UNDECIDED? FETAL PAIN?
In testimony before Congress in 2005, however, Anand was specifically asked about this idea. He responded: “No. There is — that is not my opinion. And I really don’t have any data to suggest that that could be true, or the other way.” He explained that there is some data suggesting a lower pain threshold in preterm newborns than in full-term newborns or older children, but extrapolating that back to the gestation period is not possible.
Anand also told the New York Times in 2013 that he has turned down many requests to testify in court cases regarding fetal pain, objecting to the politicization of his research.
Noem also mentioned that a fetus at 20 weeks “could be viable outside the womb with proper care.” Rep. Virginia Foxx, a Republican from North Carolina, also mentioned this and cited a recent study on extremely preterm infants:
Foxx, May 13: The New York Times reporting just last week on a study that the New England Journal of Medicine published that found that 25 percent of children born prematurely at the stage of pregnancy covered by this legislation survive.
The study in question analyzed the outcomes regarding 4,987 babies born before 27 weeks gestational age.
(It is important to note that gestational age and post-fertilization age are different. Gestational age, which the study on viability used, is measured from the mother’s last normal menstruation before conception. Post-fertilization age is the time since conception. Generally, one can add two weeks to post-fertilization age to calculate an approximate gestational age. H.R. 36 refers to abortions after 20 weeks post-fertilization age, which is equivalent to 22 weeks gestational age.)
We asked Foxx’s office for clarification, but received no response. We are unsure to what exactly her 25 percent figure refers.
In the study she referenced, a total of 357 babies were born at 22 weeks gestational age, and 5.1 percent of them survived; 2.0 percent survived without moderate or severe impairment. At 23 weeks, the rate rose substantially, with 23.6 percent surviving overall and 11.3 percent surviving without impairment. By 26 weeks, most babies survive, at 81.4 percent, and 58.5 percent survive without impairment.
Noem is right that a fetus at 20 weeks post-fertilization — or 22 weeks gestational age — “could be viable outside the womb with proper care.” But at least in one study, only 2 percent of these babies survived without moderate or severe impairment, and only 5.1 percent survived at all.
Some experts argue, as Anand does, that pain in the fetus is not precisely the same as in an adult and may occur earlier than 20 weeks. Martin Platt, an honorary and clinical reader in neonatal and pediatric medicine at Newcastle University in the U.K. who has criticized arguments against early fetal pain, told us in an email that “it is now clearly recognized that infants and preterm babies process pain through different structures than adults, so ‘adult based’ arguments are not relevant.” Still, he said, “we are no closer to defining a gestational age below which” pain might not be felt.
In his 2011 editorial in the journal Archives of Diseases in Childhood, Platt stressed the need for better understanding of this complicated issue before firm proclamations are made:
Platt, 2011: [T]he literature on fetal behaviour, perception, organisation, movement and responses focuses largely on fetuses above 28 weeks of gestation, with a relative lack of studies on the fetus between 20 and 24 weeks. This results in too much reliance on neuroscience, too much reference to animal work, too much extrapolation from both of these and too little real-world human investigation on which to base a realistic view. No one would deny that there are important issues to be confronted, but a sensible debate needs a solid base of rigorous empirical enquiry.