For the third time since 2013, the US House of Representatives has passed legislation to ban abortions twenty weeks or more into a pregnancy. According to the Republican authors of the bill, that is the point at which foetuses can experience pain.

The bill’s sponsor, Representative Trent Franks from Arizona said, “very late term abortions are an extreme and barbaric practice. The US is only one of seven countries in the world, including North Korea and China, which allows elective abortions after 20 weeks.”

“Scientific evidence suggests the baby is capable of feeling excruciating pain during the procedure,” according to Melanie Israel, a research associate at the Heritage Foundation. Although President Trump has announced that he will sign the bill should it pass, it is unlikely to pass the Senate.

What exactly does the bill entail?

The bill, called “Pain-Capable Unborn Child Act” will make abortions past twenty weeks illegal in every state. Currently, they are not allowed in only certain states. This means women living in those states who require an abortion are able to travel to other states to obtain it.

Doctors who provide abortions when these conditions do not apply would be subjected to up to five years in prison. The women, however, will not be penalised. To date, 99% of abortions take place before 21 weeks, according to Planned Parenthood.

The bill makes exceptions only in the cases of rape, incest or if the mother’s life is at risk. The House majority leader, Kevin McCarthy remarked that “the Act will protect the voiceless, the vulnerable, and the marginalised. It will protect those children who science has proven can feel pain.”

Debates over basis of scientific justification

Firstly, far more than just seven countries allow abortions past the 20-week time period; and secondly, the issue of foetal pain is, scientifically speaking, still relatively unsettled.

“There’s actually conclusive evidence that shows that the neurologic structures in a foetus aren’t completely laid down and working yet until much further along in pregnancy, we think even the third trimester,” explained Jennifer Conti, a clinical assistant professor and gynaecologist at Stanford University. In fact, twenty weeks is, she said, “just an arbitrary limit set in place by politicians that have no medical or scientific backing.”

A review of literature published in 2005, in the Journal of the American Medical Association, which many consider the most comprehensive examination of foetal pain, found that the structures do not develop until 23 – 30 weeks and “no research since its publication has contradicted its findings,” asserted Mark DeFrancesco from the American Congress of Obstetricians and Gynaecologists (ACOG) – which expressed its opposition to the bill.

One of the reasons provided in the bill, for the claim that foetuses feel pain at 20 weeks, is the recoiling motion they make as a reaction to stimuli that an adult human would find painful.

Yet, the Advancing New Standard in Reproductive Health group at the University of California in San Francisco, America says that “limb withdrawal occurs even in full-term babies in response to non-painful tactile sensations, including light touch. Thus, the appearance of limb withdrawal on ultrasound represents a reflex rather than a response to pain.”

The biggest concern, though, for those against the Act is not that it will get passed – but, that the public will be fed with misinformation about foetal pain. “By even putting this issue on a national platform, you’re misleading the American people. You’re really providing false and dangerous information that is affecting millions of women,” echoed Conti.

The opposition

For advocates of the bill, the science is also clear. The application of pain stimuli is associated with release of the stress hormone and when anaesthetic is administered, this stress hormone is significantly reduced.

A paper by anaesthesiologist Laura Myers, published in the journal Best Practice and Research: Clinical Anaesthesiology, says that pain receptors and the nerves that link them to the thalamus and subcortical plate are present throughout the foetus by no later than 20 weeks.

In fact, Bjion Merker, a Swedish neuroscientist, in a paper published in 2007 in the journal Behavioural and Brain Sciences, goes so far as to say, that using mammalian decortication as strong evidence, a functioning cortex is not necessary to experience pain.

Roland Brusseau substantiated this idea in 2008 in the paper Developmental Perspectives: Is the Foetus Conscious in the journal International Anaesthesiology Clinics. According to Brusseau, children with hydranencephaly, show reaction to pain.

“We should consider that if cortical activity is not a prerequisite for pain perception in adults, then by analogy neither would it be a necessary criterion for foetuses,” he added.

Ultimately though, pro-choice representatives in the house said in a statement that the ban, “endangers women, interferes with their private health care decisions, and marginalises sexual assault victims while also being blatantly unconstitutional.” MIMS

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