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Pain in the Fetus and the Preterm Baby

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Meanings of Pain

Abstract

The presence of pain in the earliest phases of human development is a recent acquisition of modern medicine and physiology. The main arguments against fetal and neonatal sentience and pain have been overcome: the full development of the cortex is not necessary to feel pain because the main structures needed for pain are in situ after the first half of pregnancy: peripheral receptors, neural spino-thalamic fibers, pain neurotransmitters, the thalamus, and the subplate. Fetuses have a rudimental though essential sense of experience. They have a primordial consciousness that becomes more and more efficient as the brain cortex is developing, and that will bloom with the arrival of the multiple stimuli given at, and after, birth. If we associate the “meaning of pain” with the ability to self-ascribe “pain,” it clearly does not exist at this stage of human development. But if we use the word “meaning” to express how pain affects the fetus/newborn, this has three levels. First, suffering and the changes it provokes, that can help bystanders to care correctly; second, the impact of pain on fetal development; and third, the anxiety, that we cannot measure in the fetus and newborn, but that is presumably present, because both the fetus and newborn have active centers (amygdala and thalamus) to experience these feelings. Conclusion: Fetuses and very preterm babies live in a word of drowsiness, similar to adults' imageless dream; when external stimuli disrupt the fetus/preterm-baby, this sort of dream can become similar to a nightmare.

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Authors and Affiliations

  1. Department of Pediatrics, University of Siena, Siena, Italy

    Carlo V. Bellieni

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  1. Carlo V. Bellieni
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  1. Department of Philosophy and Gender Studies, School of Humanities, University of Tasmania, Hobart, TAS, Australia

    Simon van Rysewyk

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Bellieni, C.V. (2022). Pain in the Fetus and the Preterm Baby. In: van Rysewyk, S. (eds) Meanings of Pain. Springer, Cham. https://doi.org/10.1007/978-3-030-95825-1_2

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