3. Intrauterine condition

In the uterus, amniotic fluid in the homeostatic condition surrounds the fetus. This chemical and physical state guarantees the protection of the fetus from any external variation. In the darkness of this "before birth" condition there is no light stimulation. Although around the 22nd post conceptional week (PCW) visual connections are already partially formed, the sight function has not developed yet [9, 10]. Clinical experience and publications have shown that from the 23rd to 24th PCW, the fetus is capable of surviving without any developmental harm if adequately assisted with medical intensive treatment. This is what is defined as viability, a condition that implies not only being born alive but it is closely related to the concepts of capability of meaningful life and of reasonable period of survival [11]. Viability appears to be strictly related to the subplate zone which plays a major role in the structural development of connectivity and cerebral cortex neuromaturation [11]. The subplate is a transient compartment of the fetal telencephalic wall, placed under the cortical plate. This hosts the majority of fetal neurons and reaches a developmental peak around the 23rd–24th PWC. The subplate zone functions as a waiting compartment for growing cortical afferents, in particular thalamic-cortical connections, which play an important function in the somatic-sensory function.

These develop in the subplate zone, creating temporary synaptic circuits and normally wait months before being relocated in the cerebral cortex, their final target [10, 12, 13]. In the occipital zone, the subplate's main function is to organize the optical orientation columns. Moreover, this is an area of intense synaptic activity where endogenous stimuli trigger specific fetal electrical activities: the spontaneous transient activity (SATs), which can be traced through electroencephalography (EEG) [14]. Its role is to organize and structure neuronal nets in the fetal brain (the thalamus cortical connection) and to give origin to transient circuits. This activity ends at birth when the permanent cortical circuit and the externally driven cortical circuitry, situated in the cerebral cortex will be activated [12]. The subplate has a fundamental role in brain plasticity and some of its neurons survive after birth until adolescence and early adulthood as subcortical interstitial neurons of the gyral white matter [12]. In the subplate zone, excitatory neurons which work with the gamma-aminobutyric acid (GABA) are implied in the connectivity and cerebral cortex structure development. At birth, GABA will become the major neurotransmitter inhibitor (and will play this role for the whole life) determining a change in the cerebral electrical activity of the newborn. This switch is triggered by the retina light stimulation [15]. These scientific observations consistently support the Theory of Birth formulated by Massimo Fagioli. The concept of viability has been strictly related to capability to react to sensorial stimuli that will occur at birth [11]. Other author highlight how cortico-cortical and thalamo-cortical connections, the subplate, the SAT and the somatosensory reactivity are all present at the same time when the capability to survive has been reached at 23rd–24th PCW. This has been linked with what will occur after birth [16]. In particular the sensation experienced in contact with the amniotic fluid which is a fundamental prerequisite to realize what Fagioli called "memory fantasy" [1, 16]. When the fetus is in contact with the amniotic fluid, can the uterus be considered a closed system. At the same time the fetus's brain electrical activity has the only role to organize and structure neuronal networks. At birth this condition will completely change in the dramatic passage from the intrauterine condition to the external world: the organization and the fetal brain function will be modified. The subplate as guide and cytoarchitectonic structure disappears, the SATs frequencies decrease until their presence on the EEG disappears and regular waves, which are correlated with alive condition, will appear [12, 14]. The GABA neurotransmitter function changes as previously stated. Finally the external environment condition is now dramatically different for the newborn. This determines a drastic caesura between the intrauterine and the extra uterine condition.

described by Massimo Fagioli in 1972. Moreover, several authors have interpreted these biological data in the light of this theory [11, 16]. In the central nervous system the retina, through the pupil, is the only part of the cerebral matter open to external stimuli. At birth, photo-retinal stimulation triggers an immediate pulsional reaction specific to humans which is a specific biological feature of Homo sapiens,

[1, 4–6, 17]. Recent scientific studies have shown that a single photon is sufficient for the activation of retinal cells [18]. As soon as it passes through the pupil and hits the retina, light immediately determines the brain's activation. This happens within a timeframe of the order of femtoseconds, so as to trigger the chain of chemical and physical events leading to the activation of brain circuits [19]. It has been studied that at birth the activation of the brain through visual connection and occipital cortex stimulation is faster than other cortical stimulation nervous pathway for the activation of vital processes such as respiration [20]. In addition, it has been shown how light is involved in the functional change of the GABA neurotransmitter at birth [15]. The newborn experiences a dramatic change, passing from the homeostatic condition in the amniotic fluid to the completely new extrauterine condition. The newborn reacts to the aggressiveness of the external non-human world (such as light, air, noise, cold) by closing the eyes and 'making it dark'. By doing so the newborn makes mentally disappear the external inanimate material world and at the same time, it would tend make itself disappear too. This is the pulsional defensive and non-conscious reaction defined by Fagioli as annulment pulsion. Through this pulsion, the mind of the newborn by wishing of returning to the previous stage makes both the external world and itself disappear. However, this cannot happen as the brain has been activated by light and the mind is now functioning together with the body. The fetus does not exist and neither the conditions that allowed its existence. The newborn cannot return into the darkness of the intrauterine condition. If the newborn managed to make itself "disappear" as a body-mind reality, it would not attach to the breast, and this wouldn't permit a natural movement toward another human being. The newborn would die. Thus, it is not possible for the newborn to annul its birth because something impedes this pulsion to turn into auto-destruction: vitality [1]. Vitality, a specie-specific human feature, has its roots in the capability to react that develops at 24th PCW and is strictly connected to the biological reality of the body. At birth the capability to react arises in the newborn, making possible the reaction to the light stimuli. This reaction is the annulment pulsion which simultaneously activates vitality. At birth vitality and the annulment pulsion are merged together. This latter does not exist independently, as it occurs in serious mental illness on a non-conscious level. Moreover, as it was previously stated, this would lead to the newborn's death. The fusion between vitality and annulment pulsion becomes 'fantasia di sparizione' or disappearance fantasy [1]. This formulation was theorized and firstly published by Massimo Fagioli in 1972. Since then, this theory has been confirmed by further investigation and research.

denominated by Fagioli as annulment pulsion (pulsione di annullamento)

Physiology of Human Birth and Mental Disease DOI: http://dx.doi.org/10.5772/intechopen.82216

The author brings together two concepts that identify two inherently and

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antithetical human features. Fantasy is related to imagination and therefore to the creation of something that did not exist before. However, 'disappearance' implies that something that existed before now does not exist anymore. This concept may sound contradictory but it is indeed able to express a creative act that happens without awareness in the newborn (which is a non-conscious act). Similarly, at birth, the newborn, by making the external non-human world disappear, creates the first image-idea of itself. This is the first creative act of the newborn, the first human thought. As the external inanimate world disappears in the newborn's mind, vitality allows the formation of a first undefined image. (Fagioli called this first image inconscio mare calmo, providing a clear visual image). At birth, the newborn realizes a first sensorial memory of the experience had in the previous homeostatic
