Fetuses Before 24 Weeks Gestation Cannot Feel Pain, Experts in Nebraska Hearing Wrong


In what may be news to Nebraska senator Mike Flood, but not to many scientists and doctors, the BBC is reporting that once again, it has been found that fetuses are incapable of feeling pain before the 24th week of gestation.

Via BBC.com:

The first of the college’s reviews examined whether or not a foetus can experience pain.

It found that nerve connections in the cortex, the area which processes responses to pain in the brain, does not form properly before 24 weeks.

The report states: “It can be concluded that the foetus cannot experience pain in any sense prior to this gestation.”

Even after 24 weeks, the college concluded a foetus is naturally sedated and unconscious in the womb.

This could mean that late abortions, which are permitted for serious abnormalities or risks to the mother’s health, may not result in foetal suffering.

In addition, the report says anaesthetics, which can be risky, would not be required if a foetus requires surgery.

It was this erroneous claim that fetuses could feel pain much earlier that allowed Nebraska legislature to pass the Pain-Capable Unborn Protection Act earlier this year.  The bill is being legally challenged and is currently unenforced.

New Scientist writes that these new findings are a direct contradiction to everything that the Nebraska legislature and their experts claimed during hearings over the bill.

When Nebraska legislators debated the state’s new abortion law, it was claimed that fetuses must feel pain because they have the same reflex reactions to pain as children and adults. Templeton dismisses this reasoning. “There are indeed reflex responses, but in our view, because the nerves are not wired up to the cortex, they are reflex actions without experience of pain,” he says.

The report notes that the same reflexes are seen in seriously malformed fetuses that have no brain at all, and therefore can’t possibly experience pain.

Templeton says the working party rejected the claims of Kanwaljeet Anand of Le Bonheur Children’s Medical Center in Memphis, Tennessee, who contends that young fetuses can feel pain in a more primitive part of the brain called the subcortex, which receives pain signals before the cortex has been wired up.

“Our scientists say there’s no evidence that the subcortex can provide for the pain experience,” Templeton told New Scientist. Anand’s evidence is widely cited by anti-abortion groups.

Templeton says that Anand’s evidence comes mainly from observations of responses in babies born prematurely, and that it cannot be assumed that these are expressions of pain, rather than painless reflex responses.

“Anand’s conclusions apply only to neonates,” Templeton says. “He has written opinions about how that might apply also to fetuses, but it’s not evidence, it’s opinion.”

The report argues that pain responses may begin to develop only after a baby is born, and no longer sedated in the womb, and that this may explain why neonates experience pain differently to fetuses. “It is only after birth, with the separation of the baby from the uterus and the umbilical cord, that wakefulness truly begins,” it concludes.

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  • cmarie

    right…. thanks “experts”

    glad to have that straightened out

    .http://www.terrylarimore.com/BabiesAndPain.html.

     Pain of Surgery Without Anesthesia. Hospitalized newborns, from preemies to babies up to 18 months of age, have been routinely operated upon without benefit of pain-killing anesthesia. This has been the practice for decades but was unknown to the general public until 1985 when some parents discovered that their seriously ill premature babies had suffered major surgery without benefit of anesthesia. [67,68,69,70,71,72] Up to this time, babies were typically given a form of curare to paralyze their muscles for surgery, making it impossible for them to lift a finger or make a sound of protest!
    .
    Jill Lawson reported that her premature baby, Jeffrey, had holes cut in both sides of his neck, another in his right chest, an incision from his breastbone around to his backbone, his ribs pried apart, and an extra artery near his heart tied off. Another hole was cut in his left side for a chest tube, all of this while he was awake but paralyzed! The anesthesiologist who presided said, “It has never been shown that premature babies have pain.” [73]
    .
    Mrs. Lawson was describing the most common surgery done on premature babies, thoracotomy for litigation of the patent ductus arteriosus, which experts taught could be “safely accomplished with oxygen and pancuronium as the sole agents. [74]” After the parents told their story with the help of nation-wide television, radio, and print media, the ethics of these practices was seriously discussed for the first time. [75,76,77,78,79] Resisting change, some doctors continued to argue that “following major operations, most babies sleep,” and that “all we need to do is feed them…” [80]
    .
    Surveys taken of policies and practices of infant surgery in the United Kingdom and the United States revealed ambivalence about whether infants really needed anesthesia or would be endangered by it. [81,82] Although some hospitals reported twenty years of successful use of anesthesia with infants, [83] surveys of common practice revealed infrequent use of anesthesia, under-utilization of anesthesia, and the lack of policies on the subject. [84,85]
    .
    Key medical objections to infant anesthesia -that it was (a) unnecessary and (b) dangerous -were resolved by the brilliant research of Kanwal Anand and colleagues at Oxford from 1985 to 1987. Making precise measurements of infant reactions to surgery, they proved that the babies experienced pain, needed and tolerated anesthesia well, and had probably been dying of metabolic and endocrine shock following unanesthetized operations. [86,87,88]
    .
    When these findings arrived in the midst of the parent rebellion, official bodies of physicians began to acknowledge the need for change and promised to five neonates the same consideration in surgery as they gave to other patients, [89] ending 140 years of discrimination. This was a milestone, but not a guarantee. We have no way to predict just how many doctors and hospitals actually follow these policies. Historically, announcement of new policy by a guild has not always affected the practice of individual members. [90]
    . 

  • equalist

    The article is referring to the pain sensation of a fetus in the womb, not a neonate, which would be different, and it makes sense that a fetus in the womb does not feel pain before birth because otherwise the experience of birth itself, being squeezed out of the mother’s body through the birth canal with enough force to give vaginal birth babies the “conehead” effect so commonly seen would be excruciating.  Seriously, can you say that a fetus in the womb can feel so much horrific pain when a baby in the birth canal is squeezed to the point that the skull plates shift as part of the natural process doesn’t appear to be in massive horrific pain after the experience?

    Secondly, it’s a known fact that general anesthetic can be devistating to a neonate or fetus being operated on.  My daughter had to have surgery at three months old and they all but refused to give her general anesthesia because they were afraid it would stop her breathing.  And honestly, as a mother, I can say I’d prefer it that way.  I personally would refuse to risk my child’s life in order to spare him or her pain that he or she wouldn’t even have the developed brain function to remember.

  • amyc

    I was going to reply to cmarie but you did such an excellent job. Also, I noticed that she/he was quoting Dr. Anand’s research. The post specifically mentioned Anand and points to reasons why the research does not apply to fetuses in the womb (and it may not even actually prove that neonates feel pain). I’m going to guess that cmarie didn’t even read the post. Either that or she/he has terrible reading comprehension.

  • equalist

    In addition, those discussing fetal/neonate pain and anesthesia also forget that general anesthesia is the most dangerous part of most surgeries, even for a healthy adult.  with newborns already having a risk of stopping breathing due to their lack of development, add to that a respiratory depressant like anesthesia, and you’ve got a dangerous combination.  That a medical doctor could claim general anesthesia perfectly safe and harmless for use on neonates which are already at risk is absurd.

  • grayduck

    The Nebraska bill measures pregnancy based on fertilization, whereas UK law- and presumably the RCOG study (although it did not define how it measured weeks of gestation)- measures it from the woman’s last menstrual period. “24 weeks gestation” can mean anything from twenty weeks after fertilization- the point at which the Nebraska law restricts abortion- to twenty-four weeks after fertilization.

     

    Furthermore, the report precedes “24 weeks” with the term “around.” Thus, it might be surmised that the point at which fetuses can be able to experience pain- given the level of precision in the report- may be nineteen weeks after fertilization or earlier. Thus, the report leaves open the possibility that the Nebraska law actually may fail to protect fetuses that have the capacity to experience pain.

     

    http://nebraskalegislature.gov/FloorDocs/Current/PDF/Final/LB1103.pdf

     

    http://www.rcog.org.uk/files/rcog-corp/RCOGFetalAwarenessWPR0610.pdf

     

  • amyc

    Funny how they passed this law to keep fetuses that may or may not feel pain from being aborted, yet I’ve never heard of any legislators getting their panties in a wad because doctors don’t use anesthesia during surgery on fetuses, neonates, or even some newborns. If they really believed that the fetus could feel pain, then why don’t they fight for doctors to use anesthia during fetal surgery? Could it be that they don’t really care whether or not fetuses feel pain, and they only want to throw this new law out there as yet another roadblock?

  • robin-marty

    that is why the term is being used. Also, if you watch the video in the first article, he explains “around” ie: that at 23/24 weeks the possible neurons may begin to start forming connections. However, due to the sedate manner of the womb, that still doesn’t make a difference on whether it can feel pain or not.

  • grayduck

    amyc on June 28, 2010 – 12:51am: “…doctors don’t use anesthesia during surgery on fetuses, neonates, or even some newborns.”

     

    What is your source for this assertion? Many of the cases for the existence of fetal sentience are based on the assertion that anesthesia is routinely used on fetuses during surgery.

     

  • grayduck

    Robin Marty, RH Reality Check on June 28, 2010 – 10:25am: “24 weeks gestation IS 24 weeks fertilization that is why the term is being used.”

     

    The RCOG/BBC report was measuring gestation against the mother’s last menstrual period. It used the term “gestational age.” That term is defined in another page on the RCOG site as “The age of the baby in the womb, measured in weeks from the first day of the woman’s last menstrual period.”

     

    http://www.rcog.org.uk/womens-health/patient-information/medical-terms-explained

     

    Also see “term” and “trimester” on that page and note that they indicate that pregnancy lasts 40 weeks. If they were counting from conception, they would have indicated only 38 weeks.

     

    Look at Box 3.1 on Page 30 of the following link. It clearly indicates that “[i]n the UK, the duration of gestation is measured from the first day of the pregnant woman’s last menstrual period.” The box also uses the phrase “weeks of gestation.” If they were switching back and forth between the two measurement systems with calling attention to that fact, they were needlessly creating much confusion.

     

    http://www.nuffieldbioethics.org/fileLibrary/pdf/CCD_web_version_22_June_07_%28updated%29.pdf

     

    Here is another page from the RCOG site that switches back and forth between “gestational age” and “weeks’ gestation.”

     

    http://www.rcog.org.uk/womens-health/clinical-guidance/gestational-age-and-ctg-query-bank

     

    Here is a page that talks about 41 “weeks of gestation.” If they were counting from conception, then they would be talking about three weeks after full term. That seems unlikely.

     

    http://www.rcog.org.uk/womens-health/clinical-guidance/delivery-uncorrected-coarctation-aorta-query-bank

     

    “Also, if you watch the video in the first article, he explains “around” ie: that at 23/24 weeks the possible neurons may begin to start forming connections.”

     

    Neither guest even used the term “around,” much less define the amount of precision meant by it. Moreover, if you listen to his comments made between 1:50 and 2:00, he implies that connections are being made before 24 weeks gestation as measured from the woman’s last menstrual period.

     

    “However, due to the sedate manner of the womb, that still doesn’t make a difference on whether it can feel pain or not.”

     

    Even if natural prenatal sedation makes the fetus completely immune from pain, evidence that the fetus has the capacity to experience pain is of great legal significance. That is true because Roe v. Wade was based on the idea that the unborn are not alive. The existence of the capacity to experience pain indicates that the unborn have brain function. Brain function is already used as the determinant of whether someone has died. In addition, “lacking feeling or sensitivity” is one of the definitions of being dead.

     

  • crowepps

    That is true because Roe v. Wade was based on the idea that the unborn are not alive.

    Roe v Wade is based on the idea that the unborn are not yet ‘persons’ as defined in the Constitution because there is no CONSENSUS on when ‘life’ begins.  That doesn’t mean Roe v Wade said that fetuses are ‘not alive’.  I’ll grant it’s a subtle distinction, but it’s there.

     

    Grossly malformed fetuses (i.e., anencephalic) have a heartbeat and minimum brain stem function but can be considered ‘alive’ only so long as their mother physically animates them.  At birth or very soon after birth they are definitely dead because without the parasitic use of her body organs they cannot sustain themselves.  It can be argued ad infinitum whether life that continues only if life support is provided from outside is ‘life’ in any meaningful sense or at what point it is ‘moral’ to remove life support in hopeless cases.

     

    I will agree with you that it would be really, REALLY nice if everybody could get together and use the same counting method for gestation so that it would be easier to compare studies.  It would be even nicer if all those studies were done in a scientific manner, without preconceptions about how the results should turn out ‘morally’.

  • cmarie

    http://www.dailymail.co.uk/news/article-1296361/Twins-prove-baby-survive-23-weeks.html

    the “best rated” comments are very worth reading too.