Proposals to tell women seeking abortions that their unborn child will feel pain, or to provide pain relief during abortions, are therefore scientifically unsound and may put women at unnecessary risk, argues Stuart Derbyshire, a senior psychologist at the University of Birmingham.

He examined the neurological and psychological evidence to support a concept of fetal pain.

Although still immature, the neural circuitry necessary for processing pain can be considered complete by 26 weeks' gestation, he explains. However, pain experience requires not only development of the brain but also development of the mind to accommodate the subjectivity of pain.

Development of the mind only occurs outside the womb, through the actions of the infant and interactions with primary caregivers.

So, not only is the biological development to support pain experience ongoing, but the environment after birth, so necessary to the development of pain experience, is also yet to occur, he says. As such, fetuses cannot experience pain.

The absence of pain in the fetus does not resolve the morality of abortion, but does argue against legal and clinical efforts to prevent such pain during an abortion, he adds.

Proposals currently being considered in the US to inform women seeking abortions of the potential for pain in fetuses, are not supported by the evidence. While a mandate to provide pain relief before an abortion may expose women to inappropriate interventions, risks, and distress.

"Avoiding a discussion of fetal pain with women requesting abortions is not misguided paternalism but a sound policy based on good evidence that fetuses cannot experience pain," he concludes.

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Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
13-Apr-2006