Womb: The First Classroom

Some of us may mistakenly believe that the process of education begins only when a child goes to school. This equivalence of the commencement of learning with formal education is unfounded - school is certainly imbued with learning, yet learning precedes the advent of the big yellow school bus. Learning begins much earlier, with our environment and community informing our values, ideas, and beliefs. 

A growing body of evidence emphasizes, in no uncertain terms, the formative quality of our time in the womb. Even before our personhood is solidified, we evolve a nascent sentience. From prosody to polygons, we begin our journey of learning warmly ensconced in our mother’s womb. Yet, a core formative period of infant brain development may be overlooked in this bustle - that of nascent sentience, even before our personhood is solidified. 

Each cell of the embryo is already engaged in processes of formation and differentiation which affect not just the body but the psyche as well. Advances in epigenetic study have also suggested that prenatal stress can cause fundamental changes in cell structure and functioning, thus altering personality and physiology. (Menzam-Sills, 2023) Carl Jung, a noted psychiatrist has, in his theory of personality, expounded on how at birth, the infant isn't a tabula rasa - rather, it already possesses the imprints of its ancestral past through a pre-existing storehouse of transpersonal remnants and archetypes. Hence, we are born with primordial images that have potentially pre-trained our cells to coalesce into certain cognitive patterns.

Cultures across the world have recognized the significance of an expecting mother’s well-being. Contemporary prenatal care is often restricted to regular visits to an OB/GYN, ensuring good nutrition, and prenatal education classes. With higher female labour force participation, the availability of time and resources to ensure holistic prenatal care is further restricted. Countries across continents - Africa, Asia and Europe- have prenatal care practices for a mother’s emotional, mental, and physiological well-being, that are at their core,  geared towards creating an enriching ecosystem for an unborn child. These practices influence the development of the fetus in vitro and have repercussions on emotions, cognition, and learning well into adulthood. Maternal behaviours closely correspond to fetal responses that in turn inform personality development and behavioral traits in later years. 

Illustrative examples from India, South Korea, and Africa give one a peer into how local socio-cultural realities, belief systems, and folklore converge to create a system of prenatal care practices. The Garbh Sanskar and Garbhopanishad in India often guide prenatal care praxis in India; the Garbhopanishad, translated to "Esoteric Doctrine of the Embryo,"  is a manual, which for its part, considers the fetus as an undefined intellectual substance and goes on to elaborate on physiological and mental factors to be considered in the growth and development of this human life structure. (Gadgil,2022) Garbha Sanskar is a holistic set of traditional practices for the physiological and psychological well-being of an expecting mother and her child. It translates to “education in the womb”. Listening to classical music, meditation, yoga, and eating a wholesome Satvik diet that is shad rasatmakahar i.e., comprising all the six tastes are some practices in this system. The latter, for example, helps to keep all the tridoshas (vata, pitta, kapha) and the pancha mahabhutas in balance (“Garbh Sanskar in Pregnancy: Benefits and Practices”). Creative exercises as well as intellectual pursuits are also recommended to stimulate the baby’s brain development. 

The practice of Taegyo or Korean traditional prenatal education has many similarities with the tenets of Garbh Sanskar. It is based on the idea that the growing fetus is a developing personality that requires comprehensive biological and psychological protection of its environment. Sajudang Lee's 'Taegyo singi', a seminal publication on the practice was published 200 years ago on the compelling premise that “the effects of ten years of education after birth are less than those of the ten months during pregnancy”. Notably, Teagyo emphasizes maternal-fetal attachment as a positive influence on the mother’s adaptation to her pregnancy, a factor in integrating the identities of mother and child. It stresses the importance of intentional and active interaction of the parents with the fetus to increase affiliation and promote the transmission of affection to the unborn baby.  It is observed that this practice helps expecting mothers become more self-sufficient in the pregnancy, reduce feelings of stress and anxiety, and develop more sanguine maternal feelings towards the process of pregnancy and childbirth. (Chang et al., 2004)

Across African countries, communities establish a range of prenatal guidelines. Prime among them are guidelines about food, abstinence, and local spiritual modalities. Prohibited foods range from okra in Zambia, animal organs and eggs for the Kalenjin in Kenya and snails in Nigeria. In some African cultures, expecting mothers are administered mbita, a boiled herb concoction consumed by expecting mothers to protect the unborn baby from any sorcery. (Musie et al., 2022)

These are merely some illustrative examples of prenatal education and care that align with Oriental and indigenous philosophy. Western prenatal care and education practices have also evolved in their bespoke manner, reflecting the growing awareness and evolving socio-cultural requirements. 

Prenatal practices such as these strengthen the mother-child bond, in addition to raising the child’s emotional sensitivity, linguistic receptivity, and physical health after birth. Of the beneficial impacts such proactive measures can have on the unborn child, a marked and measurable impact is observed in terms of learning outcomes, particularly language learning. As the second trimester begins, the baby begins to make sense of auditory input in consonance with the mother’s moods and actions (Gervain, 2024). Upon hearing the mother’s voice, the baby’s heartbeats begin to decelerate, an indication of its soothing nature. Music and other sounds also reach the fetus, although all sounds are attenuated by the amniotic barrier. While most music is beneficial, babies even get attuned to sounds that startle, with heart decelerations gradually increasing upon familiarity. Through this process of auditory input neural pathways and mental schema form, thus laying the foundation for later growth and learning. 

A parallel process in this regard, and one that is instructive in understanding how prenatal experiences shape postnatal life,  pertains to the flavour preferences of unborn children. The food and drink that an expecting mother consumes penetrates the amniotic sac and fluid, altering the sensory perceptions of the fetus. After birth, neonates and infants being weaned show clear preferences for the foods commonly ingested during pregnancy courtesy of their sensory familiarity with the same (Julie, 2001). Other kinds of beverages and foods might not be so innocuous - alcohol consumption can have a malignant impact on the growing child, more so during the embryonic stage than at the fetal stage. Fetal alcohol syndrome (FAS) represents a spectrum of disorders that can impede functioning in the later stages of life,  including neuro-developmental and behavioural disorders, birth defects, delayed development, learning difficulties, psychiatric ailments and others. ((Understanding Fetal Alcohol Spectrum Disorders | National Institute on Alcohol Abuse and Alcoholism (NIAAA), n.d.)

In this broader context, it has been found that fetuses can detect and discriminate between the sensory inputs associated with the mother’s native language and any other languages that are spoken to/around it. By the eighth month, the baby develops the ability to receive and interpret sights and sounds as its cognition develops - visual, auditory, and speech (Broca’’s area) cortices are all in their nascent stages. 

Postnatal responses such as the infant’s cries and their reactions to speech mirror the patterns they have been exposed to in the womb. This is because the unborn baby picks up language components such as intonation, pauses, phonetics, melody, and rhythm while in the womb. This forms a baseline for the development of grammar and lexicon in later life, with children exposed to language in the womb forming these linguistic structures earlier and more comprehensively compared to those without such input (Gervain, 2024). Thus, mothers who talk to their bump are much more likely to not only bond with their baby more and establish a stronger emotional connection but also give their baby a headstart in cognitive development! In this process, infants also begin to receive and understand cues on word order and sequential learning, a key skill whose utility extends beyond language learning. 

The mother’s environment is of manifest importance in creating a nurturing environment for the growing fetus. The expecting mothers must be surrounded by community and healthy habits that promote peace and contentment. The more the mother resides in familiar, comfortable surroundings with social support and readily accessible prenatal care, the more likely to have healthy, happy babies with normal average birth weight. Mothers with a conflict-ridden familial or social scenario, lack of cultural moorings or synergies, inadequate nutrition, and negative emotions regarding the pregnancy can have a detrimental effect on the child’s cognitive and affective development, in addition to precipitating maladaptive behaviour in the long term. 

While the positive impacts are manifold, there are equally detrimental impacts on a child’s learning trajectory, should the mother’s environment be, in any way, adverse. Such a risk is not limited to extraneous factors such as the consumption of unhealthy food, alcohol, smoking, or constant exposure to pollution. The mother’s state of mind and mental health are equal, if not of paramount importance. ( Herzog-Petropaki et al., 2022)

Prenatal stress during critical periods of fetal brain development can significantly harm the hippocampus and as a consequence, lead to neurobiological and behavioral defects. The heightened corticosterone responses in the fetus when exposed to stress, impede learning-induced neurogenesis i.e., the formation and growth of new neurons in response to learning stimuli. This retardation of neurogenesis in turn harms learning ability and creates memory deficits later in life. It may also lead to maladaptive stress coping behaviours e.g./, autism and schizophrenia (Lemaire, 2000). Chronic/ acute stress can also affect the spatial strategies that originate in the hippocampus. Spatial strategies involve the acquisition and storage of information and its retrieval for use in novel situations. The flexibility with which spatial strategies can be generated for a new situation is thus compromised, resulting in more simple and rigid response strategies that are not as effective (Schwabe, 2024). Before you even take your first breath, the foundations of your ability to follow directions could have already been laid! 

Considering the magnitude of the impact of prenatal learning and its composition, this is an aspect of prenatal health and well-being that requires greater research and attention. Concrete scientific evidence that is coherent and comprehensive is lacking in this regard. Rigorous research is essential to evolve methods for optimal fetal development in ways that are socially relevant, culturally resonant, and medically efficacious.

Studying the extent of the impact of the prenatal formative period remains ripe for further exploration and study. The studies at present are relatively few comprising smaller cohorts of participants. Self-selection bias cannot be ruled out, and the samples may not be representative enough to generalize to a wider population. The paucity of studies therefore does not substantiate the claims of prenatal learning sufficiently at the population scale. It is therefore imperative that medically-validated studies across a wider cross-section of different populations be conducted to ensure that the findings are valid and verified. Fetal medicine continues to break boundaries in terms of its cutting-edge research to improve pregnancy outcomes and mitigate risks and loss. These advances include the establishment of repositories of bio-disorders and the development of non-invasive placental screening, to address matters such as preeclampsia, gestational diabetes, maternal hemodynamics etc. amongst others. Yet, much scope remains to probe the neurological and psychological factors of prenatal growth, beyond the present psychological emphasis. In addition, in spite of these advances in maternal-fetal medicine, significant ethical issues such as the adversarial value investment of medical professionals vis-a-vis the expecting mother. (Paintin, 2002)

It is bewildering to think of how many character traits might have resulted from our time in the womb. The possibilities are endless- so the next time you wonder why you’re abnormally good at English Literature, ask your mother if she read you Dickens or Shakespeare! 

Endowed with the capacity to learn, express, and effect change from the moment we are conceived, we are tasked with making our way through our second womb- that of Mother Nature. It is our individual and collective responsibility to nurture our intrinsic potential to optimize our stay here on earth and amplify our positive imprint on our people and our planet. 

Dr H.S. Nagaraja 

Manaswini Vijayakumar 

(With inputs from Dr. Venkata Krishna Bayineni) 

Citations 

1. Menzam-Sills, C. (2023). Embryo as Person: As in the Womb, So in the World. 1–9. https://doi.org/10.24946/ijpls/202312305

2. “Garbh Sanskar in Pregnancy: Benefits and Practices.” iMumz, https://www.imumz.com/post/garbh-sanskar-in-pregnancy-benefits-and-practices. Accessed 14 June 2024.

3. Gadgil, Neha D. “Garbhopanishad an Optimal Doctrine over the Embryo: A Literature Research.” www.ayurvedjournal.com, 2022, DOI: 10.31254/jahm.2022.8206.

4. Herzog-Petropaki, Nathalie, Christina Derksen, and Sonia Lippke. 2022. "Health Behaviors and Behavior Change during Pregnancy: Theory-Based Investigation of Predictors and Interrelations" Sexes 3, no. 3: 351-366. https://doi.org/10.3390/sexes3030027

5. Panel, I. E. (2023b, August 4). Garbh Sanskar in Pregnancy: Benefits and Practices. https://www.imumz.com/post/garbh-sanskar-in-pregnancy-benefits-and-practices

6. Chang, S., Park, S., & Chung, C. (2004). Effect of taegyo-focused prenatal education on maternal-fetal attachment and self-efficacy related to childbirth. Journal of Korean Academy of Nursing, 34(8), 1409. https://doi.org/10.4040/jkan.2004.34.8.1409

7. Musie, M. R., Anokwuru, R. A., Ngunyulu, R. N., & Lukhele, S. (2022). African indigenous beliefs and practices during pregnancy, birth and after birth (pp. 85–106). https://doi.org/10.4102/aosis.2022.bk296.06

8. Gervain, Judit. “The role of prenatal experience in language development.” Current Opinion in Behavioral Sciences, no. 21, 67, p. 62. ScienceDirect, https://www.sciencedirect.com/science/article/abs/pii/S2352154617301365?via%3Dihub. Accessed 24 May 2024.

9. Julie, Mennella A. “Prenatal and Postnatal Flavor Learning by Human Infants.” Pediatrics, vol. 107, no. 6, 2001, pp. 1-6. https://sci-hub.st/10.1542/peds.107.6.e88. Accessed 26 05 2001.

10. Understanding Fetal Alcohol Spectrum Disorders | National Institute on Alcohol Abuse and Alcoholism (NIAAA). (n.d.). https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-fetal-alcohol-spectrum-disorders

11. Gervain, Judit. “The role of prenatal experience in language development.” Current Opinion in Behavioral Sciences, no. 21, 67, p. 62. ScienceDirect, https://www.sciencedirect.com/science/article/abs/pii/S2352154617301365?via%3Dihub. Accessed 24 May 2024.

12. Lemaire, V. “Prenatal stress produces learning deficits associated with an inhibition of neurogenesis in the hippocampus.” Proceedings of the National Academy of Sciences of the United States of America, vol. 92, no. 20, 2000, pp. 11032-11037. https://doi.org/10.1073/pnas.97.20.11032. Accessed 29 May 2024.

13. Schwabe, Lars. “Prenatal Stress Changes Learning Strategies in Adulthood.” Hippocampus, 2012. Hippocampus, https://sci-hub.st/10.1002/hipo.22034. Accessed 29 May 2024.

14. Paintin, D. (2002). Ethical Issues in Maternal -- Fetal Medicine. Journal of the Royal Society of Medicine, 95(7), 371–372. https://doi.org/10.1258/jrsm.95.7.371

References 

1. Childs, M. R. (1998). Prenatal Language Learning. Journal of Prenatal and Perinatal Psychology and Health, 13(2), 99. https://www.questia.com/library/journal/1P3-1380835861/prenatal-language-learning

2. Chang, S., Park, S., & Chung, C. (2004). Effect of taegyo-focused prenatal education on maternal-fetal attachment and self-efficacy related to childbirth. Journal of Korean Academy of Nursing, 34(8), 1409. https://doi.org/10.4040/jkan.2004.34.8.1409 

3. Panel, I. E. (2023b, August 4). Garbh Sanskar in Pregnancy: Benefits and Practices. https://www.imumz.com/post/garbh-sanskar-in-pregnancy-benefits-and-practices

4. Mueller, B. R., & Bale, T. L. (2007). Early prenatal stress impact on coping strategies and learning performance is sex dependent. Physiology & Behavior, 91(1), 55–65. https://doi.org/10.1016/j.physbeh.2007.01.017

5. Kapoor, A., Kostaki, A., Janus, C., & Matthews, S. (2009). The effects of prenatal stress on learning in adult offspring is dependent on the timing of the stressor. Behavioural Brain Research, 197(1), 144–149. https://doi.org/10.1016/j.bbr.2008.08.018

6. (Understanding Fetal Alcohol Spectrum Disorders | National Institute on Alcohol Abuse and Alcoholism (NIAAA), n.d.)

7. Tierney, A. L., & Nelson, C. A. (2009). Brain Development and the Role of Experience in the Early Years. PubMed. https://pubmed.ncbi.nlm.nih.gov/23894221