Pregnancy Care Center of Martinsville and Henry County

Fetal Pain

Can my pre-born child feel pain?
The answer to this question in one word is YES.

Read on for a detailed explanation:

Scientists have shown for the first time that newborn babies have a "unique" nervous system which makes them respond differently to pain than adults.  In research that has far-reaching implications for the medical and surgical treatments of infants, the scientists have found that newborn children feel pain longer and more sensitively.

In premature babies, the mechanism that allows older children and adults to "dampen down" the pain messages does not work properly.

Until recently it has been presumed that a baby's pain system was too immature to function properly, or that they reacted in a similar way to adults, but less efficiently.  Researchers at University College London have now discovered that babies' sensory systems have a unique pain-signaling mechanism, which disappears, as they grow older.
In the absence of confirmatory communication because of the inability of the fetus to tell us of her pain, medical practice and science judge that pain exists when anatomical structures necessary to pain sensation are in place and when physiological responses normally associated with pain occur.

In other words, if the biological sensory machinery exists, if something causes a response like that which pain would cause, and if that something would elect the same response from human beings generally, then we can deduct that pain occurs.

Certain neurological structures are necessary to pain sensation:
* Pain receptive nerve cells
* Neural pathways
* The thalamus

In the skin and throughout the body are free nerve endings that act as pain receptors.  These pain receptive cells are called nociceptors. When a nociceptor is affected by something harmful or potentially harmful to the cell, it discharges an electrical impulse that travels through interfacing nerve fibers to the spinal cord, and often to the brain.

However, a nociceptor may be stimulated and result in a reflex response without causing pain awareness. A reflex response in its simplest form, is a movement following a stimulus: it is an automatic reaction such as a child withdrawing her hand from a hot object.

By studying sensory nerve cells in infants, scientists discovered that their reflex to pain or harm is greater and more prolonged than that of adults. The sensory nerve cells are also linked to larger areas of skin which means that they feel pain over a greater area of their body. While adults produce pain reflexes only when they encounter harmful stimulation, newborn children respond less selectively and produce the same reflex even to a light touch.

Scientists believe that this is because in babies, the sensory nerve fibers that communicate non-harmful touch - known as A fibers - end in a different part of the spinal cord than adults.

But in adults the cells are connected only to pain-transmitting C fibers. Maria Fitzgerald, Professor of Developmental Neurobiology at the Thomas Lews Pain Research Centre, based at UCL, said another contributing factor in the new born child's pain system is that the nerve pathways, which carry pain-inhibiting messages from the brain stem to the spinal cord, mature later than other parts of the system.

Prof. Fitzgerald adds "These nerve fibers from the brain stem start to grow down the spinal cord early in fetal life, but they do not extend branches into the spinal cord for some time, and do not function fully until soon after birth." This means the premature baby cannot benefit from the natural pain-killing system which, in adults, dampens down pain messages as they enter the nervous system.

The Unborn Child Feels Pain

The sensory nerve of the face, the Trigeminal nerve, is already present in all of its three branches in a four week old human embryo. At seven weeks they twitch or turn their head away from a stimulus in the same defensive maneuver seen at all stages of life.

When doctors first began invading the sanctuary of the womb, they did not know that the unborn baby would react to pain in the same fashion as a child would. But they soon learned that he would.

Pain isn't just psychological. There is also organic, or physiological pain which elicits a neurological response to pain.

One of the most uncomfortable ledges that the unborn can encounter is his mother's backbone. If he happens to be lying so that his own backbone is across hers [when the mother lies on her back], the unborn will wiggle around until he can get away from this highly disagreeable position.

Changes in heart rate and fetal movement also suggest that intrauterine manipulations are painful to the fetus.

The changes in heart rate and increase in movement suggest that stimuli are painful for the fetus. Certainly it cannot be comfortable for the fetus to have a scalp electrode implanted on his skin, to have blood taken from the scalp or to suffer the skull compression that may occur even with spontaneous delivery. It is hardly surprising that infants delivered by difficult forceps extraction act as if they have a severe headache.

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