Jesse and Scarlett, 22 weeks 5 days
I wish that somehow it were possible for every person who believes pain isn’t possible until 24 or 28 weeks to take a tour of a neonatal intensive care unit. I wish every member of the SMFM, ACOG, and RCOG could walk through those double doors into the NICU and see babies less than 24 weeks who are 1 pound or less. I wish they could talk with the parents of those babies and hear how at times they will see their baby showing obvious signs of pain and get the nurses attention for help. I wish they could talk to the NICU nurses, respiratory therapists, neonatal nurse practitioners, neonatologists, occupational therapists, and physical therapists who work with these babies every day.
We try to minimize the pain when these tiny babies are first born. We try to touch them only every six hours to minimize the stimulation. Just moving their position hurts. Touching them hurts. Gently changing their diaper is painful. Suctioning their endotracheal tube and removing the tiny EKG leads from their chest is stressful for them. Even the gentlest touch is painful to babies less than 24 weeks. We see the pain in their facial expressions, body movements, and their vital signs on the monitors. Even though we can’t hear their little cry because the endotracheal tube is in their trachea, we see the cry. Parents see the cry and they see their tightly closed eyes. They see the brows bulged and deepened nasolabial folds. Parents immediately know.
Nurses also know when our tiny patients are in pain. We use the premature infant pain profile (PIPP) scale. We try our best to alleviate their pain without pain medications when we can, but sometimes we have to give those pain medications. We try to keep the NICU as quiet as possible. We ask parents not to stroke or pat their tiny babies, because it’s painful to them. We teach them how to gently place their finger in their baby’s hand and talk quietly to them.
If our NICU parents can see this obvious pain in their babies and NICU nurses and staff constantly try to minimize the pain, use pain scales to assess the pain, and give pain medications for pain in our extremely premature patients, why won’t doctors and scientists outside of the NICU acknowledge that pain? NICU nurses, doctors, and medical staff have got to speak out more. We care about our babies’ pain in the NICU, it’s time someone cares about the pain of babies being aborted as well. It is inhumane. It has to stop.
Rebecca Cobain @becccobain is a Neonatal ICU Nurse who works in a level 4 NICU where they routinely care for preemies as young as 22 weeks.