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The Embodied Pregnancy

Presentation Review by Ruchi Puri, MD, MSc, FACOG

Pregnancy is a distinct experience that impacts us individually and collectively. Culturally, we wrongly moved away from relating to pregnancy as a sacred phase that is an initiation and rite of passage into parenthood. As a result, we are experiencing many problems that come from an absence of conscious conception and inadequate nourishment. Today 50% of pregnancies remain unintended , while 34% of the US population experience economic insecurity.  

Pregnancy is the closest experience we have to the divine mysteries of creating life and it carries a transformative and healing potential regardless of the fate of the pregnancy or the level of difficulty that arises during it. All pregnancies, including miscarriages, abortions, fetal losses, as well as live births carry this potential.

What is it?

An embodied pregnancy is an experience that is fully integrated and coherent across our physical, emotional, mental, and spiritual dimensions of being. Our inner world and outer world experience is the same. In other words, when I express my excitement of being pregnant, of becoming a mother, and that I feel ready, then this is internally true for me too. In my inner reality, I have integrated my fears, the uncertainties ahead are non-threatening, and I feel able to meet the challenges of a new chapter in my life.  All the circumstances arising in relation to the pregnancy are coherent in how I feel about it, the way I think about it and the choices I make around it. Ideally, the feelings and thoughts are positive and supportive to achieving my goals. We can make a conscious choice to have an integrated experience of a pregnancy that helps to enrich our lives or unconsciously choose to have an experience where the past repeats itself. Also known as waking up one day to realize we are repeating our parent’s mistakes. Collectively, this looks like the next generation being worse off than the last.

An embodied pregnancy allows us to stay grounded in the existential uncertainties of a state that brings us to the precipice of life or death.  As pregnant parents grow aware of their physical, emotional, mental, and spiritual internal experience, they can enter a process of integration that leads to attuned choices in relation to the pregnancy and responsible parenting.  Achieving coherence across these dimensions of our being both internally and our external expression results in an embodied pregnancy.

Why is it important?

The benefit is to grow our capacity to be fluidly present to what arises in the pregnancy state rather than fearing our circumstances. Some circumstances we can change, some we cannot. The point is to confront them responsibly, not reactively. We need clarity. Clarity is devoid of the fog of resistance, denial, avoidance, numbness, or disassociation that tends to be part of reactive decision making. Going through pregnancy in the fragmentation of these latter qualities appears as: fears of the unknown; effort to control that which is beyond control; or fixation with achieving a "perfect pregnancy" that conforms to some unrealistic ideal.  When pregnancy is experienced through this lens, it becomes stressful and leads to the very complications we are striving to avoid.

We carry our experiences within us starting from conception. There is more data from research in early developmental attachment, epigenetics, and neurobiology substantiating this. Experiences form us regardless of them being good/bad, easy/hard, comfortable/uncomfortable. Our experiences need a digestion process for us to incorporate them, for them to become part of our growth, development, and maturation.

Even if the experiences around pregnancy and childbirth go smoothly medically, there is still a lot to process.  A new child is a big responsibility. It comes with a lot of change to the way we live. That new life brings a whole world of potential fears and other feelings about childhood and parenting.  They can be carried over from our parents and our own childhood experiences if they have not been processed. There may be new hiccups along the way, less than ideal circumstances arising too. These experiences will need to be explored to see how they land in us and what we are making out of them. Are the lemons turning into lemonade or just burning acid in old wounds?

Inviting everybody involved in a pregnancy to proactively process how the pregnancy is living in them, inviting them to digest experiences in real time can help people integrate and move forward with the responsibilities of a new child in a healthier way, rather than postponing the feelings that a pregnancy is triggering until circumstances force a reckoning.

Who does it involve?

The pregnancy state is not an exclusive experience of the new child or expectant mother. It extends through a relational network and environment of the expectant parents.  Supporting individuals impacting a pregnancy, to maintain presence and integrate their experience is important to the future of the child, parents, and collective society. The choices they make in relationship to a pregnancy impact all of us eventually.

The participants of a pregnancy have become complex with advancing technologies around conception. Today we must ask who is involved in the conception, gestation, subsequent parenting, as well as the lineage being inherited by the child. There are genetic donors/biological parents, as well as surrogates, and they may not go on to raise the child or stay connected to them but are still an integral part of the pregnancy and that child’s creation. They, along with the future parents, are the inner core of relational intimacy for a pregnancy. Each person’s experience is as unique as the role they are playing.

The next group involved with a pregnancy are the siblings, grandparents, aunts, uncles, and cousins. As we learn more about the epigenetic imprinting influencing one generation into the next, ancestral context is also becoming relevant when considering who is involved in the pregnancy.

The next tier are individuals holding and supporting the pregnancy. These are friends and social network of the family. Then there are the midwives, doulas, therapists, nurses, and physicians. Our qualities, capacities, and state of being have an impact through the relational care we provide.

The last group we must consider is the community and environment that this family grows in. We have seen a growing disconnect from institutional leaders ignorant to the implication of their choices on pregnancy, children, and families.  In the absence of easy access to family planning methods, resources that nourish us and social safety nets around our necessities, we have created large reverberating social problems for ourselves.

Which Circumstances Matter

There are specific life circumstances that demand our attention during pregnancy. They tend to focus on securing the most fundamental birthrights that we are entitled to as we come into BEING.  These birthrights ensure our survival and capacity to thrive in our lives. When the environment or context surrounding a pregnancy undermines our capacity to secure these birthrights for ourselves and child it creates stress that we call “problems.” It is part of our context that needs to be integrated for the pregnancy to be embodied and to act on these problems in preparation for birth.  While pregnancy catalyzes us to address these issues at the behest of protecting and providing for our child, personally it becomes a positive force with its potential to restore our own wounded birthrights that are suboptimal in our lives. These problems are good forces even if they are difficult for us and require us to seek out help and support that have been previously absent.

To keep it simple, to thrive in life we are all entitled to these four basic categories which distill down to our birthrights:  
•    The right to safety, security & stability,
•    The right to have needs & receive nourishment,
•    The right to one’s uniqueness, autonomy and space,
•    The right to power and individual agency.

Pregnancy happening in an environmental context where our birthrights are threatened, undermined, or overtly violated is not healthy. On the most practical level, it is the capacity to generate enough money to secure the basics of survival. It is more than just money for food, clothes, shelter, healthcare, and education. It is also being safe from harms that violate our autonomy and having the agency to change abusive environments. At the heart of a living wage is having the spacetime to personally care for our lives and family.

Public health research touches this with initiatives to recognize and prevent Adverse Childhood Events (ACE’s) and Toxic Stress (TS).  The vast range of circumstances encapsulating ACE’s and TS boil down to a violation of an individual’s birthright, which creates an existential threat to survival.  While we are working towards recognizing pregnant women with a history of high ACE's, we still need to understand how those past and on-going experiences affect behavior, stress, and subsequent pregnancy outcomes. We do know a high ACE score correlates to a higher risk of complications in the perinatal period.


A holistic approach to a healthy pregnancy is one that extends beyond the physical changes and risks associated with it. We need to include the diverse spectrum of contextual experiences impacting pregnancy within our environment and relationships. An embodied pregnancy is critical to a healthy pregnancy since it becomes a proactive process of digesting all the challenges and obstacles we are facing. Ideally, we address these challenges to cultivate optimal circumstances that create and nourish a healthy human being.

Ruchi Puri, MD, MSc, FACOG

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