Fetuses may not feel pain until week 30
They are “unlikely” to be able to feel pain until the last stage of pregnancy, a controversial US study claims, adding to the debate on abortion laws. Fetuses are unlikely to be able to feel pain until the last stage of pregnancy, a controversial new US study suggests. The analysis of medical literature relating to […]
They are “unlikely” to be able to feel pain until the last stage of pregnancy, a controversial US study claims, adding to the debate on abortion laws.
Fetuses are unlikely to be able to feel pain until the last stage of pregnancy, a controversial new US study suggests.
The analysis of medical literature relating to fetal pain concludes that fetuses of less than 30 weeks are unlikely to feel pain. It concludes that vital brain connections relating to pain perception form only between 23 to 30 weeks of gestation, and even if formed are unlikely to be functional until 30 weeks.
The findings come into direct conflict with legislation in several US states – and a proposed US Congress Bill – that requires doctors to inform women seeking abortions 20 weeks after conception that the fetus can feel pain. The physician must also offer to give an anaesthetic or painkiller directly to the fetus.
“Evidence is limited but indicates that fetal perception of pain is unlikely before the third trimester,” write the researchers, led by Mark Rosen at the University of California, San Francisco, US.
They add in the Journal of the American Medical Association (JAMA): “Fetal anaesthesia or analgesia should not be recommended or routinely offered for abortion because current experimental techniques provide unknown fetal benefit and may increase risks for the woman.”
Politics and ideology
“For two years, we’ve had a committee of leading experts studying this issue, and they reached the same conclusions the authors of this study did,” says Wendy Chavkin, chair of the Physicians for Reproductive Choice and Health, based in New York City, US.
“Laws dealing with this issue aren’t about medicine or public health – they’re about politics and ideology,” she adds. “This new JAMA article is another indication that legislation on this issue has no medical or scientific basis. These laws would force doctors to provide inaccurate, incomplete information to their patients.”
She claims the proposed laws are “clearly intended to stigmatise abortion, the women who have abortions and the doctors who provide them”.
But the study is likely to upset others. “This is going to inflame a lot of scientists who are very, very concerned and are far more knowledgeable in this area than the authors appear to be,” Kanwaljeet Anand, a fetal pain expert, at the University of Arkansas told the Associated Press. “This is not the last word – definitely not.”
Psychological nature
The authors of the controversial review define pain as “a subjective sensory and emotional experience that requires the presence of consciousness to permit recognition of a stimulus as unpleasant”.
It is this psychological nature of pain which distinguishes it from automatic responses to physical stimuli, like the reflex reaction. Fetuses do show some withdrawal reflexes and “facial movements similar to those of adults experiencing pain” in behavioural studies. But these movements may not be necessarily controlled by the cortical area of the brain, they say.
Fetal awareness of pain would require nerve connections to a region of the brain called the thalamus to be wired and working. But the studies analysed suggest this does not exist before 29 to 30 weeks.
Journal reference: Journal of the American Medical Association (vol 294, p 947)
