Article for Pathways
Three Hearts: The Neurobiology of Love in the Childbearing Year
Right from the beginning, from conception onward we are in training to develop and refine our capacity to love, through learning to co regulate our autonomic nervous system, and eventually to do a balance of self regulation and co regulation. Our preconception, prenatal and birth and very early history affect our level of anxiety and our basic response to connection. Mothering (not gender specific) creates an ongoing oxytocin response that lets us know we are safe and lovable in human connection. This oxytocin response helps us grow parts of our hearts and brains that produce and receive oxytocin, ‘the love hormone’, which makes love one of the best feelings possible.
We may ask ourselves how does this happen anyway? What does love have to do with it? The basic premise is that there is no such being as a baby - there is only a mother/baby (Winnicott), in a particular social and emotional environment. And we know from the science of epigenetics this begins long before conception even, especially the 110 days before conception. The egg in the mother’s womb begins maturing and preparing to ovulate, and is selecting genes in the second meiosis. At this time follicular cells surrounding the egg are a whole communication structure with the mother and her environment. Already, this egg is recording what the mother is experiencing, and through the mother, what the family is experiencing. Once the egg is fertilized this process continues and the embryo/fetus/baby builds her body, brain, heart and nervous system to suit this environment. This social and emotional environment, through these epigenetic changes, affects the health of this being decades later. We can think of the unborn baby as the inner body, the mother as the outer body, and the partner and extended family as the social body – a layered field that the baby is growing in.
Pregnant couples create this resonant field together that holds all three hearts. The embryo’s cardiogenic cells are present from the first vertical structure created by the embryo. If the mother is a single mother then the significant others in her life are creating this field with her. Our focus is this system of connection, where individual assets are joined into mutual assets, where the sum is greater than the parts, This is the environment, the field, that the growing fetus is held in. Each partner’s well being rests in the devotion to the well being of the other. If they are able to provide safety, comfort and security, especially in times of distress, the couple will develop a system of mutual regulation as well as self regulation. This is the optimal support for the developing baby’s brain and nervous system. From preconception onward the experience in the womb shapes the expression of health, personality, emotional temperament, and the power for higher thought. These unborn babies are listening to us about what this world is like, long before we are listening to them.
By 24 weeks gestation the fetus responses with precise movements to each sound in the mother’s speech, at the exact nanosecond, if she is awake. We can hardly imagine the level of attunement. Even in the first trimester the baby is hearing the mother’s voice through the vibration in her forming bones, and eventually develops hearing within her ears. These unborn babies react to arguing and fighting, with extreme startle and stress responses. And of course, if that happens very occasionally this is not going to negatively affect brain development, but if it is frequent the growing fetus is building anxiety and a highly reactive acute stress response into the hypothalamus pituitary adrenal axis. Of course, if the couple is experiencing, mostly, a loving, supportive relationship this is creating a relaxed, calm baby. Unborn babies ask that their parents clear up tensions in their relationship and develop a style of “our job is to take care of each other and go towards the other if she/he is distressed”. Parents growing empathy for each other is one of the main skills necessary to be wonderful parents. We don't need to be perfect – if we get it right with our partner or our child from an emotional perspective about 2 out of 3 times, we are doing ‘good enough’ to grow love and safety. The heart of the matter of being human IS seeking and maintaining contact with significant others, and fearing isolation and loss. Even as adults we need those safe havens.
Dr. Gerhard Schroth (2009, 2015), at the University of Hamberg, Germany, researched working with mothers around their own pregnancy and birth, over a period of twenty weeks prenatally, and discovered that if the mother came to resolution with any trauma from her own birth and spent time in quiet stillness each day she would begin to develop a strong sense of what her unborn baby wants to communicate to her. This is listening to the baby, who is able to directly communicate by the second half of pregnancy. Mothers could even ask specific questions of the baby. One personal experience I know is a mother who was listening to her baby and the baby was specifically telling her “We need an ultrasound”. This mother had not had, and was not planning to have any ultrasounds during the pregnancy and was expecting to have a natural home birth. After several weeks of the baby communicating this to her she finally decided she needed to do it. She discovered that the baby had a very short umbilical cord, only about 7 inches long, and both she and her baby would have been in grave danger if she had gone into labor. As she lived 45 minutes from hospital they would not have been safe, due to the cord tearing during the labor. She was able to have a necessary Caesarean Section birth, with no separation of her and her son, skin to skin and nursing within twenty minutes. Another set of experiences I have personal knowledge of is three mothers who had a blood test that was positive for Down’s Syndrome. This blood test has many false positives and the medical recommendation is to follow up with an Amniocentesis, which has a level of risk of triggering premature labor, and therefore pregnancy loss. It is also an incredibly emotional and invasive procedure. These mothers, through the baby communicating with them that they were healthy, and did not have Downs’ Syndrome, were able to relax, believe their babies, not worry, and sure enough, all delivered healthy, normal babies with no genetic abnormalities. Schroth also showed that mothers who have this delightful communication and connection with their babies in utero have easier births and breastfeeding and calmer, happier babies than when this is missing prenatally.
Mothers can learn to differentiate their own feelings from their baby, for example, “I am angry with your papa, I am not angry with you, sweet baby in my tummy, and both your papa and I love you.” This consciousness helps both the parent and the unborn baby,or born baby and child, not fall into a relationship where the child takes on the responsibility for the parent’s feelings.
Safety, security and a sense of being lovable are established in our limbic system of our brain in the last trimester of pregnancy and the first three months of life outside the womb. This implicit knowing is somatic, and lasts a lifetime. This is the source of our approach and avoidance impulses, and tolerances with our primary attachment people like our parents and later our partners Our brain continues to grow and develop our emotional and regulating capacity from three to nine months, when, with positive parenting, we develop our ability to hold attention and concentration, know who and what we like and receive comfort and safety in the known, hence a positive development of separation anxiety. As a baby learns to crawl away and explore, she learns that she can trust her parent to be there when she turns back to show excitement, or if she needs to be comforted. By eighteen months the baby has grown the neural pathways up to the prefrontal cortex, the emotional CEO of the brain, and can begin to modulate her responses to the environment, read faces and social cues accurately. By this time, the template for our relationship with ourselves, others, our capacity to concentrate and learn, our ability to and style of coping with stress and our neural pathways to our organs are established. This will influence our immune system, our cardiovascular, and metabolic health decades later. It is important to note that our brains are plastic and can change, if we have expanded, corrective emotional experiences later on.
Emotion is the prime change place and supporting couples to restructure the emotional dynamics will help optimize baby’s brain development. It is not insight that brings change. Having a new baby can motivate and help couples learn to focus on, validate and accept the other’s experience and be with it, with support. The couple together then can structure key healing experiences, in this new parenthood period - IF they have enough support. Sex can continue to help forge and strengthen the bond, and in orgasm oxytocin is released, and the good feeling is linked with that particular person. Skin to skin with baby and each other after the birth releases this same oxytocin.
As professionals, we can help the couple expand their awareness of their experience and make new meaning of it. Often unmetabolized, unprocessed events of each parents own prenatal, birth and childhood experiences will arise to be worked with. We can start by mapping out the cycles where they ‘miss’ each other, and name the patterns. The couple can build positive appreciation by doing something daily that their partner would like. And they can spend time daily talking to and interacting with their unborn or born baby together. It is important that they begin naming their own emotions out loud, increasing awareness of each other, and themselves. This is crucial for positive, self reflective parenting. This also helps pregnant couples prepare for labor, as they are practicing hearing each other. The partner is hearing the pregnant mom, and practicing what actually feels supportive to her, and she is doing the same. In labor, this resonant field of their heart together helps the labor go more smoothly, even if the birth plan changes.
How much stress and lack of love and safety is detrimental to the unborn and infant? Small amounts of moderate stress is unavoidable in life, and is helpful to the developing baby. Stress becomes toxic to the child if it is a truly acute overwhelming traumatic experience, like the death of the partner, an experience like 9/11, or a hurricane. Also, if a high level of stress is chronic and the mother feels helpless to change her situation, hopeless in her life, this negatively affects the baby. Toxic stress creates high levels of cortisol in the baby’s growing body and brain, which reduces the actual number of cells, nerves and blood vessels that are created in the organs. The baby will be more irritable, less consolable, and even at age six will show signs of inhibition of motor skills and ability to concentrate.
When Mom has a natural childbirth without medication or other interventions, during labor, oxytocin levels rise gradually, reaching a peak just around the time of the actual birth, and they stay incredibly high for at least four days. The baby also produces increasing amounts of oxytocin during labor and peaks just after birth. The skin to skin, eye contact, and first suckling reinforce and support nursing, secure attachment and help maintain high oxytocin levels – the deep falling in love period.
High levels of beta-endorphins in mom and baby at birth also enhance attachment and mutual pleasure, and the peak of prolactin, the hormone of tender mothering, ensures feeling of love and pleasure. Fathers also show an increase in oxytocin and prolactin if they care for their babies. Just 15 minutes alone with their baby for dads, in the first week, means they will spend much more time with this little one over the first two years. Prolactin and oxytocin are the main hormones in breast milk, and both are important for optimal brain and neuroendocrine development in the baby. Epidurals, analgesics, induction drugs all alter the hormonal picture during labor and delivery, and the emotional connections present at a natural delivery. Skin to skin and physical handling influence the concentrations of cortisol receptors, allowing the infant to produce less cortisol and return to baseline faster. This helps with stress management in energy efficient ways, and that contributes to long term health.
Back to what the hearts have to do with it. Somewhere between 35-50% of the heart cells are neurons, which function as a brain structure, and connect with the prefrontal cortex through the amygdala and thalamus. The heart is a highly complex, information processing center which is in direct communicate with our limbic system. The mother’s heart, when her baby is within the three feet zone of her heart, is regulating the baby’s physiology: temperature, breathing, glucose regulation, which is why skin to skin is so important. A personal example of this is when a young couple I worked with had twin baby girls. Although she was 38 weeks and a good size, one twin was having problems with glucose regulation and was taken to the NICU. Her sister was far away, with her mother. 24 hours passed, and the sick twin was not recovering, so this young father, age 23, went to the NICU, picked up his daughter, saying ‘she belongs with her twin and her mother. Then nurses were desperate to stop him from taking her out of the NICU to the ward, but he plowed through and put her skin to skin with sister and mother. Within one hour her glucose regulation was normal and they all went home the next morning.
If the mom has a coherent heart rate variability, reflecting a balanced autonomic nervous system, the baby will have more sustained visual attention, less temperament difficulties, learn to be more effective in self soothing, show more exploration, creativity, and learn socially appropriate behaviors earlier. When a baby is growing in this resonate heart field, and the dad also is in a coherent heart rate variability the eye contact between mom and dad, the parents and baby stimulate dopamine and opioids in the pleasure and reward centers of the brain, which also increases the availability of fuel to the brain. It also increases the density and strength of the connections from the autonomic nervous system to the right prefrontal cortex – this helps the infant integrate and stay in a moderate state of attention and arousal. Good news for mothers too. Motherhood improves learning, memory, and increases the connections within mom’s brain, literally reshaping the limbic system, if mom has enough support and love. This early time is the perfect opportunity for early intervention to support mothers.
Parents can realize emotions, and the heart field they hold with each other, is central to their baby’s ability to learn and to eventually self regulate. The parent’s ability to detect, empathize with, name and help with feelings predicts future happiness in their children, and in partnerships. Each person in the triad is really worth it, worth the effort involved to learn to name emotions, work with them, and create a healthy emotional dynamic between the couple. Then their baby can be held within a safe, secure, loving container and develop optimally.
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