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Can a fetus feel pain?

Various opinions

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Overview:

The short answer is yes. At some stage during pregnancy, a fetus becomes capable of feeling pain. But, there appears to be no consensus among experts about the point in the pregnancy when this happens:

bulletMany physicians and researchers into fetal development, who are not pro-choice, believe that synaptic connections within the fetus' brain are necessary to perceive pain. These are not formed until well into the third trimester, when fewer than 1% of all pregnancy terminations are done.
bulletOthers, who tend to be pro-life advocates, believe that a fetus as early as 7 weeks after conception can feel pain. Thus, they believe that a fetus can feel pain part way through the first trimester, when most abortions are performed

It would appear that some of the experts' opinions are so heavily biased by their pro-life/pro-choice stance that they are incapable of making objective observations.

Many women seriously consider this factor when they are deciding whether or not to have an abortion. They are reluctant to submit to an operation that would be painful to the fetus. Women deserve to have precise information on which to base their decision. Unfortunately, emotional factors seem to intrude in this, as in all other matters related to abortion. Information is very easy to find. But its accuracy is almost impossible to evaluate.

Pain in an adult, child, newborn or late-term fetus originates as an electrical signal in some of the body's pain receptors. This signal is sent via nerve pathways to the spinal column, then to the thalamus - an egg-shaped structure within the brain. Finally the signal is transferred to the cerebral cortex where it is sensed as pain. In a fetus, the pain receptors develop around 7 weeks after conception; the spino-thalamic system at about 13 weeks. Finally, the connections to the cortex are established about 26 weeks into pregnancy. Some pro-life advocates believe that pain can be felt by the fetus when these systems are only partly formed. Most pro-choice advocates believe that the complete system has to be "wired up" before the fetus can feel pain - i.e. at about 26 weeks into pregnancy.

Statement by a Panel of Experts:

The issue of fetal pain was addressed by a working group appointed by the Royal College of Obstetricians and Gynecologists in the United Kingdom. The panel consisted of experts in fetal development, law and bioethics. Dr. Anne McLaren headed the group. She commented: "Fetal awareness of pain is a very emotive topic, of particular concern to pregnant women, but we have tried to approach it without preconceptions, to examine the scientific evidence dispassionately, and to identify areas where further research is urgently needed.'' 1

The group determined that pain can only be felt by a fetus after nerve connections became established between two parts of its brain: the cortex and the thalamus. This happens about 26 weeks from conception.  Professor Maria Fitzgerald of University College London, author of the working group's report, says that "little sensory input" reaches the brain of the developing fetus before 26 weeks. "Therefore reactions to noxious stimuli cannot be interpreted as feeling or perceiving pain." 10

They recommended that the administration of painkillers should be considered before an abortion for any fetus which is 24 or more weeks since conception. This would give a 2 week safety factor in case the date of conception is incorrectly calculated.

Recent statistics show that of the 177,225 abortions performed in Britain during a recent year, 92 (0.05%) occurred after 24 weeks.

Statement by an "All Party Parliamentary Pro-Life Group"

A group of pro-life advocates from various political parties in England issued a statement on "Foetal Sentience" in 1996.  They concluded:

"Since no direct objective method of assessing fetal pain exists, the crucial question with regard to fetal sentience is:  At what stage of human prenatal development are those anatomical structures subserving the appreciation of pain present and functional?

The balance of evidence at the present time indicates that these structures are present and functional before the tenth week of intrauterine life.
" 8

Statement by Dr. Paul Ranalli

Dr. Ranalli is a neurologist at the University of Toronto, in Toronto Canada. He is acting president of the de Veber Institute for Bioethics and Social Research. He gave a presentation called "Pain, Fetal Development, and Partial-birth abortion" on 1997-JUN-27 to the House Judiciary Committee of the State of Ohio. 2,3 He has concluded that the "spino-thalamic" system is fully developed at about 12 to 14 weeks of gestation. This is the system that conveys pain signals from pain receptors throughout the body to the thalamus. He apparently believes that the thalamus can feel pain, even though a connection between it and the cortex is missing.

To support his belief that a fetus in the second trimester can feel pain, he cites three signs:

bulleta fetus will "withdraw from painful stimulation"
bullettwo types of stress hormones which are detected in adults who are feeling pain are also found in a fetus from when a blood sample is withdrawn. He quotes:
bulletNicholas Fisk of London, England who observed this reaction as early as 19 weeks 4, and
bulletJ Partch of Kiel, Germany who observed it at 16 weeks.

Commission of Inquiry into Fetal Sentience

The House of Lords in Britain conducted an inquiry into "fetal sentience." 5 One part of the study dealt with the ability of a fetus to feel pain. Conventional wisdom among researchers is that the brain's cortex is the only location where pain can be felt. However, they mention recent evidence that if an adult suffers from an injury or disease which causes the cortex to function poorly, that some sensation may be felt from an area lower in the brain. They speculate that a fetus may be able to sense some "form of pain sensation or suffering" before the cortex is linked to the lower levels of the brain. They note that babies who are born with a major brain defect can sometimes feel pain. This includes babies born with hydranencephaly in which "the cerebral hemispheres are substantially or entirely absent at birth" and anencephaly, in which "the cerebral hemispheres and the top of the skull may be absent."

They concluded:

bullet"After 23 weeks of growth, higher areas of the brain are active and starting to form connections with nerves that will convey pain signals to the cortex."
bullet"By 24 weeks after conception the brain is sufficiently developed to process signals received via the thalamus in the cortex."
bullet"While the capacity for an experience of pain comparable to that in a newborn baby is certainly present by 24 weeks after conception, there are conflicting views about the sensations experienced in the earlier stages of development. The current scientific understanding is that 6 weeks after conception the elements of the nervous system start to function. Most scientists currently agree that this marks the earliest possible point at which sensation might occur."6

Statement by the Medical Research Council at Edinburgh University, UK:

According to Fox News for 2001-AUG-31, the Council's study revealed that "a fetus was absolutely aware of pain by 24 weeks." This is earlier than the 26 weeks previously accepted by medical specialists.

Statement by Vivette Glover:

Professor Glover of Queen Chalotte's and Chelsea Hospital in London, UK, believes that there is a possibility that a fetus aged 18 weeks can feel pain. On 2000-AUG, she recommended that late pregnancy terminations be done under anesthetic. She suspects that the fetus would not respond to sensations in the same way as newborns. It is unlikely to produce the feelings of anxiety that people have. 10

Statement by Professor Robert White

Dr. White gave testimony before the House Constitution Subcommittee.  He stated that the fetus at 20 weeks gestation "is fully capable of experiencing pain...Without question, all of this is a dreadfully painful experience for any infant subjected to such a surgical procedure."

1984 Statement by a Group of Physicians

In a speech by then President Ronald Reagan to National Religious Broadcasters in 1984-JAN, he said  "When the lives of the unborn are snuffed out, they often feel pain, pain that is long and agonizing." 7
This belief was denied by some experts. However a group of "professors, including pain specialists and two past presidents of the American College of Obstetrics and Gynecology" wrote a letter to President Reagan supporting his statement. They wrote:

"We state categorically that no finding of modern fetology invalidates the remarkable conclusion drawn after a lifetime of research by the late Professor Arnold Gesell of Yale  University. In The Embryology of Behavior: The Beginnings of the Human Mind (1945, Harper Bros.), Dr. Gesell wrote, 'and so by the close of the first trimester the fetus is a sentient, moving being. We need not speculate as to the nature of his psychic attributes, but we may assert that the organization of his psychosomatic self is well under way.' "

Use of anesthetic during late term pregnancy terminations:

A bill was introduced to the Health Committee of the California Assembly on 1998-MAY-5. It would have required that pain medication be used to anesthetize the fetus during any late-term pregnancy terminations. 9 The cutoff age the start of the third trimester; after this gestational age, anesthetics would be compulsory during any hysterotomy or D & X procedure. The intent of the legislation was to make certain that the fetus did not feel pain. The bill was rejected by the committee.

There was some indication that Planned Parenthood Federation of America is opposed in principle to such legislation. This is not true. A spokesperson for PPFA responded to our inquiry on 1999-MAY-4 with: 

"Planned Parenthood does not currently have an official statement specifically regarding fetal anesthetic use."

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References:

  1. "The Republican" Web site contains an news report from an uncited British source at: http://www.ideasign.com/chiliast/abortion/pain.htm
  2. Carolyn C. Gargaro's home page has an essay: "Does the Fetus Feel Pain?" at: http://www.gargaro.com/fetalpain.html
  3. Paul Ranalli, "Abortion and the Unborn Baby: The Painful Truth," is available on the California Pro-Life Council home page at: http://www.californiaprolife.org/paintrut.htm
  4. N.M. Fisk et al, "Fetal plasma cortisol and beta-endorphin response to intrauterine needling." The Lancet 344, 77-81 (1994)
  5. "The Problem of Pain: A Report by the Commission of Inquiry into Fetal Sentience" at: http://www.care.org.uk/issues/fs/hs05.htm
  6. "The Timing And Development Of Mechanisms For Pain Reception: A Report by the Commission of Inquiry into Fetal Sentience" at: http://www.care.org.uk/issues/fs/hs06.htm
  7. Ohio Right to Life has a copy of a letter to President Reagan at: http://www.ohiolife.org/qa/qa10.htm
  8. "Foetal Sentience," Catholic Medical Quarterly, XLV11 no 2, 1996-NOV, Page 6. Reprinted at: http://homepage.interaccess.com/~dfroula/steve/fpain.html
  9. George Runner, (R-Lancaster) California Assembly bill AB 1758, introduced on 1998-MAY-5.
  10. "Abortion causes feotal pain," BBC News, 2000-AUG-29 http://news.bbc.co.uk/hi/english/health/newsid
  11. Kelley O. Beaucar, "Fetal study adds fuel to late-term abortion debate," Fox News, 2001-AUG-31, at: http://foxnews.com/story/0,2933,33437,00.html

Copyright © 1999 to 2001 inclusive by Ontario Consultants on Religious Tolerance
Latest update: 2001-SEP-1
Author: B.A. Robinson

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