Professor Vivette Glover is an international expert on the effect of the mother’s emotional state in pregnancy on the development of the fetus and her child. She is Professor of Perinatal Psychobiology at Imperial College London. She originally studied biochemistry at Oxford and did her PhD at University College London. In 1975 she came to work at Queen Charlotte’s, and developed an interest in biological psychiatry in relation to pregnancy and the postnatal period. In more recent years she has focused especially on the effect of the mother’s mood on fetal development. She has over 400 publications, and is invited to speak, including giving the keynote address, at meetings around the world. She is a special advisor to the Department of Health on the Family Nurse Partnership, which supports teenage mothers, and on antenatal education.
The Importance of the Time in the Womb
Infant mental health is very important because it lays the basis for child and even adult mental health. And infant mental health starts before the baby is born. Our vulnerability or resilience for mental health starts in the womb.
The brain starts to develop early in gestation, and continues to be changed throughout life. But its “plasticity” or ability to change in response to the environment, is greatest at the beginning. This response to the environment in the womb is called “fetal programming”. The fetal brain is under construction, and its neuronal pathways start to be formed in response to the biological environment it receives from the mother’s blood. Programming does not mean that the trajectory is set in stone and cannot be changed. We know that it can be changed later. Insensitive mothering, or an abusive environment can make things worse, and sensitive mothering after birth can improve outcomes.
We all know that alcohol or smoking during pregnancy can affect the development of the baby in the womb, including the brain. But the emotional state of the mother matters also. We now know that if the mother is stressed, anxious or depressed while she is pregnant this increases the risk of her child having a range of problems later. It can double the risk of her child having a mental disorder. Most children are not affected, and those that are can be affected in different ways, some having ADHD, others problems with learning, for example (1,2). This is in part because of the genetic make-up of each child, giving them specific vulnerabilities or resilience which interact with the environment in the womb. We do not understand all the mechanisms that cause changes in the development of the fetal brain in response to the mother’s emotional state, but exposure to increased levels of the stress hormone cortisol is probably part of the story. Epigenetic changes in the fetal brain are important too.
All this means that if we want to improve infant mental health we have to improve the mental health of their mothers, starting in pregnancy. We do not want to make women feel guilty or make them worry about being worried. We need to give more support, and raise awareness among both health professionals and the general public. If we can reduce stress, anxiety and depression during pregnancy we will improve the mental health of the next generation.
Glover V (2014) Maternal depression, anxiety and stress during pregnancy & child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol 28(1) 25-35
Stein A, et al (2014) Effects of perinatal mental disorders on the foetus and child. Lancet. 384 1800-19