In defense of the sanctimonious women's studies set || First feminist blog on the internet

Fetal Pain Is a Myth

Lauren

Taking on one of the most highly charged questions in the abortion debate, a team of doctors has concluded that fetuses probably cannot feel pain in the first six months of gestation and therefore do not need anesthesia during abortions.

Their report, being published today in The Journal of the American Medical Association, is based on a review of several hundred scientific papers, and it says that nerve connections in the brain are unlikely to have developed enough for the fetus to feel pain before 29 weeks.

The finding poses a direct challenge to proposed federal and state laws that would compel doctors to tell women having abortions at 20 weeks or later that their fetuses can feel pain and to offer them anesthesia specifically for the fetus.

UPDATE: And more context for the study.

18 thoughts on Fetal Pain Is a Myth

  2. Lauren,
    Saying that “fetal pain is a myth” because one study (whose lead researcher was a medical student) with a number of pro-choice authors (one of whom directs an abortion clinic) found that fetal pain is unlikely before 29 weeks would be something I would think below you.

    What fetal pain for 30 week fetuses? Is that a myth too?

    What about children born before 29 weeks? Have you read studies on the pain of premies? Did this study take those into account?

    You could try linking to something a little more comprehensive – say, the Britisth Medical Association’s take on fetal pain – http://www.bma.org.uk/ap.nsf/Content/AbortionTimeLimits~Factors~pain

  3. Considering the study was done using “several hundred” papers by a slew of doctors, I assume our polemics don’t matter much in the way of education and access to their materials. I neglect to see how a person who runs an abortion clinic should not have an interest in this kind of study. An agenda, perhaps, but it’s their job to be knowledgeable. I’d rather that than holding onto some fantastical idea of what human developement looks like.

    Fetal development is pretty standard. The study you cite says that because the cerebral cortex doesn’t form until week 26 that a fetus cannot feel pain. In fact, it cites that anaesthesia is to comfort parents and doctors, not fetuses.

    Read your whole article, not just the introduction.

  5. Jiven: Have you read your own link? Quoting from the BMA link you provided: “…current mainstream professional guidance suggests that a fetus cannot begin to have the possibility of experiencing pain until after 26 weeks’ gestation.”

  6. I should have mentioned early that the “study” isn’t really a study – it’s a meta-analysis. A meta-analysis is fairly easy to direct/control if you like because you can choose what information to include and what information to not include.

    I did read the whole article I posted. Notice how I mention something more “comprehensive.” Expert opinions on when pain starts vary and no one seems to be certain. My point is that simply declaring something a “myth” based on reading one NY Times article on one meta-analysis seems to be jumping to conclusions especially when the authors seem to be politically motivated.

    You are incorrect regarding the cerebral cortex – it begins to form long before 26 weeks. It actually begins to differeniate from the other parts of the brain at around 33 days after conception. The BMA article states that the different parts of the brain and other important parts of pain perception aren’t completely structurally integrated.

    Here’s the abstract – http://jama.ama-assn.org/cgi/content/short/294/8/947
    Notice how the writers don’t have a date limitation – this caught my attention because the widespread knowledge that newborns feel pain is fairly new in terms of medical history (last 20 years or so).

    Also notice this quote, “Pain perception requires conscious recognition or awareness of a noxious stimulus. Neither withdrawal reflexes nor hormonal stress responses to invasive procedures prove the existence of fetal pain, because they can be elicited by nonpainful stimuli and occur without conscious cortical processing”

    They basically define pain how they want to and then unequivocally assert that other types of evidence for pain don’t count.

    By the way, I love your pictures of Pablo. I have a mainecoon and a half mainecoon at home. Not quite as hefty, though.

  7. Oops, Lauren already said it.

    Javin also criticized the paper based on the educational status and affilitations of the authors. At risk of sounding condescending, let me just say that the purpose of having peer reviewed literature is to make sure that the data in publications are sound regardless of the authors’ personal or political views. JAMA is a highly respectable journal and the paper was probably reviewed by 3-4 reviewers and at least one editor, all of whom were aware of where the authors worked, before being accepted. The data are the data, whether they show what the authors wanted them to or not.

  8. “They basically define pain how they want to and then unequivocally assert that other types of evidence for pain don’t count.”

    Uh, they said that pain only “counts” if it is perceived and that responses to noxious stimuli that do not involve awareness of that stimuli are not pain. When people have surgery on their intestines, their intestines react to the noxious stimulus of being cut. However, the person in question is asleep and completely unaware–hence, in no pain. In a fetus that has not developed sufficiently, the neurology required for feeling pain does not exist so it is not possible for them to feel pain.

  10. Hi Dianne,
    Well that depends on who’s reviewing the literature, doesn’t it?

    Also, you seem to not know that the JAMA spokesperson has said that they were unaware of the researchers’ pro-choice connections. Either that shows an extremely high level of incompetence (is it that hard to check credentials?) or that they really knew and didn’t care.

    Why would I need to be aware of what is causing me pain (noxious stimuli) in order to feel pain? For example, can’t babies who might have no clue what is hurting them still be in pain? Can’t I have stomach pain even if I don’t know if the pain was caused by bad Chinese food or stomach cancer?

    I think sheep aren’t human beings. I would also question the “postulation” (aka unproven theory) that an organism can’t feel pain unless it has a high level of oxygen. Also, since when does a high level of oxygen support awareness.

  11. Jivin:

    The first article you posted is comprehensive like this: “some people say this, others say that, but there’s no proof that fetuses feel pain.”

    I quoted a NYTimes article, a paper that seems to be masquerading as news lately, so if you don’t like it take it up with their editors. Or even better, with JAMA. I’m sure they’ll appreciate your expertise. In the meantime, I aim to comment on news that interests feminists, like this article.

  12. But Lauren you’re still not admitting that calling fetal pain a myth is quite inaccurate (especially since the recent study doesn’t make any conclusion or claim about fetal pain after 29 weeks).

    It’s comprehensive with regards to the fact that it links to a variety of references of various studies with various conclusions. It never says there is no proof fetuses feel pain. It says “no incontrovertible evidence that fetuses experience pain” – of course their is no incontrovertible evidence – we can’t poke a fetus with a needle and then ask them, “Did that hurt?”

    If you just wanted to link to the article and summarize it I would have never commented but you inaccurately called fetal pain a myth based on reading one story in the NY Times.

  13. To be more accurate, the NYTimes article says that fetal pain is “probably” a myth. And it’s even in my blockquote! Yeah!

    That’s why I included a link. You can read it yourself if you’re so inclined. Any more semantic questions?

  14. And you know, I don’t heed much to people who accuse others of having an agenda when that person himself is quite open about his own opposing agenda.

  15. “since when does a high level of oxygen support awareness.”

    Since the evolution of the cerebral cortex. Why do you think that the plane in Greece crashed? The plane depressurized and the pilots didn’t have enough oxygen to stay conscious.

  16. That’s the thing Lauren, the researchers weren’t open about their agenda or their positions in abortion advocacy organizations. I’m much more open to trusting someone who comes out and says, “I work for so and so” instead of someone who works for “so and so” yet doesn’t openly admit that. It just seems like they were tring to hide their advocacy.

    It says “myth” in your blockquote? Where? I don’t see it.

  17. Dianne,
    Did the pilots not have “high levels” of oxygen or hardly any oxygen at all?

    I’m also wondering if we’re talking about two kinds of consciousness/awareness and talking past each other a bit. For example, when I fall asleep I’m unconscious but that obviously doesn’t mean that I lose my ability to be an aware organism.

    Research with unborn children shows that they have sleep/awake cycles before birth so I doubt they need to breathe through their lungs to be awake.

    http://www.leaderu.com/orgs/tul/psychtoday9809.html

  18. “Did the pilots not have “high levels” of oxygen or hardly any oxygen at all?”

    In the abstract I refered you to, “high levels” of oxygen meant the levels associated with breathing air with healthy lungs at sea level. A fetus has a pO2 (partial presssure of oxygen) of around 20-30 and a hemoglobin O2 saturation of around 70%. A person breathing air (trying not to either endorse or deny the “personhood” of a fetus for the moment, for the sake of argument) has a pO2 in the 80-100 range and an O2 sat of 98%. I’ve never seen a pO2 of less than 50 or sat of less than 85% on an awake, alive person (and he was pretty disoriented). So it’s likely that even after the neurons are in place and hooked up to each other, the fetus is not concious simply because it doesn’t have enough oxygen for the cortex to operate properly. Evolutionarily, why should it be concious? It’s not like it has something to do.

    “I’m also wondering if we’re talking about two kinds of consciousness/awareness and talking past each other a bit. For example, when I fall asleep I’m unconscious but that obviously doesn’t mean that I lose my ability to be an aware organism.”

    I think you’re right. The sort of lack of awareness I’m talking about is more like being unconcious under deep anesthesia than being asleep. Sleep is actually a quite active state.

    “Research with unborn children shows that they have sleep/awake cycles before birth so I doubt they need to breathe through their lungs to be awake.”

    Sleep and activation are brain stem functions. The brainstem is much more tolerant of low oxygen levels than the cortex. A term I’ve heard is “usable consiousness”. A person can be apparently awake (ie eyes open, sitting up) and completely unaware of his or her environment if the cortex is not receiving enough oxygen to function. I don’t know if anyone’s ever done an EEG on a person in such a state, but I suspect it would show an active brainstem in an “awake” configuration, but no specific activity from the cortex.

    All that having been said, I would use fetal anesthesia in a third trimester abortion (except on an ancephalic fetus, where it’s clear that the fetus doesn’t have the brain to feel anything). It’s likely that the fetus feels no pain, but the risk to the mother is fairly minor and it would save everyone wondering whether they might have made a dreadful mistake.

Comments are currently closed.