December 23, 2010

Pain in the Unborn and Newborn Child



    
NRLC President Dr. Wanda Franz
     NRLC President Dr. Wanda Franz

When I had my first baby forty years ago, I was told that he could not feel or "register" pain like adults. When he was a few days old, I had to hold him in order for the medical personnel to "stick" his heel repeatedly with a razor-blade-like instrument in order to draw blood. It was obvious to me that he felt this procedure as a painful stimulus.

What were the signs that told me he felt pain? First of all, he screamed loudly. As the procedure was repeated, he tried to pull his foot away, and the technician had to hold on tightly to the little foot. Finally, he turned very red and sweated profusely. When the procedure was over, I fed him and he fell asleep for an extended period.

Meanwhile, I was being told by the doctors that he felt no pain. How could the medical personnel have seen what I saw, yet still claim that newborn babies do not feel pain? They always implied that mothers were too emotionally-involved to be able to evaluate, with scientific accuracy, what we were seeing.

Although I was a mother, I was also a developmental psychologist; and I had learned something about doing evaluations on newborn babies. Eventually, the doctors got the scientific evidence they needed to be able to see what I was seeing.

The problem with recognizing pain is to understand how pain works. Pain is what one feels as a result of some kind of event from outside being monitored by the body. The nervous system brings the stimulus into the body to the brain where it is registered, that is, felt. We can't see that part of the event. What we see is the response to the pain. However, the response of the body to the pain is managed by different nervous pathways than those used for experiencing the pain.

The ability of the individual to respond to the pain is affected by many different things. A person may be sick, under the effect of medications, or distracted by other events, which can limit the ability to respond. A very important factor in the response to pain is the developmental maturity of the individual. Babies have, what developmental psychologists call, a "limited behavioral repertoire." That is, babies can cry and pull away, but they can't speak and express their anger at being hurt. Babies can't do the things that adults can do to demonstrate that they are in pain.

In other words, all of us, including the doctors taking blood from my baby, rely on the behavioral response of the person to determine whether or not they think that person is in pain. It is easy to mis-read the cues the person is giving us. The baby's behavior alone wasn't enough to give the doctors the idea that the baby was really hurting.

Since I had my experience with my first baby, we have learned a lot more about pain, and we have new ways of assessing its presence or absence. For example, we now know that pain causes stress hormones to be released into a person's bloodstream. It is possible to measure how much pain a person is feeling by measuring the amount of hormones in the person's blood.

That is the same stress response that causes a person in pain to turn red and sweat, just as my baby did. There is no question that those symptoms are further signs that he was in pain. I had assumed that, while it was certainly unpleasant, that it would pass and be forgotten leaving no negative side-effects. However, research suggests that the effects of experiencing pain in infancy can be more negative than one would have expected.

Contact:
Dr. Wanda Franz
Source: National Right to Life
Publish Date: December 22, 2010