New York Times Magazine Examines Views About Fetal Pain, Effects On Abortion Policy

Main Category: Abortion
Also Included In: Pain / Anesthetics;  Pediatrics / Children's Health
Article Date: 13 Feb 2008 - 5:00 PST

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The New York Times Magazine on Sunday examined different views about fetal pain among medical experts, lawmakers and advocates, as well as how such views have affected abortion policy.

According to the Times Magazine, some research -- including studies conducted by Sunny Anand, a pediatrician at Arkansas Children's Hospital and a professor at the University of Arkansas for Medical Sciences -- has suggested that fetuses can feel pain beginning at about 20 weeks' gestation. However, a 2005 review of 2,000 medical journal articles that involved fetal pain studies found that fetuses do not have the capacity to feel pain until about 29 to 30 weeks' gestation. The review was conducted by Mark Rosen and colleagues at the University of California-San Francisco and published in the Journal of the American Medical Association.

According to the Times Magazine, some researchers believe that fetal responses interpreted as pain are just reflexes to the fetus' environment. Still other researchers, including University of Birmingham physiologist Stuart Derbyshire, believe that pain is not inherent at birth but rather is a learned experience during an infant's first year. Marc Van de Velde -- an anesthesiologist and pain expert at the University Hospital Gasthuisberg in Leuven, Belgium -- said the debate is "irrelevant" as to whether to give anesthetic to a fetus when performing a prenatal surgery. "We know that the fetus experiences a stress reaction, and we know that this stress reaction may have long-term consequences -- so we need to treat the reaction as well as we can," Van de Velde said.

However, the debate about fetal pain is "not irrelevant when applied to abortion," the Times Magazine reports. Since 2004, antiabortion groups have cited fetal pain in their efforts to restrict or ban abortion. In 2004, Anand testified as an expert witness in a case involving the federal ban (S 3) on so-called "partial-birth" abortion. Anand told the court that he "assume[d]" the procedure would cause "severe and excruciating pain" in fetuses beginning at 20 weeks' gestation. After Anand's testimony, federal Judge Richard Kopf in his opinion said it was impossible for him to determine whether a "fetus suffers pain as humans suffer pain." Kopf ruled the law unconstitutional on other grounds, but the law was upheld in April 2007 by the U.S. Supreme Court.

Legislative Implications

According to the Times Magazine, Anand's 2004 testimony "helped clear the way for legislation aimed specifically at fetal pain." Sen. Sam Brownback (R-Kan.) in 2004 and every year since has introduced a bill he called the Unborn Child Pain Awareness Act. The measure would require physicians to tell women seeking abortions at 20 weeks' gestation or later that their fetuses could feel pain and offer to deliver anesthesia "directly to the pain-capable unborn child." State-level legislation similar to Brownback's bill also has been introduced in 25 states. Five states -- Arkansas, Georgia, Louisiana, Minnesota and Oklahoma -- have passed the measures into law. In addition, abortion counseling materials in Alaska, South Dakota and Texas mention fetal pain.

Anand -- who studied at Oxford University and Harvard University -- has become the "favorite expert" of abortion-rights opponents "precisely because of his credentials" as a neonatal pediatrician, the Times Magazine reports. Rep. Mike Pence (R-Ind.) in 2004 said Anand's position is "made more astonishing" because he is not the "stereotypical" opponent of abortion rights. Although Anand believes that decisions on abortions should be made on a case-by-case basis, antiabortion advocates who quote him are "clear[ly]" attempting to change "perceptions of the fetus," according to the Times Magazine. Abortion-rights opponents who cite Anand are aiming to "personif[y]" the fetus by telling women seeking abortion that their fetuses can feel pain in an effort "to steer the woman's decision away from abortion," Elizabeth Nash, a public policy associate at the Guttmacher Institute, said.

Laura Myers -- an anesthesia researcher at Children's Hospital Boston and Harvard Medical School who analyzed Brownback's measure -- said abortion clinics do not have the necessary equipment to administer anesthesia to fetuses. Brownback's bill "makes a promise that the medical community can't fulfill," Myers said, adding that providing fetal anesthesia during abortions would be an experimental procedure that could carry health risks for the woman, including infection and bleeding. Rosen said that anesthesia during fetal operations is necessary to prevent complications but that administering anesthesia during abortions could endanger the woman's health. It is not "erring on the safe side" to endanger a woman's health by administering fetal anesthesia before an abortion, Rosen said (Paul, Times Magazine, 2/10).

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