In this review, we look at recent work that examines the genesis of conscious awareness in utero in humans. We focus on observable behaviours that suggest a state of anticipatory perceptual awareness evident in the foetal period, and the foetus’ first expression of agency through self-generative engagement with it. This predictive, anticipatory awareness is first evident in the prospective sensorimotor organisation of bodily movements of the second trimester foetus, revealing an early adaptive awareness and agency that establishes the foundation for additional forms of abstract, reflective, and conceptually-backed conscious experience in adults. Improved understanding of these early sensorimotor foundations of psychological development and health affords an improved understanding adult human consciousness, the nature of its early ontogeny, and its particular expression mediated by the integrative nervous system.