Political Cortex: Brain Food for the Body Politic

The bill would require health care staff to discuss fetal pain and offer women anesthesia for the fetus during the abortion procedure. This, despite the fact that this has been a subject of political and medical controversy for twenty years and that there is yet no scientific consensus on this issue at this time. In fact, the August 2005 issue of the Journal of the American Medical Association indicates the opposite. Researchers (a mix of pediatricians, neuroscientists, and anesthesiologists, among others) at the University  of California in San   Francisco reviewed nearly 2,000 studies and said that the data currently indicates that fetuses are likely incapable of feeling pain until approximately 28-30 weeks of gestation, which is about the seventh month of pregnancy. Based on the extensive evidence that they studied, the authors concluded that discussion of fetal pain for abortions performed before the end of the second trimester of pregnancy should not be mandatory.

The medical evidence looked at by the researchers, led by UCSF obstetric anesthesiologist Mark Rosen, does demonstrate that brain structures of the fetus involved in feeling pain do begin forming earlier in pregnancy, but likely do not function until the 28-30th week of pregnancy. That is when pain-signaling nerve pathways from the spinal cord to the brain are fully wired. In 1996, Stuart Derbyshire, MD, wrote about this subject for the British Medical Journal in an article entitled "Commentary: `Fetal Pain' is a misnomer." Dr. Derbyshire stated: "Though far from resolved, it is widely acknowledged that pain is a multi-dimensional experience incorporating sensory, emotional, and cognitive factors. If this multi-dimensionality is the basis of conscious pain experience, then we cannot attribute this to a fetus, which is naïve for all sensory experiences and all (of the accompanying) cognitive, affective, and evaluative associations."  

Therefore, offering fetal pain relief in the fifth or sixth month of pregnancy (about 20-24 weeks) when the fetal brain is still too immature and undeveloped to feel pain, is confusing and alarmist to women, violates the basic premise of medical informed consent, is medically inappropriate, and could even result in additional dangers and absolutely unacceptable health risks to the woman having the abortion.  

Having worked in the field of abortion care for 36 years, I can attest that women will, at times, ask about the pain of the fetus when seeking an abortion. It can be troubling to some women who believe that that they may be hurting the pregnancy. These questions come up more frequently if the woman is further along in her pregnancy. The staff of Aradia Women's Health Center in Seattle, where I was the executive director for 18 years, always answers any question that the woman has openly, compassionately, and with the best, most accurate medical information possible. This is true informed consent supportive of women's needs, dilemmas, and choices. We do not need manipulative propaganda dictated by Congress to tell us what to tell women about their abortion care and what the fetus may - or, more accurately, may not - feel. We share all of the information about the abortion, including the rare but possible risks, and we certainly never hide anything from any woman. Telling the truth is key to any decision a woman makes and aids positive outcomes for her, both medically and psychologically. This is, of course, what all women's health providers want for their patients.

In 2004, Senator Sam Brownback (R-Kansas), when referring to a similar bill, proudly stated: "I'm pro-life and if a woman decides not to abort her fetus with this (fetal pain) information, that would certainly be fine with me."

So there it is. Thank you, Senator. If only the senator and the current Congress would address the issue of women's pain when they are stigmatized for having an abortion, or denied access to safe and compassionate abortion care. Or the real pain and suffering that women feel when they desperately turn to illegal and unsafe abortions. This is the real pain issue that we should be discussing and hearing more about - the lack of access to safe, quality abortion care in the United States that denies women their destinies and their rights.

Perhaps I will write to Senator Brownback today and try to talk with him about women's pain. He may wish to continue the debate around fetal pain, but I will tell him that there is no debate around women's pain.  

Is there, Senator?