Dr. Sanjay Gupta’s response to a recent JAMA article about Fetal Pain

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For a long time, almost till 1987, medical science believed that newborn babies do not feel pain because their brain is not fully developed . This led to many painful procedures and surgeries performed on newborn babies without anesthesia. We know now that that was a terribly wrong presumption . We also know that pain experience early in life can lead to serious late consequences including chronic pain conditions etc.

In the recent JAMA article on fetal pain , a similar presumption is being made that the fetus brain is not fully developed till 29 weeks and therefore fetus will not feel pain before that age. There is no evidence that a fully developed cortex circuitry is required to feel pain. In contrast, we do have evidence from the neonatal experience that this presumption is wrong . It is also possible that an incomplete and dysfunctional circuitry may cause increased pain in fetus below 29 weeks of age.

Medical science should not repeat the mistake of presuming that fetus, before 29 weeks, does not feel pain. Rather, It should continue doing research on this topic further and also in finding ways of providing pain relief to fetus especially because a significant number of premature babies are able to survive now as early as 23 weeks and many of them require surgery or procedures. It would be a terrible mistake to not provide analgesia to these premature infants, or fetuses for surgery or other procedures.

Dr. Sanjay Gupta is a pain specialist and the director of Pain Institute in Philadelphia, PA. He can be reached via email at sguptamd@yahoo.com or at 856-313-7911.

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