbalance in the parent-child relationship. Children usually show signs of readiness between age 2 and 3. When parents can’t wait until then, and impose toilet training as their idea, the child will feel the pressure as an invasion.

All parents, of course, want their child to grow up and cross this threshold. Preschools often insist that a child be “trained” before he comes to school.

Other parents may offer advice and condescending comfort when their children are already trained. Grandparents may imply that toilet training is a measure of effective parenting and of a child’s overall competence. Some families may see the child’s entire second year as preparation for success in this area.

A toddler for whom independence is a passionate issue anyway will have his own struggles. He may stand in front of a potty, screaming with indecision. Or, he may crawl into a corner to hide as he performs a bowel movement, watching his parents out of the corner of his eye.

It’s a rare parent who won’t feel that such a child needs help to get his priorities straight.

When a parent steps in to sort out the guilt and confusion, the child’s yearning for autonomy becomes a power struggle between them. Then the scene is set for failure.

In bedwetting, as in many of the problems encountered with toilet training, a child’s need to become independent at his own speed is at stake. When a child’s need for control is neglected, he may see himself as a failure: immature, guilty and hopeless. The effect of this damaged self-image on his future will be greater than the symptoms themselves.

Given that toilet training is a developmental process that the child will ultimately master at his own speed, why do parents feel they must control it? My experience has led me to the conclusion that it’s very hard for parents to be objective about toilet training.

The child becomes a pawn – to be “trained.” It may take us another generation before we can see toilet training as the child’s own learning process – to be achieved by him in accord with the maturation of his own bladder and central nervous system.

When Problems Exist:

A.) Discuss the problem openly with your child. Apologize and admit you’ve been too involved.

B.) Remember your own struggles, and your eventual successes, so that you can let the child see that there is hope ahead.

C.) State clearly that toilet training is up to the child. “We’ll stay out of it. You’re just great, and you’ll do it when you’re ready.”

D.) Let the child know that many children are late in gaining control, for good reasons. Then, let him alone. Don’t mention it again.

E.) Keep the child in diapers or protective clothing, not as a punishment, but to take away the fuss and anxiety.

F.) Don’t have a child under age 5 tested unless the pediatrician sees signs of a physical problem. A urinalysis can be done harmlessly, but invasive tests and procedures – enemas, catheters, X-rays and so on – should be reserved for children who clearly need them.

G.) Make clear to the child that when he achieves control, it will be his own success and not yours.

(This article is adapted from “Touchpoints: Birth to Three,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Prior to Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

THE PACIFIER PROBLEM

NEW YORK TIMES COLUMN: FAMILIES TODAY:
THE PACIFIER PROBLEM
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My almost 4-year-old refuses to give up her pacifier and I am concerned about her teeth. Since her sister was born 10 months ago, she seems to be using it much more. Do you recommend we get rid of it cold-turkey as some pediatricians have recommended? Will the pacifier cause long-term damage to her palate and/or teeth?

A. Some studies associate pacifier use with orthodontic problems, especially as children get older. Such findings don’t mean that any child who uses a pacifier will need orthodontic treatment, but treatment appears to be necessary more often with pacifier use.

We know of no studies that link cold-turkey termination of the pacifier with significant psychological problems later. Concerns arise from the notion that interfering with a young child’s need for oral soothing may lead to overeating and other problems.

The practical challenge in stopping pacifier use is that there’s no sure way to do it. Often, when a parent tries, the child just clings harder to the pacifier.

You mention that a baby sister came along 10 months ago.

Children often suck their thumbs, fingers or pacifiers to reduce stress. They’re bound to feel more anxious when the whole family is.

When a new baby is brought home, parents are understandably preoccupied, worn out and less available to the older child. She may wonder why her parents had to go to all that trouble for this crying, demanding, inert little creature who won’t be much fun for a long time. The question may vaguely cross her mind, “Is the new baby here because I wasn’t enough to satisfy them?”

As she tries to adapt to her new role of older sister, and learns to wait until her parents have time for her, she’s likely to feel upset. As the baby grows, there will be new challenges for the older child – when the baby says her first words, or begins to crawl or walk and get into all of the older child’s toys. A thumb, finger or pacifier can be a welcome refuge.

It may help to offer this child other strategies for soothing herself – a “lovey” such as a soft blanket to stroke and cuddle, or a stuffed animal to squeeze tight. There’s no need for lots of dolls and animals – too many will just distract her. Instead, she’ll need to become attached to a single special one. Hand it to her when she’s distressed, tired or has scraped an elbow or knee, and tell her to hug it hard to help her feel better.

After a new baby is born, the older child feels the need to be a baby, too. The baby just seems to suck up all the time and get all the parents’ attention – so why wouldn’t an older child try the same thing?

Parents often think they can help the older child adjust by praising her for being such a “good big sister.” But the older child also needs reassurance that she can be a baby again when she needs to. The more her need to regress is openly expressed and accepted, the less she’s likely to do so.

Family life is especially busy with a 10-month-old, but the older child might need some extra time to cuddle with you. Don’t say a word about it, and don’t make it an issue, but try to give her some gentle one-on-one time when she doesn’t have her pacifier. Thus she’ll learn – through actions rather than words – that there are even more rewarding places for her to find the comfort she seeks.


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Prior to Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.