At what stage of an abortion should anesthetics be used to blunt fetal pain?

[ARCHIVED THREAD] - At what stage of an abortion should anesthetics be used to blunt fetal pain? (Page 1 of 4)

Posted: 2/9/2006 2:47:41 PM EDT

As some of you may be aware, Senator Sam Brownback has introduced legislation (Unborn Child Pain Awareness Act to inform women that an unborn child past 20 weeks fertilization could feel pain during the abortion procedure.

The law, if passed,:

"would require those who perform abortions on unborn children 20 weeks after fertilization to inform the woman seeking an abortion of the medical evidence that the unborn child feels pain--

a. through a verbal statement given by the abortion provider, and also

b. by providing a brochure--developed by the Department of Health and Human Services--that goes into more detail than the verbal statement on the medical evidence of pain experienced by an unborn child 20 weeks after fertilization"

Some anti-abortion sites argue that a fetus can 'react' to pain as early as 8 weeks gestation. They also make many other claims, backed up by physicians in the field, that prove a fetus can 'feel' pain after 20 weeks of gestation:

Fetal Pain

By 8 weeks? Show me!

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.

Give an example.

Try sticking an infant with a pin and you know what happens. She opens her mouth to cry and also pulls away.

Try sticking an 8 week old human fetus in the palm of his hand. He opens his mouth and pulls his hand away.

A more technical description would add that changes in heart rate and fetal movement also suggest that intrauterine manipulations are painful to the fetus. Volman & Pearson, "What the Fetus Feels," British Med. Journal, Jan. 26, 1980, pp. 233-234.

O.K., that is activity that can be observed, but is there other evidence of pain? After all, the fetal baby can’t tell us he hurts.

Pain can be detected when nociceptors (pain receptors) discharge electrical impulses to the spinal cord and brain. These fire impulses outward, telling the muscles and body to react. These can be measured. Mountcastle, Medical Physiology, St. Louis: C.V. Mosby, pp. 391-427 "Lip tactile response may be evoked by the end of the 7th week. At 11 weeks, the face and all parts of the upper and lower extremities are sensitive to touch. By 13 1/2 to 14 weeks, the entire body surface, except for the back and the top of the head, are sensitive to pain." S. Reinis & J. Goldman, The Development of the Brain C. Thomas Pub., 1980

Give me more proof.

In 1984 President Reagan said: "When the lives of the unborn are snuffed out, they often feel pain, pain that is long and agonizing." President Ronald Reagan to National Religious Broadcasters, New York Times, Jan. 31, 1984

This provoked a public reaction from pro-abortion circles and a response from an auspicious group of professors, including pain specialists and two past presidents of the American College of Obstetrics and Gynecology.

They strongly backed Mr. Reagan and produced substantial documentation. Excerpts of their letter (2/13/84) to him included:

"Real time ultrasonography, fetoscopy, study of the fetal EKG (electrocardiogram) and fetal EEG (electroencephalogram) have demonstrated the remarkable responsiveness of the human fetus to pain, touch, and sound. That the fetus responds to changes in light intensity within the womb, to heat, to cold, and to taste (by altering the chemical nature of the fluid swallowed by the fetus) has been exquisitely documented in the pioneering work of the late Sir William Lily — the father of fetology."

We state categorically that no finding of modern fetology invalidates the remarkable conclusion drawn after a lifetime of research by the late Professor Arnold Gesell of Yale University. In The Embryology of Behavior: The Beginnings of the Human Mind (1945, Harper Bros.), Dr. Gesell wrote, "and so by the close of the first trimester the fetus is a sentient, moving being. We need not speculate as to the nature of his psychic attributes, but we may assert that the organization of his psychosomatic self is well under way."

Mr. President, in drawing attention to the capability of the human fetus to feel pain, you stand on firmly established ground. Willke, J & B, Abortion: Questions & Answers, Hayes, 1991, Chpt. 10

What of The Silent Scream?

A Realtime ultrasound video tape and movie of a 12- week suction abortion is commercially available as, The Silent Scream, narrated by Dr. B. Nathanson, a former abortionist. It dramatically, but factually, shows the pre-born baby dodging the suction instrument time after time, while its heartbeat doubles in rate. When finally caught, its body being dismembered, the baby’s mouth clearly opens wide — hence, the title (available from Heritage House '76 at http:www.heritagehouse76.com). Proabortionists have attempted to discredit this film. A well documented paper refuting their charges is available from National Right to Life, 419 7th St. NW, Washington, DC 20004, $2.00 p.p. A short, 10-minute video showing the testimony of the doctor who did the abortion in Silent Scream definitely debunks any criticism of Silent Scream’s accuracy. The Answer, Bernadel, Inc., P.O. Box 1897, Old Chelsea Station, New York, NY, 10011.

Pain? What of just comfort?

"One of the most uncomfortable ledges that the unborn can encounter is his mother’s backbone. If he happens to be lying so that his own backbone is across hers [when the mother lies on her back], the unborn will wiggle around until he can get away from this highly disagreeable position." M. Liley & B. Day, Modern Motherhood, Random House, 1969, p. 42

But isn’t pain mostly psychological?

There is also organic, or physiological pain which elicits a neurological response to pain. P. Lubeskind, "Psychology & Physiology of Pain," Amer. Review Psychology, vol. 28, 1977, p. 42

But early on there is no cerebral cortex for thinking, therefore no pain?

The cortex isn’t needed to feel pain. The thalamus is needed and (see above) is functioning at 8 weeks. Even complete removal of the cortex does not eliminate the sensation of pain. "Indeed there seems to be little evidence that pain information reaches the sensory cortex." Patton et al., Intro. to Basic Neurology, W. B. Saunders Co. 1976, p. 178

How about during an abortion?

This really hit the fan during the 1996 debate in the U.S. Congress over a law to ban partial birth abortions. Pro-abortionists had claimed that the anaesthetic had already killed the fetal baby. Top officials of the U.S.

Society for Obstetric Anaesthesia & Perinatology vigorously denied this explaining that usual anaesthesia did not harm the baby. D. Gianelli, Anaesthesiologists Question Claims in Abortion Debate, Am. Med. News, Jan. 1, ’96

This brought the issue of fetal pain into the news, and testimony was given to the Subcommittee on the Constitution of the U.S. House of Representatives.

"The fetus within this time frame of gestation, 20 weeks and beyond, is fully capable of experiencing pain. Without doubt a partial birth abortion is a dreadfully painful experience for any infant. R. White, Dir. Neurosurgery & Brain Research, Case Western Univ.

Also, "Far from being less able to feel pain, such premature newborns may be more sensitive to pain"...that babies under 30 weeks have a "newly established pain system that is raw and unmodified at this tender age." P. Ranalli, Neuro. Dept., Univ. of Toronto

Give me more research data.

Data in the British Medical Journal, Lancet, gave solid confirmation of such pain. It is known that the fetal umbilical cord has no pain receptors such as the rest of the fetal body. Accordingly, they tested fetal hormone stress response comparing puncturing of the abdomen and of the cord.

They observed "the fetus reacts to intrahepatic (liver) needling with vigorous body and breathing movements, but not to cord needling. The levels of these hormones did not vary with fetal age." M. Fisk, et al., Fetal Plasma Cortisol and B-endorphin Response to Intrauterine Needling, Lancet, Vol. 344, July 9, 1994, Pg. 77

Another excellent British study commented on this:

"It cannot be comfortable for the fetus to have a scalp electrode implanted on his skin, to have blood taken from the scalp or to suffer the skull compression that may occur even with spontaneous delivery. It is hardly surprising that infants delivered by difficult forceps extraction act as if they have a severe headache." Valman & Pearson, "What the Fetus Feels," British Med. Jour., Jan. 26, 1980

Much of the controversy surrounding fetal pain was rekindled after the Journal of the American Medical Association published an article (JAMA 2005; 294: 947-954) stating that:

"a fetus is not capable of experiencing pain until 28-30 weeks (emphasis added) after conception, when the nerves that carry painful stimuli to the brain have developed. Before that, the fetal reaction to a noxious stimulus is a reflex that does not involve consciousness."

A lay article that supports the JAMA findings:

When Does a Fetus Feel Pain?

By Elise Kleeman
DISCOVER Vol. 26 No. 12 | December 2005 | Biology & Medicine

With Roe v. Wade, the U.S. Supreme Court gave states the right to legislate abortion restrictions during a woman's second trimester. Many states enacted laws that make it more difficult to terminate a pregnancy. Among them, Arkansas, Minnesota, and Georgia require physicians to tell women that 20-week-old fetuses can feel pain during the procedure unless they are anesthetized. A newly released review of the scientific evidence, however, suggests the premise of those laws is wrong.

Fetuses cannot feel pain until at least the 28th week of gestation because they haven't formed the necessary nerve pathways, says Mark Rosen, an obstetrical anesthesiologist at the University of California at San Francisco. He and his colleagues determined that until the third trimester, "the wiring at the point where you feel pain, such as the skin, doesn't reach the emotional part where you feel pain, in the brain." Although fetuses start forming pain receptors eight weeks into development, the thalamus, the part of the brain that routes information to other areas, doesn't form for 20 more weeks. Without the thalamus, Rosen says, no information can reach the cortex for processing.

Fetuses do have reflex reactions that can make them seem pained, Rosen says. "If you see a fetus in utero react to needle stimulation, then the common conclusion is that it must feel." But just as with paraplegics, "that's a reflex that's mediated by the spinal cord; that's not a conscious reaction," he says. It is possible that a temporary structure of neurons that appears in a fetus's brain during the second trimester allows it to sense pain. But Rosen and his colleagues believe a fetus's brain doesn't function coherently enough to be conscious.

The use of fetal anesthesia is justified during other surgeries, Rosen says, to block the production of stress hormones. In the case of abortion, he says, it is not necessary and puts the mother at increased risk of adverse reactions, and even death.

www.discover.com/issues/dec-05/rd/fetus-feel-pain/

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Let's not get this locked. I want a serious discussion here based on facts.

Posted: 2/9/2006 2:49:51 PM EDT

[#1]

No doubt in my mind that this one will get locked .

Posted: 2/9/2006 2:49:59 PM EDT

[#2]

AGNTSA.

Posted: 2/9/2006 2:51:59 PM EDT

[#3]

Past 20 weeks? Isn't that almost into the third trimester?

I thought third-trimester abortions were illegal in most place to start with?

(But I'm not an expert on abortions, since I don't have a uterus and all).

Since third-trimester abortions SHOULD be illegal anyway (in my opinion, whether or not they are in reality), I'd be in favor of some kind of aneastesia, "just in case". I'm sure a third-trimester abortion is probably not cheap anyway - what's a few extra CC's of anestesia really going to add, and where's the harm in being safe - regardless of whether the concern is real or not.

Posted: 2/9/2006 2:53:02 PM EDT

[#4]

Posted: 2/9/2006 2:53:52 PM EDT

[#5]

I don't know much about this kind of thing but couldn't the anesthesia itself possibly kill the fetus?

Posted: 2/9/2006 2:54:44 PM EDT

[#6]

This shit makes me sick.

Posted: 2/9/2006 3:01:56 PM EDT

[#7]

Quoted:
Past 20 weeks? Isn't that almost into the third trimester?

I thought third-trimester abortions were illegal in most place to start with? (But I'm not an expert on abortions, since I don't have a uterus and all).

Since third-trimester abortions SHOULD be illegal anyway (in my opinion, whether or not they are in reality), I'd be in favor of some kind of aneastesia, "just in case". I'm sure a third-trimester abortion is probably not cheap anyway - what's a few extra CC's of anestesia really going to add, and where's the harm in being safe - regardless of whether the concern is real or not.

Everybody reads Roe, but nobody ever reads Doe.

In Roe, the Court did imply that the state had an interest in the third trimester. But in the companion case, Doe, the Court said that no state could ever pass a restriction unless it had an exception for the "health of the mother" and then defined "health of the mother" to basically include whatever her doctor says is dangerous to her health. So far, I don't believe any state has passed a third-trimester ban which would satisfy the Doe test. Such a law would, of course be useless since you could simply shop for a doctor who would tell you what you wanted to hear.

The last time the S. Ct. visited the issue, IIRC, was Stenberg v. Carheart where the State of Nebraska passed a law banning partial birth abortions, and had a string of well-respected doctors saying "this procedure is never medically necessary." That law was struck down under the Doe standard because there was no exception for health of the mother, even though the experts said it wasn't necessary. The only plus side was that Dr. Carheart, the abortion doctor who challenged the law, in doing so pissed of the guy who owned his parking spots, and refused to lease them back to him again. Dr. Carheart now has to park his Porsche somewhere else.

Posted: 2/9/2006 3:20:18 PM EDT

[#8]

Quoted:
I don't know much about this kind of thing but couldn't the anesthesia itself possibly kill the fetus?

The idea is to kill the fetus without causing it pain, much like they do with lethal injection of murderers. You give the latter sodium pentothal to 'knock them out' so they don't feel the suffocation when you inject the succinylcholine.

Now does it all make sense?

Posted: 2/9/2006 3:22:15 PM EDT

[#9]

Quoted:
This shit makes me sick.

+1 IBT much needed L

Posted: 2/9/2006 3:26:55 PM EDT

[#10]

Quoted:
Quoted:
I don't know much about this kind of thing but couldn't the anesthesia itself possibly kill the fetus?

The idea is to kill the fetus without causing it pain, much like they do with lethal injection of murderers. You give the latter sodium pentothal to 'knock them out' so they don't feel the suffocation when you inject the succinylcholine.

Now does it all make sense?

except for the fact that they don't feel "pain" the way we do. Hell, even a fish reacts to stimuli, including pain, does that mean that we should dope up fish whenever we cut their heads off?

Posted: 2/9/2006 3:28:39 PM EDT

[#11]

19 pages, two accounts locked.

I could never kill my child. That's my opinion on the matter.

Posted: 2/9/2006 3:32:19 PM EDT

[#12]

Here we go!

Now HANG ON THERE...

REMEMBER...we're dealing with a "RIGHT TO CHOOSE"...NOT an abortion...or fetal pain...or infanticide...or any of those inflammatory right-wing religious whacko-nutjob, "Right to LIFE" descriptions of this "issue". A woman's "RIGHT TO CHOOSE" trumps ALL...right up to the delivery day.

ETA: I HOPE you guys get the sarcasm...

Somebody please pass the popcorn!

This is headed for a quick locking...

Posted: 2/9/2006 3:32:49 PM EDT

[#13]

It is murder!

Posted: 2/9/2006 3:36:58 PM EDT

[#14]

I think that it should be the mothers decision. Why? For the same reason that she is allowed to have an abortion, the baby is part of her body.

This is also because I no faith in our government to make an inteligent decision when other peoples lives are involved.

Posted: 2/9/2006 3:38:22 PM EDT

[#15]

Some people are anti-abortion, some people are pro-choice, I figured out I am NO-Choice.

One day, some girlfriend in college comes up and does the; “I am late this month, I think I am pregnant.” At that moment, I knew I didn’t have a choice on the future of that embryo. How can I ask she keep it? How can I ask she rid of it. I am stuck with her values, no matter what.

Posted: 2/9/2006 3:42:29 PM EDT

[#16]

Quoted:
Quoted:
Quoted:
I don't know much about this kind of thing but couldn't the anesthesia itself possibly kill the fetus?

The idea is to kill the fetus without causing it pain, much like they do with lethal injection of murderers. You give the latter sodium pentothal to 'knock them out' so they don't feel the suffocation when you inject the succinylcholine.

Now does it all make sense?

except for the fact that they don't feel "pain" the way we do. Hell, even a fish reacts to stimuli, including pain, does that mean that we should dope up fish whenever we cut their heads off?

Oh really? How is that? Are unborn babies' synapses that different from those of an adult? Are they lacking in ACh? Does their sodium-potassium pump operate differently? Oh...I KNOW...babies don't have any ATP until they are born...right?

Please...

Posted: 2/9/2006 3:43:05 PM EDT

[#17]

Quoted:
This is headed for a quick locking...

The purpose of this thread is to discuss:

At what stage of an abortion should anesthetics be used to blunt fetal pain?

Quoted:
except for the fact that they don't feel "pain" the way we do. Hell, even a fish reacts to stimuli, including pain, does that mean that we should dope up fish whenever we cut their heads off?

After catching a fish I always 'bonk' it in the head unless I am releasing it (too small). Don't you?

Posted: 2/9/2006 3:44:20 PM EDT

[#18]

What I don't get is the "murder" bit.

Laws in the US are based on the majority opinion of Americans. (or at least should be)
Abortion is legal within whatever months of conception so in theory, the majority of Americans think that Abortion is OK.
Calling something that is presently legal, murder, doesn't make sense to me.

Concerning the post topic, if there is any chance of the foetus feeling pain, use anaesthetics if there is no reason not to.
No expert but I think that whatever cc's of anaesthetics shouldn't add much on to the medical bill.

Posted: 2/9/2006 3:47:09 PM EDT

[#19]

Quoted:
Oh really? How is that? Are unborn babies' synapses that different from those of an adult? Are they lacking in ACh? Does their sodium-potassium pump operate differently? Oh...I KNOW...babies don't have any ATP until they are born...right?

Please...

When I recently pressed on a pregnant woman's belly (26 weeks) I felt something hard. It went away and then I felt 2 or 3 kicks, so presumably it was the fetus' foot. I'm sure that it was 'its' reptilian 'spinal reflex' acting up again.

Posted: 2/9/2006 3:47:52 PM EDT

[#20]

Double tap.

Posted: 2/9/2006 3:48:11 PM EDT

[#21]

Abortion is an abomination. That being said, its likely to remain a part of our culture up until the day when somebody uninvents the pill. Too many people want it as birth control in case they get pregnant at an "inconvenient" time. Treating people as chattel is simply par for the course in human history. Slavery existed for the first 10,000 years of civilization, and is now making a comback in the form of human trafficking. Color me not surprised.

"The strong do as they will, and the weak submit as they must."
- Thucydides

Posted: 2/9/2006 3:50:25 PM EDT

[#22]

Quoted:
It is murder!

Agreed.

Posted: 2/9/2006 3:50:38 PM EDT

[#23]

Well I'm sitting here playing with my mini-me and trying to contemplate why somebody would want to have an abortion.

Posted: 2/9/2006 3:51:11 PM EDT

[#24]

Quoted:

Abortion is legal within whatever months of conception so in theory, the majority of Americans think that Abortion is OK.