On April 1, the University of Toronto held a conference for Health Care Professionals on the subject of “Pain in the Fetus and Neonates” – that is pain in pre-born and premature babies and in newborns.
Until the late 1980’s, few doctors or nurses realize that the unborn and newborn child have much, if any, pain sensation.
However, it is realized that prematurely born infants have greater pain sensitivity than older age groups. Many premature born infants undergo painful procedures such as needle pricks and heel sticks (up to as many as 500) while in the neonatal intensive care ward.
Their endocrine- metabolic and other stress responses to these invasive procedures and to surgical operations, was up to 3 to 5 times that of adults undergoing similar surgery. Also, higher doses of anesthetic drugs are required for neonates compared with older age groups.
The immediate response to pain of the pre-born and newborn infant is facial grimacing and bodily movement. The facial grimace has been carefully analyzed. The response to pain is specific and easily recognizable. There is some evidence that there may also be long term “pain memories.”
At present the best treatment for pain is sugar solution by mouth, pacifier (sucking) swaddling and opioid analgesics. More research is needed and better ways of managing and treating the premature neonatal baby must be found. In particular, the medical profession must learn how to avoid painful procedures unless absolutely necessary.
The gap between medical science and medical practice requires the development of a properly designed and performed randomized and controlled trial regarding the effectiveness of the “treatments” that doctors and nurses use on these patients.
Pain has been shown to be associated with intracranial hemorrhages may lead to brain damage.
Despite this, analgesics are not routinely given to these patients. Immediate application of the results of such research is of paramount importance.
Experiments on rats show that the skin is fully innervated at birth. The timing of the connection between the thalamus and cortex is crucial for the cortical perception and awareness of pain. In primates, this connection is made before mid term (equivalent to sometime before 20 weeks gestation in the human).
It is estimated that less than 100% completion of this connection may allow awareness of pain well before the 20 week stage in the human unborn baby. The harrowing implication is that many surgical abortions result in the unborn baby feeling the pain of its own dismemberment as portrayed so vividly in Dr. Bernard Nathanson’s The Silent Scream.
The medical and particularly the nursing profession are now far more empathic with the pre-born, the premature and the young infant.
The work that will follow this convention will undoubtedly result in less suffering and trauma to the pre-born. Pro-lifers hope that these newly discovered realities will help to stem the abortion onslaught.