Fetal Pain

Busted: Fetuses do not feel pain until very late in gestation, well past 20 weeks

In 2010 , Nebraska passed a ban on most abortions past 20 weeks, despite the US Supreme Court’s ruling that states can only ban abortion past viability, 24 weeks. The state is attempting to set a new precedent, limiting abortion, not by viability, but by the scientifically unsound concept of “fetal pain.”

Several states, including Minnesota, Oklahoma, and Texas, and other states require doctors to tell their patients that a fetus can feel pain after 20 weeks, among other lies.

Incidentally, only 1.3% of US abortions occur past 21 weeks, according to the Center of Disease Control’s 2006 report.

Reports

• Fetal Awareness – Review of Research and Recommendations for Practice – Royal College of Obstetricians and Gynecologists, 25/06/2010

In reviewing the neuroanatomical and physiological evidence in the fetus, it was apparent that connections from the periphery to the cortex are not intact before 24 weeks of gestation and, as most neuroscientists believe that the cortex is necessary for pain perception, it can be concluded that the fetus cannot experience pain in any sense prior to this gestation. After 24 weeks there is continuing development and elaboration of intracortical networks such that noxious stimuli in newborn preterm infants produce cortical responses. Such connections to the cortex are necessary for pain experience but not sufficient, as experience of external stimuli requires consciousness. Furthermore, there is increasing evidence that the fetus never experiences a state of true wakefulness in utero and is kept, by the presence of its chemical environment, in a continuous sleep-like unconsciousness or sedation. This state can suppress higher cortical activation in the presence of intrusive external stimuli. This observation highlights the important differences between fetal and neonatal life and the difficulties of extrapolating from observations made in newborn preterm infants to the fetus.

Fetal Pain, A Systematic Multidisciplinary Review of the Evidence - The Journal Of The American Medical Association,  Susan J. Lee, JD; Henry J. Peter Ralston, MD; Eleanor A. Drey, MD, EdM; John Colin Partridge, MD, MPH; Mark A. Rosen, MD, JAMA. 2005;294:947-954.

Evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester. Little or no evidence addresses the effectiveness of direct fetal anesthetic or analgesic techniques. Similarly, limited or no data exist on the safety of such techniques for pregnant women in the context of abortion. Anesthetic techniques currently used during fetal surgery are not directly applicable to abortion procedures.

Articles

• Can a Fetus Feel Pain? U.K. Report Says No. -  Newsweek.com, Alan Mascarenhas June 25, 2010

(Article about RCOG report)

With passions entrenched on both sides, it is likely the issue of “fetal pain” will continue to polarize and sour America’s abortion debate—even if this week’s British report suggests it belongs closer to the medical fringe.