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He blinded me with science

Posted by Joshua Holland at 11:28 AM on January 25, 2006.


"Fetal pain" is just one more bit of propaganda for the forced childbirth set.
eight weeks
eight weeks

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Several of us "blogged for choice" on Sunday, the anniversary of Roe v. Wade. A commenter on a recent post, who I have no doubt is sincere in his or her beliefs, wrote this (and left a similar comment on another post):

My opposition [to abortion] has nothing to do with law, it has to do with the often-protracted suffering of those being aborted. Some procedures, such as saline poisoning, cause the baby to suffer for hours as he is being burned to death by the solution… it may take the baby many hours of intense suffering before he dies.
Not surprisingly, there's a blizzard of misinformation out there on the subject of "fetal pain." On this site, belonging to a "crisis pregnancy center," they say an eight-week old fetus is a "tiny human [who is] perfectly developed, with long, tapering fingers, feet and toes."

This site, by an anti-choice group, backs up its assertion that at eight weeks a fetus has the capacity to experience pain with some pretty convincing sounding science:
By this age the neuro-anatomic structures are present. What is needed is (1) a sensory nerve to feel the pain and send a message to (2) the thalamus, a part of the base of the brain, and (3) motor nerves that send a message to that area. These are present at 8 weeks. The pain impulse goes to the thalamus. It sends a signal down the motor nerves to pull away from the hurt.
They offer as further evidence, under the heading "Give me more proof," this: "In 1984 President Reagan said: "When the lives of the unborn are snuffed out, they often feel pain, pain that is long and agonizing," followed by a letter supporting Reagan from "an auspicious group of professors."

After perusing the abortion sites, pro and con, I figured I'd shine some serious scientific light on the subject. The short version is: this is all disinformation according to the best available science.

To cut through the crap, I went outside of the debate, to peer-reviewed scientific journals, specifically a review article in the Journal of the American Medical Association and another in Pain, a journal for clinicians in the business of pain management. The author of the latter went so far as to note that he wasn't trying to weigh in on abortion, but to give clinicians a handle on how to treat pregnant women.

Before I get to the science, though, some reality-based data on the crucial issue of when women terminate a pregnancy. According to the Allan Guttmacher Institute - whose data is used by both sides - 98.6 percent of abortions take place at or before 20 weeks. Almost nine out of ten happen before 12 weeks. That's key. The majority of the remaining 1.4 percent are due to complications that threaten the pregnant woman.

With that in mind, let's look at the science, which I'll annotate (feel free to skip the gobbledy-gook if you trust me to translate it accurately). According to Pain:

Fitzgerald (1987, 1994), who has reviewed the biological development of the fetus and examined the possibility of fetal pain at each stage of development. At 7.5 weeks' gestation, reflex responses to somatic stimuli begin, and touching the perioral region results in a contralateral bending of the head. The palms of the hands become sensitive to stroking at 10.5 weeks, and the rest of the body and hindlimbs become sensitive at approximately 13.5 weeks. Shortly after the development of sensitivity, repeated skin stimulation results in hyperexcitability and a generalized movement of all limbs. This hyperexcitability has been interpreted as evidence for the presence of a functional pain system, reflecting an immature but intact pain response with early hypersensitivity to stimulation (Barr, 1994). This view is not widely accepted, however, and is rejected by Fitzgerald herself. Prior to 26 weeks, the thalamocortical fibers have not yet penetrated the cortical plate, and it seems unlikely the cortical structures considered necessary for pain are responding to noxious stimulation (Mrzljak, Uylings, Kostovic, & van Eden, 1988).
Translation: as early as 7.5 weeks, there are autonomic responses that are consistent with a reaction to pain. This "has been interpreted" (I wonder by whom) as evidence of prenatal pain. But the researchers who did the study reject that view, and it is "not widely accepted."
Giannakoulopoulos et al. (1994) from the Queen Charlottes Hospital in London, England, successfully demonstrated intrauterine needling to obtain blood samples from fetuses at 20 to 34 weeks' gestation results in a hormonal stress response. They demonstrated that needling the innervated intraabdominal portion of the umbilical vein, rather than the placental cord (which is not innervated) resulted in increased cortisol and b-endorphin concentrations in fetal plasma.
Translation: research has shown that between 20-34 weeks of gestation (remember: 1.4% of abortions), there's an endocrine response that is consistent with the stress reaction observed in fully formed people.

But…
The undisputed discovery that the neonate and fetus launch a hormonal and neural response to invasive practice cannot be considered proof there is an experience of pain. An experience implies sensations have been interpreted in a conscious manner…
Although all of these phenomena are associated with the notion of "pain," none of them adequately describe or explain the phenomenological experience of "pain." These phenomena may exist independently of conscious experience…
Pain experience is now widely seen as a consequence of an amalgam of cognition, sensation, and affective processes, commonly described under the rubric of the biopsychosocial model of pain. Pain is no longer regarded as merely a physical sensation of noxious stimulus and disease, but is seen as a conscious experience that may be modulated by mental, emotional, and sensory mechanisms with sensory and emotional components. The biopsychosocial concept emphasizes the multidimensional nature of illness, injury, and pain, rather than emphasizing pain as a purely physical fact of illness or injury.
If this 'multidimensionality' is the basis of conscious pain experience, it seems unlikely we can attribute this experience to the neonate or unborn fetus, which is naive to the cognitive, affective, and evaluative experiences necessary for pain awareness. This is accepted in the current definition of pain, which is further expanded to state, "Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life." Pain does not, so to speak, spring forth from the depths of the person's mind prior to any experience, but is gradually formed as a consequence of general conscious development.
Interestingly, even those authors who support a concept of fetal pain tend to back away when confronted with the need to explain pain phenomenology. Giannakoulopoulos et al (1994), for example, distanced themselves from any implied fetal pain experience with the statement, "a hormonal response cannot be equated with the perception of pain." Lloyd-Thomas and Fitzgerald (1996) have suggested if feeling and pain are properly understood, the fetus cannot be said to feel pain.
A further reason to doubt the viability of fetal pain post-26 weeks' gestation is the development of the fetal cortex. Although the thalamocortical fibers penetrate the cortical plate at approximately 26 weeks' gestation, the cortical regions that have been identified as important in processing the various components of pain (Derbyshire, 2000) do not become fully responsive until after birth (Chugani & Phelps, 1986).
Translation: pain, as we understand it, is a combination of stimulus, cognition and experience. Even the researchers who have done the studies the forced childbirth movement likes to cite back off of the notion that a developing fetus can experience "pain." And there are neurological structures associated with pain, as we know it, that don't fully develop until after birth. Again, the evidence is based on studies looking at fetuses after 20 weeks, after 98.6% of abortions occur.

The Journal of the American Medical Association concurs:
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. Fetal awareness of noxious stimuli requires functional thalamocortical connections. Thalamocortical fibers begin appearing between 23 to 30 weeks' gestational age, while electroencephalography suggests the capacity for functional pain perception in preterm neonates probably does not exist before 29 or 30 weeks…
Evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester.
Of course, this doesn't prove anything; the point is there's no scientific evidence to support the claim that a fetus or embryo experiences pain. And the larger point is that those who make those claims do so based on ideology, not science.

They are, as I've said before, hucksters dedicated to muddying the waters of intelligent debate with rhetoric meant only to stoke their followers’ righteous rage.

And this particular piece of intellectually dishonest rhetoric is being used to stigmatize women seeking to terminate a pregnancy. Last year Minnesota Citizens Concerned for Life pushed a “fetal pain law” that requires doctors to give higher doses of anesthesia to women seeking abortions after 20 weeks (there were 67 such abortions out of 14,000 performed in minnesota), a practice that the American College of Obstetricians and Gynecologists says puts women at greater medical risk.

Update: The Department of Health and Human Services sent a bill to the House yesterday modeled on Minnesota's bill.

Digg!

Joshua Holland is a staff writer at Alternet and a regular contributor to The Gadflyer.


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Good, but...
Posted by: laura153 on Jan 25, 2006 12:25 PM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Thanks for all the work you put into this post. Now if only the anti-choice side would actually listen to things like logic, reason, and cold-hard science...

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» RE: Cold Hard Science Posted by: uksda
» RE: Cold Hard Science Posted by: Ian MacLeod
» RE: Cold Hard Science Posted by: VannaLaRoche
» RE: Cold Hard Science Posted by: Ian MacLeod
» RE: Cold Hard Science Posted by: Ian MacLeod
well I'll tell you one thing for sure
Posted by: sln70 on Jan 25, 2006 12:26 PM   
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fully grown women feel pain. It hurts to have your period, hurts be pregnant, hurts to give birth, hurts to have an abortion.

My body, my pain, my choice.

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But, how is any of this relevant?
Posted by: Kneel on Jan 25, 2006 7:25 PM   
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I actually think this plays in a bit to wrong side of the debate.

Because it seems to imply, somehow, that if if it could be solidly established that a fetus at X weeks feels pain, that would somehow provide justification for restricting the right to terminate a pregnancy.

Is there a point where we could agree that a fetus feels pain? At 5 or maybe 8 months? What happens after that?

Would you support the right to an abortion for a woman one week from delivery? (As things stand, I do.)

But if we can ever somehow take it out of this scary realm of encroaching theocratic legislation, we can really have these discussions, really look at these issues. We might then agree that, say, once a fetus is viable, there's some obligation to take reasonable medical measures towards his or her survival. We might.

Or we might not.

But we can have that discussion without fear that it'll lead to someone sending in the thugs.

I don't know how to do it, but I think we have got to get this issue out of the legislative realm. I think that's key. Maybe it's impossible. I don't know. But I'd sure like to put more thinking and discussion into how to do that.

Some reality checks might help, like pointing out the far lower teen pregnancy rates (and abortion rates) in countries that are much more open on the issue might be one way to go about it, and debunking the fantasy that banning abortion is actually going stop abortion, and not just result in maim and kill a lot of women.

Because the only way to stop abortion, not just ethically but realistically (by "stop" I really mean "dramatically reduce" - there will always be reasons and the right - whether recognized in law or not - to terminate a pregnancy) is by stopping the need for abortions.

We could decide to put resources into significantly improving birth control, and into supporting those who carry to term, etc. If we really wanted to deal with the abortion issue we'd start looking at those things. Genuinely pro-life people tend to feel the Right-to-Lifers are working against them (with reason).

Even strong supporters of reproductive rights tend to have some misgivings. It's natural. But as long as we're under this legislative Damoclean Sword, open discussion and progress are going to be impossible, and that's just making it worse for everybody.

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» RE: But, how is any of this relevant? Posted by: JoshuaHolland
more rhetoric?
Posted by: jj69 on Jan 26, 2006 3:33 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
The medical quotes suggest we can't prove or disprove fetal pain at this point. I agree with the previous comment that it is time for some creative individuals to pull back from the legislative all-or-nothing, mother vs. baby rhetoric and have a more wholistic discussion of better rights for everyone, in keeping with a progressive agenda.

Generalizing the pain argument to the point where you're saying, we don't know there is pain for sure, so let's assume there isn't any, doesn't fit with my definition of standing with the oppressed.

There are many liberals who are pro-life - just as mad at Bush and the do-nothing Dems on Iraq, the environment, corporate scandals, lack of healthcare reform, Wal-Martization of society etc. etc. and also yet believe life in its earliest stages should be respected. Perhaps because I'm from Europe and things are not so polarized there, I just don't see it that way. But there are lots of liberal Americans who feel this way too, and are looking for ways to work for both mothers and babies.

I love Alternet and read it every day. It is always so disappointing to read the polarized stuff about abortion though, because it just keeps the debate at shouting pitch.

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» RE: more rhetoric? Posted by: JoshuaHolland
» RE: more rhetoric? Posted by: JoshuaHolland
» RE: more rhetoric? Posted by: Ian MacLeod
CHOOSING THE LESS PAINFUL SOLUTION
Posted by: JayBee on Jan 26, 2006 8:08 AM   
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Does a fetus feel pain? The answer could be debated until the end of time.

A more relevant question might be, "What IS pain?"

Does anyone dispute that living is a lifetime full of pain?

An unplanned/unwanted child born into the world is going to experience pain. Look at the abuse, neglect, and lack of nurturing, endured by the human bodies populating the planet.

Look at the meanness, the wars, the bullying, the injustices, the inequity a person faces....much more so for those whose birth was accidental and unwanted.

I'm much more concerned about the pain inflicted on living, breathing, human beings than the "possible" pain endured by a bloody speck of mucus.

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If you are against abortion, don't have one
Posted by: juliemom on Jan 27, 2006 9:17 AM   
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I am a pro-choice Democrat, but your article made me feel queasy. I am also a mother. What I've always said is, if you are against abortion, don't have one. In other words, even though I personally would not choose this option unless there was a medical emergency, I am also married and middle class. Obviously, not every pregnant woman is similarly situated, and I think every woman should be allowed to make the abortion decision for herself, no matter how painful that decision is. Republicans are supposedly small-government. They don't want the government to tell them how to run their lives, unless, of course, the government is merely telling women how to run their lives. I think this is the best pro-choice argument for a progressive agenda.
When you focus on the science and discuss whether the fetus feels pain or not, there is a gut-level reaction (at least for me) that plays into the rhetoric of the anti-abortion crusade. They always focus on the fetus because of this gut-level reaction. Saying the fetus doesn't feel pain at early stages possibly could ease a woman's conscience on her decision to abort, but from what I've seen, most women struggle with the decision for many other reasons anyway. My point is, women should be trusted to make that decision, however hard it may be, without interference from the government.
By the way, thanks for the writing you are doing on the Alito filibuster. His dissent in Casey is scary.

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Backwards
Posted by: brandon85 on Jan 27, 2006 4:25 PM   
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I think we have it backwards. Abortion shouldn't be legal except in special circumstances. It should be the other way around. Afterall, it is killing.

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MURDER IS MURDER IS MURDER...
Posted by: uksda on Feb 9, 2006 2:41 PM   
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No matter how you reason it out, it's still murder. The only possible exception might be to save the life of the mother in medical emergency...even that can be questionable.

The question of whether it is painful or not is not the issue. The question is , is it murder? The answer is yes, even IF it did not hurt.

You can't reason away evil. And murder is evil. And abortion is murder.

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What if I just don't care?
Posted by: kit79 on Aug 10, 2006 12:39 AM   
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Thanks for providing us with the information. Data is always welcome, and sorely needed in a debate that's mostly emotional.

My only experience of abortion (no one laugh) is that I took my cat to have one. She snuck out, turned up pregnant, and I didn't think I could find homes for the kittens when there were so many in shelters to adopt. That's no where near the experience a woman has when the pregnancy is in her own body and not her cat's, but I experienced a bit of the same type of judgmental rhetoric.

Maybe I'm incredibly cold-hearted or weird or just have such an intense phobia of pregnancy, but I always feel like a space-alien whenever the abortion debate turns into a hysterical cry of "The life of the baby!" I don't think I could bring myself to care about a clump of cells. If I had an abortion, it would be about *me* I just . . . it's amazingly irrelevent to me whether the fetus feels pain or not. I see people reading this and thinking what a horrible person I am. I just can't think of the fetus as a "life" or a "child". I can't wrap my head around that. I just can't view the fetus as anything but the invading enemy. It's weird.

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