There was a time not too long ago when obstetricians once claimed that newborns felt no pain, so it was okay to do a circumcision on a baby boy without anesthesia. The fact that he screamed all the harder when we crushed his foreskin was "just a reflex." Then research showed that boys who had circumcisions cried more than boys who did not when they were vaccinated two months later. Not only did they "feel" , they also "remembered". Maybe not the same way we feel or remember, but it was real for them.
It is a medical fact that by 20 weeks after fertilization, commonly known as 22 weeks gestation, the wiring to feel pain is in place. Unfortunately, those connections occur before the ability to consciously modulate the pain, so the brain is flooded with the sensation. Fetuses receiving blood transfusions at this time will react in pain, but not after they have received medication that relieves pain. Research from 2013 shows that babies born before 28 weeks gestation who have been subjected to repeated painful procedures show signs of brain damage as school children, especially in the higher areas of the brain, the cortex, that receive pain signals.
Over the years, many of us have cared for women whose babies had anomalies which we knew would probably result in the death of their child before, during, or shortly after birth. There can be nothing more heartrending than watching the anguish of parents who have been told that their child may not survive even six months, no matter if that child be an adult, teenager, toddler, infant, or even unborn. Yet it is only with the unborn where we somehow think that easing the parents’ emotional suffering includes taking the life of the child. It is no more cold hearted to deny parents of unborn children the ability to decide to end their child’s life than at any other time in that child’s life.
This is what makes perinatal hospice so important. Parents facing this tragedy need this support. When offered these hospice services, up to 87% of parents chose to parent their baby for as long as he/she lives. And since medicine is never error free, it also gives everyone a second chance in those occasions when a mistake with a diagnosis does happen.
The present bill in the state legislature, the Pain-Capable Unborn Child Protection Act, addresses a reality: that a human being before birth experiences pain, maybe not in the way you and I "feel", but in a way that is uniquely their own. It also shows concern for the parents, especially the mother, by giving support through hospice care during this trying time.
Cynthia Jones-Nosacek, MD, family physician including obstetrics
James Linn, MD, obstetrician/gynecologist
Julie Mickelson, MD, obstetrician/gynecologist
Theresa Pardoe, MD, family physician
Andrew Brayer, MD, family physician
Michael White, MD, family physician