Nebraska and the Falsehood of Fetal Pain


In August I cheered the injunction against Nebraska’s so called “Women’s Health Protection Act.”  This misleadingly named law would have required physicians to present all research about possible health risks related to abortion, even if the information is outdated, false or misleading, to every woman seeking an abortion.  Stopping that law was a victory. But Nebraska is not done with its attacks on women’s rights.

On October 15, Nebraska will enact another law that will have a chilling impact on women’s abortion access.  This law will ban abortions 20 weeks after conception or later, with exceptions only in cases of medical emergency, the pregnant woman’s imminent death, or a serious risk of “substantial and irreversible physical impairment of a major bodily function.”  The bill is based on unsubstantiated and misleading “science” that claims that a fetus can feel pain at 20 weeks.  It is also the first law in the country to exclude a woman’s mental health as a reason for an abortion.  Before this law is replicated in other states, advocates have to prepare us to fight this blatant attack on our right to abortion.

As advocates, we need to be able to talk about the reliable science of fetal pain and the connection between physical and mental health. We need to educate others, and ourselves and combat the use of pseudoscience and unsubstantiated “facts” as tools in the war to limit access to abortion.

The question of whether or not a fetus feels pain during an abortion can be a troubling one to some women and clinicians. The science of what a fetus experiences is complicated – without verbal reports and direct access to the mind of a fetus, scientists can only make inferences about what fetuses are able to experience. What is known is that to experience pain, the brain and nervous system must be developed enough to both react to a noxious stimulus and to have the enough neurological development and organization to experience the stimulus as “pain.” Authorities in both the U.S and Great Britain have conducted thorough reviews of all available studies of fetal pain. Both groups of experts have found that there is no evidence that fetuses develop the neural pathways necessary to feel pain until well into the third trimester. In fact, there is increasing evidence that the fetus never experiences the state of true wakefulness that is necessary for the experience of pain.  Instead, new research shows that the fetus is kept in a continuous sleep-like unconsciousness by the presence of specific chemicals in the uterine environment.  This makes sense; if a fetus inside the uterus could experience pain in the way that a baby can outside of the uterus, the sensation of having its head squeezed through the vaginal canal during birth would be excruciating!  These facts should be very reassuring to women who seek abortions and are concerned about fetal pain.  Advocates need to use these facts to counter those who would use claims of fetal pain to limit our rights. (For more information on Fetal Pain, see this fact sheet and these articles).

While the question of fetal pain is complicated, the concept that preserving a woman’s mental and emotional health is not a “good enough” reason for an abortion is infuriating.  Mental health is as important to women’s well-being as is physical health. Our brains and bodies are connected, and this interconnectedness is well recognized in medicine and in health care legislation. Roe v. Wade recognized the threat to a woman’s mental health as a legitimate reason for ending an unwanted pregnancy.  The Nebraska ban, however, will disallow mental health as a reason for abortion after 20 weeks.  The Nebraska legislature has decided that avoiding theoretical fetal pain (based on discredited scientific theories) outweighs the emotional well-being of a pregnant woman.  Nebraska’s law limits a woman’s right to abortion through the second trimester as codified in Roe v. Wade and presents a clear challenge to Roe.  Once in place, this law will limit the practice of Dr. Leroy Carhart, who currently is the only provider in Nebraska and most surrounding states who provides abortions to 24 weeks (and later for fetal anomalies).  The Nebraska ban will mean more delays, travel, expense and barriers for women in the heartland of our country who need later abortion care.

This is yet another attempt to erode our right to abortion, law by law, week by week. What happens in Nebraska unfortunately won’t stay in Nebraska.  Get the facts and be prepared for similar controversies over fetal pain and mental health in your state. 

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  • forced-birth-rape

    Women have vaginal pain when they give birth, and risk being cut, or torn vaginally, and the pro-lifers are all so fast at serving a woman, little girl, or rape victim up for it against her will.

  • invalid-0

    Yes… and there’s NO risk of pain or risk of being cut or torn during an abortion past 20 weeks, right?

  • jayn

    Not as much as during a full-term birth.

     

    Besides, that’s not the point.  The real pain of the woman–both physical and emotional–is being ignored for the potential, unproven pain of the fetus.  Who cares how women get hurt, as long as the baaaaybee is okay.  We’re just the sacrifical lambs used to bring new lives into the world–OUR pain is unimportant.

  • forced-birth-rape

    arex, Most of my cousins are under five-feet-two,  they usually give birth to ten-pound-boys, eight-pound-girls, and have miserable pregnancys.

  • mechashiva

    Actually, there isn’t. Though it varies from clinic to clinic what point in gestation digoxin is used prior to an abortion (some use it for all 2nd trimester, some use it at 18+, some use it at 20+ LMP), generally it is used on fetuses 21 weeks LMP (that’s 19 weeks from conception) and over. So, the fetus is already dead when the surgical part of the abortion takes place. That means, no pain. Now, the injection of the digoxin could be painful (it’s a needle that delivers the drug straight to the heart sometimes, but other times just into the amniotic fluid which causes no pain).

     

    If fetal pain were really the issue, the laws would regulate standard abortion protocol (if, when, and how digoxin is used)… not make bans based on gestational age.

     

    Oh, and I just assumed you were asking about pain for the fetus since that’s what this thread is supposed to be about. With regards to the woman having an abortion, there is no risk of being cut because there are no sharp instruments used during an abortion. There’s no pain during the procedure, because patients more than 16 weeks LMP (14 from conception) are typically under general anesthesia during the surgery. This is definitely the case for late second trimester abortions like the ones talked about in the article… remember these are 22+ weeks LMP (20+ weeks from conception). There’s generally bad cramping afterward, but not as intense as following birth.

     

    Take it from someone who has actually worked in a clinic that provided these kinds of abortions… this law is stupid.

  • carolyninthecity

    That’s such a good point MechaShiva, I never thought about that- If they actually cared about fetal pain why not just mandate the use of drugs on the fetus in late abortions? 

    Anti-choice legislation is so sneaky! Politicians don’t play fair, it isn’t right. 

    One thing I’d like to see more of (and  it probably is happening and I’m just missing it), is doctors fighting back. This law, and other ones like it must infuriate physicians- and not just ones who work in abortion care. I know if some nonsensical law restricting my work was created by someone who didn’t really know anything about my field, I would be mega-pissed, to say the least. 

  • grayduck

    Authorities in both the U.S and Great Britain have conducted thorough reviews of all available studies of fetal pain. Both groups of experts have found that there is no evidence that fetuses develop the neural pathways necessary to feel pain until well into the third trimester.”

    The first link was dead when I accessed it. The assertion is completely false regarding the second link. That study indicated that fetuses probably had the capacity to experience pain by twenty-four weeks after the mother’s last menstrual period- or between twenty and twenty-four weeks after conception. As such, the study actually showed that the Nebraska law might allow the abortions of some fetuses who are capable of experiencing pain despite the mother not having any health motivation for the abortion. See my comments in the following link.

     

    http://www.rhrealitycheck.org/blog/2010/06/25/fetuses-weeks-gestation-cannot-feel-pain-experts-nebraska-hearing-wrong

  • jodi-jacobson

    perhaps you can tell me where it says what you claim.

     

    Here is the summary of the paper:

    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.

  • mechashiva

    I’d like to take this opportunity to point out that there is some uncertainty about whether pre-term infants are an appropriate experimental model for drawing conclusions about fetuses of the same gestational age. There are considerable differences between the neural activity of fetuses and pre-term infants due to the change in environment.

  • grayduck

    Forced birth is RAPE on September 13, 2010 – 7:29: Women have vaginal pain when they give birth, and risk being cut, or torn vaginally, and the pro-lifers are all so fast at serving a woman, little girl, or rape victim up for it against her will.

     

    I cannot speak for anyone else, but, if I had my way, the laws and the criminal justice system would not allow non-consenting women to be impregnated in the first place. So laws against abortion in that situation should rarely or never happen except to the extent of the limitations of public policy.

     

    With regard to consenting women, the birth can hardly be said to be against their will when they could have avoided their pregancies by choosing not to consent to sexual intercourse.

  • prochoiceferret

    With regard to consenting women, the birth can hardly be said to be against their will when they could have avoided their pregancies by choosing not to consent to sexual intercourse.

     

    With regard to traffic accidents, your severe brain injury can hardly be said to be against your will when you could have avoided the crash by choosing not to consent to drive an automobile.

  • brady-swenson

    This comment has been removed.


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  • grayduck

    Forced birth is RAPE on September 13, 2010 – 11:20am: “arex, Most of my cousins are under five-feet-two,  they usually give birth to ten-pound-boys, eight-pound-girls, and have miserable pregnancys.”

     

    Say what you will, but the way we all started our lives is not the alien torture that pro-choicers make it out to be.

     

  • equalist

    With regard to consenting women, the birth can hardly be said to be against their will when they could have avoided their pregancies by choosing not to consent to sexual intercourse.

    Because everyone knows that sex with her husband is something a married woman should have to go without for years on end should she decide that she does not want any more children, because otherwise she would be absolutely consenting to be pregnant. and thus bearing more children whether her finances, her mind, or her body can handle it.  My question for you though is what of her husband?  Are you advocating adultry, or are you saying that a married couple who’s relationship has nothing to do with you should remain celibate as long as they decide that their family is large enough in order to satisfy your personal moral code?  What of women who don’t want to become pregnant ever?  Should they just never consumate the marriage with their husbands, or are you against women who don’t want children ever having the right to a long lasting, stable, married relationship?

  • equalist

    Keep in mind, too, that the women in these cases almost always could have obtained an earlier abortion and could have avoided the pregnancy using highly effective contraception. Moreover, they rarely did everything in their power to ensure that the pregnancy would occur in a supportive environment.

    Because we all know birth control is 100% effective, and early term abortions are as cheap and easy to come by as bubblegum.

  • forced-birth-rape

    ~Speak for your self GrayDuck, and if you are a man, shut up.~

  • equalist

    Say what you will, but the way we all started our lives is not the alien torture that pro-choicers make it out to be.

    Not in all cases, but for some women, and in some cases, it is an all out torture.  I had relatively easy pregnancies with all three of mine, and even still, during my first pregnancy the prenatal vitamins made me so sick I could barely move and was unable to hold down most food for months.  My second pregnancy had the same results (without the influence of the vitamins as my doctor decided they did more harm than good), to the point that had the third anti nausea med they tried on me not worked, my doctor suggested a feeding tube would have been the next step.  And again, a similar situation with my third pregnancy.  As a result of my three pregnancies (all of which resulted in beautiful, healthy children that are now 10, 5 and 3 years old) my body will never return to anything remotely similar to what it was, I have chronic back pain, some of which is attributed to damage done by straining my lower back during the pushing phase of labor, and my teeth are so lacking in calcium that I’ve already had several pulled and am currently having to decide whether to have them all removed just to prevent future pain.  Giving birth takes a terrible toll on a woman’s body, not just during the pregnancy, but for years beyond, her body will be forever changed.

  • triumph

    It would be nice if both sides of the debate could talk in a civilized way without accusing each other and without twisting facts in whatever way it suits them.

  • rebellious-grrl

    Well then hell, women should avoid pregnancy by boycotting sex with ignorant narrow-minded anti-choice men. Luckily my husband/lover is PRO-CHOICE.

  • rebellious-grrl

    Tell that to my friend who almost died (from blood loss) each time she gave birth. Ever hear of maternal death or uterine rupture?
    http://en.wikipedia.org/wiki/Maternal_death

    Say what you will, but the way we all started our lives is not the alien torture that pro-choicers make it out to be.

  • saltyc

    So choosing to engage in sexual intercourse is what makes one not innocent. Bullshit.

    PS a real health exception would make all abortion legal.

    Unlike you, I pushed a baby out, and it was harder than anything you have ever done in your very long life, guilty grayduck.

    I call you guilty because I know as well as you do, that you have had sex. I wonder what kind of physical punishment that’s anything like carrying a pregnancy to term would be fitting for your guilt?

    No, I don’t really think in your terms, I say you’re guilty because of your sheer contempt for women.

    PS I wonder what we’re supposed to learn from your video link of a late-term abortion (the fetus may well have been dead long before the procedure)  to tell us that the woman is guilty and the fetus is innocent. Is it the fact that the woman in the video has dark skin, whereas the dead fetus has white skin? Well, what? Tell us. And do you agree with the caption put on the video by the author that

    The mother and abortionists of this baby should be put up against a wall and executed.

    If not you should have made a disclaimer, while promoting it.

  • rebellious-grrl

    Agreed SaltyC, you can clearly hear his contempt for women in his writing. Thanks for the post.

  • squirrely-girl

    I agree triumph and I believe there are plenty of people on both sides that are interested in productive dialogue. We just tend to get drowned out by the extremists on both sides screaming at the top of their lungs. :(

  • catseye71352

    Since he insists that consent to sex = consent to pregnancy, he very likely ALSO believes that consent to dinner and a movie = consent to sex.

  • killingmother

    Making abortion illegal costs more lives than it saves.  Desperate women will get an abortion whether it’s legal or not, with the end result being both maternal and fetal death.  Advocates of women’s reproductive freedom need to be just as vocal as the irrational RTL voices.  http://killingmother.blogspot.com/2009/11/world-population-part-iii.html