Wednesday, July 28, 2010

Does Peace on Earth Begin at Birth?

© Guggie Daly 2010



Peace on Earth Begins with Birth:
Establishing Neural Connections Early in Life Can Reduce Violence

Abstract
The shadowy myth covering the connection between violence and physiological events is slowly being blown away by science. As the evidence builds, it becomes ever more clear that the experiences and events at the very beginning of life, including birth, have a strong impact on the growing brain and psyche of humans. With the obstetrical field in America slipping precariously towards dehumanization, violence and dangerous practices, it seems the one most important thing the nation can do is work to ensure that every human has a peaceful beginning.

It’s taken America a very long time to acknowledge the humanity and consciousness of baby humans. In fact, the common view of the baby was that “it” had no consciousness, no memory, no dreams and no ability to feel pain. All kinds of medical procedures, including surgery, were performed on babies without anesthesia or other pain management. In many hospitals in America, this still happens during intubation, lancing, circumcisions and even open heart surgery.

Although the concept of pain and consciousness in neonates has been widely dismissed as simply a reflex, a careful review of the literature shows that this discrimination was projected onto the infants regardless of the available science, and not because of a level of ignorance due to uncharted scientific realm at that time in history. For example, babies can sometimes be heard crying in the womb after they have been harmed by certain actions. This Intrauterine Crying was observed as early as 1919, when Graham published a paper on the phenomenon in the British Medical Journal. It was again noted in The Lancet in 1957. Today, fetal cries are heard as a result of severe or violent intervention, such as the internal fetal monitoring device that is screwed directly into the baby’s scalp. Nearly 20% of these pre-born babies went on to die in childbirth related complications. (Ryder, 1943).

Despite the mounting scientific evidence, obstetrical interventions during childbirth and the immediate post-natal period continue to spin out of control. This year, the CDC posted the depressing report that cesarean surgery has reached an all-time high of 32% nationally. (Menacker & Hamilton, 2010). The authors summarized, “In 2007, approximately 1.4 million women had a cesarean birth, representing 32% of all births, the highest rate ever recorded in the United States and higher than rates in most other industrialized countries” (Menacker & Hamilton, 2010). This is relevant to the discussion because c-sections increase the risk of neonatal complication and illness, resulting in more interventions and procedures upon the infant and even longer NICU stays. The additional procedures contribute to the level of pain the infant experiences and can also interfere with biological bonding mechanisms required for successful initiation and establishment of breastfeeding, the lack of which also increases the risk of contraction of illness and other complications due to substitute feeding.

Researchers at Georgia State University stumbled over a disconcerting consequence of neonatal pain. They found that infants who were in the neonatal intensive care unit (NICU) had altered biology that resulted in decreased pain sensitivity as adults. (Science Daily, 2009). What they found was that experiencing pain as an infant influenced the brain’s creation of opioid receptors. Modern pain killers, specifically morphine, work by enacting these receptors, so fewer receptors means the painkillers are less effective and the person requires a higher dose. “The number of invasive procedures an infant experienced in the NICU is negatively correlated with how responsive the child is to morphine later in life; the more painful procedures an infant experienced, the less effective morphine is in alleviating pain” (Science Daily, 2009).

Other studies show that infants retain some level of memory regarding painful procedures and that they react to future painful stimuli more than infants who did not experience an initial painful event. A study led by Hospital for Sick Children (SickKids) researchers has demonstrated that not only do male infants feel pain during circumcision, they remember that pain six months later when they receive their routine vaccination. “This study demonstrates two important findings," says Ms. Taddio. "It shows that infants do in fact feel pain, and that a pain experience in the newborn period can affect pain behaviours later on. Adequate pain relief may prevent these changes. Therefore, every measure should be taken to prevent pain in circumcision and other medical and surgical procedures” (SickKids, 1997).

The increasing levels of and types of pain infants experience as they come into this world are concerning in regards to human dignity, ethics, science and criminology. Two of them particularly impact future violence in the world. The biological consequence of experiencing pain during the neonatal period appears to inherently alter the functioning of the neurological system. This altered state decreases sensitivity to pain and interferes with bonding and intimacy mechanisms, both of which can lead to decreased empathy and lack of boundaries in relationships, which are precursors to violence.

But the cycle will not stop there. Violence begets violence. As was noted in this week’s discussion, seeing domestic violence affects the brain. So not only is this an issue of tertiary alteration at birth, but that person could potentially continue the cycle of abuse by becoming violent within a family unit and exposing the next generation of children (who likely also experienced pain at birth) to additional violence. As generations perpetrate this cycle, the violence will continue to escalate, which can be seen by the rapidly increasing rates of violence in our nation. By going back to the beginning and replacing the violence and pain with peace and comfort, the cycle of violence can be eradicated. In all seriousness, then, peace on earth really can begin at birth.

References

Graham, M. "Intrauterine Crying," British Medical Journal, vol. 1 (May 31, 1919): p.675. Menacker, F., Hamilton, E. B. (2010). Recent trends in cesarean delivery in the united states. NCHS Brief; Centers for Disease Control, number 35, March 2010.

Russell, P.M.G. "Vagitus Uterinus: Crying in Utero," The Lancet, vol. 1 (1957): pp.137-138.

Ryder, G.H. "Vagitus Uterinus," American Journal of Obstetrics & Gynecology, vol. 46 (1943): pp.867-872.Science Daily. (2009). Pain changes sensitivity in adults. Science Daily. Retrived May 1, 2010, from http://www.sciencedaily.com /releases/2009/09/090927130048.htm

SickKids. (1997). Study shows that infants feel and remember circumcision pain. The Hospital for Sick Children; February 28, 1997.

4 comments:

  1. Great post. You put into words everything that I've been wanting to and also brought new information to my attention.

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  2. Fascinating stuff. My daughter was badly burned by hot tea, my tea, when she was only 10 months old. The pain she endured, during the actual accident and in the three consecutive weeks of painful dressing changes, not to mention experimental treatments in hopes of avoiding a skin graft, is beyond expression. Now a happy 4-year-old, with a tendency to shriek when she gets hurt, a sound that cuts right through me like a knife, I can't help but wonder if she will forever have "issues in her tissues" as a result of this traumatic experience.

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  3. You nailed it, Guggie. Great post!

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