At what point in human development can we recognise the presence of another person like us? It’s an age-old question which cannot be avoided, and I’ve been interested in the recent discussion about this on this blog. Each one of us comes to this question from a different perspective, so I would like to offer some reflections from the perspective of a baby doctor. As a neonatologist I have cared for many tiny and fragile babies, some as small as 22 weeks of gestation and weighing less than 500g.
What is immediately apparent is that, even at extreme degrees of prematurity, babies are conscious and responsive to stimuli. In particular it is the face that seems to be the focus of their receptivity. The baby responds to touch on the face, will suck on a finger tip, responds to sounds and to light and the facial expression changes in response to painful stimuli such as a heel-prick blood sample. It is interesting that the facial expression of a 25 week gestation baby in pain is immediately recognised and instinctively responded to by adult carers and parents. Studies using optical and electrical methods of monitoring brain activity have shown responses within the cerebral cortex to heel-prick stimuli as early as 25 weeks gestation.
We know that the developing brain of an unborn or premature baby is an extraordinary hive of activity – particularly between the 5th and 9th month of gestation. The central nervous system contains approximately 100 billion nerve cells, called neurons. Every neuron that is going to make up the grey matter – the outer layer of the brain that is responsible for consciousness – starts close to the centre of the brain and grows outwards to the surface. This migration phase is largely complete by 24 weeks of gestation. After that, each individual neuron has to make on average 2000 connections with other neurons. Some of those connections are to adjacent neurons, some manage to connect with equivalent neurons in the other side of the brain, and some connect with the spinal cord. The end result is an amazing 200 trillion connections or synapses. I once calculated that there must be hundreds of millions of new connections being formed every minute. So if you ever visit a baby unit, try to imagine the feverish activity that is taking place underneath that little woolly hat!
All this activity is helping the baby to engage actively with its world from the earliest stages of development. The unborn baby responds to touch, light, sound, vibration and painful stimuli from 20 weeks onwards. Pregnant mothers will recognise sleep-wake cycles in their babies, and at times babies are actively responsive to outside stimuli. There is a body of research to indicate that the unborn baby should not be regarded as a passive occupant of the womb. Instead they are actively engaging and responding to the stimuli they receive.
Studies have shown that newborn babies recognise their mother’s voice immediately after delivery, but not surprisingly they respond most strongly to the mother’s voice when it is electronically modified as though it had been transmitted through water. Newborn babies seem to remember a range of sounds, melodies and rhythmic poems that they were exposed to before birth. Babies also recognise the taste of their mother’s breast milk, presumably because it tastes similar to the amniotic fluid that they were swallowing previously.
Above all the newborn baby is primed for relationship with other humans. Newborn babies turn their eyes preferentially towards lines and patterns that represent a human face. They respond to spoken language and vocalise responsively, and they enjoy human cuddles. Interestingly mothers across the world instinctively talk to babies in a sing-song highly inflected tone which is known as “instinctive motherese” or by linguists “child-directed speech”. This strange kind of speaking seems to be designed to capture the baby’s attention and ensure the maximum chance of receptivity and response. By 6-8 weeks post-term the newborn baby develops a “social smile” – a positive smiling response to a human face that expresses joy and delight in the recognition of the other.
This focus on relating to others fits well with a Christian understanding of personhood, which goes all the way back ultimately to the persons of the Holy Trinity. The Father cannot be who he is without the Son and the Son cannot be who he is without the Father. Just as the three persons of the Trinity are individually unique, yet give themselves continually in love, so each human person is unique, yet made for relationship with others. “Personhood” is not something we can have in isolation – in Christian thinking it is a relational concept. Persons are constituted by their relations – their very being is derived from the movement of communion and love, from the freedom to give oneself to the other.
Descartes’ famous statement, “Cogito ergo sum, I think therefore I am”, places individual conscious awareness as the bed-rock of existence. When everything else can be doubted, the final place for certainty is my own self-awareness. But this way of thinking leads inexorably to a profound individualism, which is one of the recurring features of modern liberal thinking.
By contrast we might suggest an alternative Christian version, “amor ergo sum, I am being loved therefore I am”. My being comes not from my rational abilities or self awareness but from the fact that I am known and loved by others. It is no surprise that from before birth the newborn human is designed to receive love and to give it back. And the natural human response confronted with the miracle of a newborn baby is to respond with gentleness, with compassion, with wonder and with love. Sadly not every baby receives the compassion and attention that they deserve, but an understanding of brain development reminds us of the centrality of love in our experience of being human. In the words of the Christian philosopher Joseph Pieper, “Love is a way of saying to a person, ‘It’s good that you exist, it’s good that you are in the world’”.