Nebraska fetal pain abortion restriction based on fantasy not science

Nebraska has passed two new laws designed to restrict existing abortion rights. In one, the state alleges that maturing fetuses experience pain and therefore abortion in the later stages of pregnancy is cruel and should be banned after 20 weeks gestation. These claims are not based in science, but rather in ideologically-driven fantasy and well-intentioned but unscientific assumptions.

The notion that fetuses are capable of experiencing pain at some point in development is not a brand-new concept, but rather one that has been exhaustively debated within the medical and scientific community for more than two decades. Studies have been done by hundreds of researchers from every conceivable viewpoint and the more research done, the clearer it becomes that fetuses do not – fundamentally can not – experience pain as we recognize it.

In the developing fetal nervous system, reflexive pathways begin to exhibit spinal cord-to-periphery responses at four to five weeks and avoidance response to stimulus at around five months. The later can be quite dramatic, with wriggling and apparent attempts to avoid the stimulus. To a casual observer, or one with a pre-existing bias, these maneuvers can appear to be cognizant, deliberate, and an expression of discomfort or pain.

In my own work with intrauterine surgery, from rats to rabbits to sheep to humans, I was initially surprised and discomfited by these behaviors. My early impression was that I was seeing something that was similar, if not exactly equal to, responses exhibited in children and adults. But as my familiarity increased across different forms of stimulus, I began to doubt those early conclusions. It turns out that the responses made by fetuses are nearly identical regardless of the magnitude of the stimulus; a touch elicits the same emphatic writhing as does a needle stick, and surely the two are not the same in terms of pain.

Further, once the stimulus was removed the responses quickly abated whether the act was simple touching, or a needle stick, or an incision. If it were pain that was being experienced, the greater intrusions should have had elicited sustained responses and they did not. More than anything, these responses in the fetuses of higher animals with brains and spinal cords resembled the reflexes I had seen in flatworms and other much less sophisticated orders, where “pain” as we experience it is not a possibility. Worms and maggots and the like simply don’t have the neurological structure and cognitive awareness needed to feel what we do.

As it turns out, neither do human fetuses. Recent sophisticated physiological studies have shown that neurological development in human fetuses does not allow for true pain sensation; the anatomy simply does not exist pre-term. What we see, and what can be erroneously interpreted by us as a pain response, is actually a response pattern called nociception, a reflexive behavior that does not depend on or involve conscious perception.

Why do we see these responses as we do? It is because adult humans have empathy, the evolutionary-developed ability, or rather much more than that, the driven need to project our own feelings onto every other being that has certain attributes, most notably a head relatively large in comparison to the body and big eyes compared to the size of the head. It is why there has been a hugely popular sympathetic response to the killing of dolphins, but nearly no public interest in the decimation of sharks which is a much more critical act in terms of maintaining a healthy ocean ecosystem. Dolphins are “cute” so we empathically project our emotions on them and invest ourselves in their fate, while sharks are not “cute” so we don’t.

Stuart WG Derbyshire has written multiple articles on the question of pain sensory development in humans, summarized in an essay here. Derbyshire argues from the best available scientific research that humans do not feel “pain” as adults experience it until the age of 8 months or so after birth.

human development of pain response

While there little evidence that they can feel pain earlier, there is strong evidence that they do not. Derbyshire’s summary puts an end to the fetal “pain” claims made by Nebraska and the well-intentioned few in the medical field who support them, and is a must read for anyone who wants to understand the scientific, reality-based side of what is sure to be prolonged and contentious debate all the way to the Supreme Court.

If scientific claims are too difficult to comprehend, and they can be for a lay person unfamiliar with arcane terminology and abstruse concepts, there is an every-day experience that all of us can watch and understand: the phenomenon of human birth. Observe any vaginal delivery, and monitor the responses of mother and child. What differences are there?

The mother will feel excruciating pain, if not relieved by painkillers. A so-called “natural” childbirth is not something to be experienced by the faint of heart, either as the mother or as an empathetic observer. I’ve seen any number of those, where the mother either refused pain relief or wasn’t able to have it due to allergies or other contraindications. There can be no doubt in anyone’s mind about the level of pain being experienced.

The baby is also subjected to astounding forces while being compressed through the birth canal, so severe that the cranium is actually deformed and the limbs twisted and contorted in fantastical ways. Yet babies emerge into the world uncomplaining, with an attitude generally of somnambulant indifference occasionally rising to one of apparent bemused curiosity. If they felt pain as does the mother they would be wailing in the same pitiable way, but they do not. Just to get them breathing sometimes requires a butt-smack, they are so insensate, and the small cry they give at a heel-prick for a necessary blood sample is quickly past. Full-term babies may feel many things, but not likely anything resembling our adult experience of pain. A fetus feels even less.

Why then are analgesics and anesthetics commonly used during fetal surgery? Because they also interrupt the reflexive motor responses so the fetus stays still, and to interrupt the sympathetic nervous system responses that raise levels of potentially harmful chemicals in the blood and the brain resulting in elevated heart rates, vasoconstriction and other undesirable and unhealthy responses. At a skin-to-spinal cord level, fetuses certainly can “feel” and respond to sensations; what they can’t do is experience them at a conscious, cognitive level as “pain.”

None of this exposition is meant to address the moral issue of abortion. That is a subject we have nibbled on elsewhere at Whenceforth Progress, and will no doubt discuss further. All that is asserted here is that the Nebraska claims are unfounded and false, and should not be used as a basis for any decisions regarding any aspect of abortion law.

The second law recently enacted in Nebraska mandates mental health examinations for all women contemplating abortion. If only we could get a similar law passed requiring mental health and intellectual acuity testing of all candidates for electoral office, we might be able to prevent these kinds of crazy, ill-informed and foolish laws.

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2 responses to “Nebraska fetal pain abortion restriction based on fantasy not science

  1. thanks for this. i’ve kept up pretty well with the fetal side of the research, but was ignorant of the research on infants.

    but i just love science writing anyway, whatever you choose to write on.

    as for the mental health examination requirement, i’ve always thought that the people who wanted to have kids were the crazy ones.

    more seriously, though, this should give you an idea of what i think about requirements in that vein.

  2. grahamfirchlis

    It is always good to hear from you, h, and to recognize a kindred spirit whatever our differences might be.

    Every assertion begs a question: Is being in the grip of genetically-driven hormonal drives crazy, or normal? Is reproduction an irresistable imperative of nature, or irresponsible recklessness? Is the answer to these questions pre-supposed from our species-specific heritage, or purely situational? What exactly constitutes “rising above” our “genetic distiny” and how do we know for certain what either of those might be?

    You are as always quite welcome for your appreciation of my small efforts; thank you for the thanks. The issue of right and wrong in abortion is one I have grappled with for (tick, tock, tick) 45 years this summer, from a wide range of perspectives, and yet after all this time and experience I find myself still grappling. I must say that once, long ago, I had higher hopes for the eventual product of my intellectual ability.

    It is absurd that a 16 year old child should be required to give birth. It is more absurd that a 16 year old child should be engaging in coitus without feeling confident enough to use birth control, and far beyond unacceptably absurd that such birth control and the emotional support needed to use it is not freely available to all.

    There is no possible coherent moral construct that can simultaneously wish to restrict both abortion and birth control availability. That position is, to borrow a phrase, fucking insane.

    It is an interesting study in conflicting emotions, wishing that one’s mother had been able to freely chose an abortion at the risk of endangering one’s own existence. That is one of the issues I struggle with too, being the product of an unintended pregnancy myself.

    My genetic parents married, three and a half months into the pregnancy and just six months after they had met, resulting in horrific life-long strife and still-persistent resentment towards my existence that has been far less than positive – for me, at least. Adoption is not always the worst of all outcomes for children. Abortion may not be either.

    Science can, hopefully, answer some factual questions, at least transiently until the next conceptual advance emerges. You and I both know how fleeting scientific certainty must, of its very nature, be. Moral issues are no better, shifting circumstances driving accepted morality hither and yon just as relentlessly as emerging “facts” drive changes in scientific consensus.

    Driving a stake in the sand is just exactly that, a position in the sand, be it science or morality. Of all the lessons, embracing humility instead of certitude is the one I struggle with most.

    Not that anyone would notice.

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