Prenatal Development and Parents’ Lived Experiences: How Early Events Shape Our Psychophysiology and Relationships by Ann Diamond Weinstein


Review by Anna Luise Kirkengen, MD, PhD

Perm J 2017;21:16-186 [Full Citation]
E-pub: 06/14/2017

16 186Why is this book, with its complex title linking life events to the fetus, the human psyche, physiology, and relationships—an important book for us physicians? The answer is straightforward, yet both demanding and advanced. This book provides a special body of new knowledge related to good medical care for pregnant women and babies-to-be. No other phase in the human life cycle offers us professionals a more fruitful realm for preventive measures with regard to future sickness in both parents and children. Here is the true arena for the best in family practice and the most cost-effective care. Dedicated physicians, especially primary care physicians, will see their opportunities in medical practice guided by this synthesis of multidisciplinary knowledge.  

What makes this knowledge special is its relevance to the becoming of a human being, a child, as it is embedded in the long history of the evolution of life and humankind, condensed in the specific history called phylogenesis, influenced by sociopolitical contexts and cultural practices, and informed by the personal lifetime experiences of its parents. The most recent contribution to this knowledge is provided by epigenetics, a discipline exploring how life experiences affect genetic functionality. This implies the recognition that personal experiences can affect whether a particular gene will express its genetic information or not. In simple words, genetic function can be either activated or blocked, depending on a particular person’s life experiences. What seems to activate potentially pathogenic genes most efficiently may be a person’s long-standing feeling of being powerless as a result of lifetime adversity.

Here we enter the everyday clinical scene: Our encounters with persons experiencing hardship, which is frequently more or less hidden because of secrecy, shame, or cultural conventions.  In the clinical situation of encountering and counseling pregnant women and their partners, epigenetics literally may be the key in terms of health risks for both the mother and the unborn child. The prevention of these risks is a significant medical task and challenge. To be in charge of the future health of a child-to-be demands more of a responsible physician than giving advice as to smoking, drinking, eating, and the like. The physician is called to familiarize him/herself with the life of this particular pregnant woman, and whether her life is affected by burdens that may affect her unborn child on the epigenetic level—and with potentially lifelong impact on health and functioning. Knowing this is crucial.

This is the core of the present book, which provides a three-layered complex of understanding. First, knowledge of the scientific facts about the phylogenetic process, the becoming of a human being, the literal unfolding of the evolutionary script of making human bodies adapted to the physical world. Next, the pregnant woman’s embodied, experienced knowing about her world, her sociocultural context and conditions, her familiarity with and confidence in her life-world, and her sense of safety and agency in terms of self-confidence and trust toward other people. Finally, the developing not-yet-born child’s knowing—by means of streams of information—about the “outer” world, predominantly provided by its mother’s psychophysiology.

The term psychophysiology denotes the translation of emotions into bodily, material processes involving the hormonal, cellular, and neural aspects of bodily being. We need to acknowledge that there are no body-less thoughts, perceptions, emotions, or sentiments. There are no “pure” psychic experiences. All experiences—all learning, and thereby knowing—are grounded in as well as expressed bodily. Current research in the rapidly evolving field of epigenetics is helping us recognize that the unborn “knows” not only about the physical world for which it is designed by evolution, but also the social world it is informed about in utero by its mother’s physiology. This kind of knowing is not cognitive in nature but hormonal, preparing the child for being born into sociality and relatedness. It is a major advance in our professional understanding of the earliest phenomena affecting human development, and ultimately health and social function. In short, this book is about new insights into the very earliest determinants of sickness we later see in the office, and how we, as medical professionals, might support a healthy development by early application of this new understanding.

How to Cite this Article

Kirkengen AL. Prenatal development and parents’ lived experiences: How early events shape our psychophysiology and relationships by Ann Diamond Weinstein. Perm J 2017;21:16-186. DOI:


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