Mary Spaulding Balch: Unborn babies feel pain, deserve protection

The writer, of Washington, D.C., is director of the Department of State Legislation of the National Right to Life Committee. This essay and the one immediately below were written exclusively for The World-Herald at its request.

Medical research has exponentially expanded our knowledge and understanding of fetal development.

We now know that an unborn child at 20 weeks after fertilization has pain receptors throughout his body that are linked by nerves to the brain’s thalamus and subcortical plate.

We also know that these unborn children seek to evade noxious stimuli and that certain stress hormones dramatically increase in response to that stimuli the same type of hormone increases that, in a child or adult capable of saying “It hurts,” have been associated with pain.

Both the unborn child’s recoil from a painful stimulus, and rise in stress hormones in response to it, are significantly diminished when given anesthesia, which has become routine practice when surgery is performed in utero something now increasingly common. As Dr. Laura B. Myers of the Department of Anesthesia, Perioperative and Pain Medicine at Boston Children’s Hospital notes, “We ... routinely provide anesthesia and analgesia to fetuses as early as 19 weeks’ gestation.”

Long-term negative developmental effects from exposure to unanesthetized pain stimulus have been documented. These include increased sensitivity to pain and reduced immune system response, as well as emotional, behavioral and learning disabilities later in life.

As Drs. Anita Gupta and James Giordano wrote in the medical journal Pain Physician in 2007, “Using a computer analogy, the presence of the ‘wetware’ (i.e., the neural substrates) is often a reliable predictor that the program (i.e., pain) can and will be executed. This is strengthened by robust comparative studies of mammalian species of anatomical, physiological and behavioral models of human morphology, development, neurophysiology and pain.”

This sort of evidence has led multiple medical experts to agree with Dr. Rajani Anand, professor of pediatrics and anesthesiology at the University of Tennessee Health Sciences Center. She has testified that “the human fetus possesses the ability to experience pain from 20 weeks of gestation.”

Are there skeptics in the medical community? An oft-cited 2005 article in the Journal of the American Medical Association argued that the cortex is necessary to experience pain, and therefore unborn children do not perceive pain until nerves from the pain receptors fully reach the cortex at 29 to 30 weeks.

Yet, recent research establishes that children born without a cortex experience both consciousness and pain, and this research indicates that in the human unborn child the subcortical plate provides the necessary neuroanatomy, even before nerve pathways to the cortex are complete.

Interestingly, the lead author of this JAMA study was not a doctor but a medical student formerly employed by NARAL Pro-Choice America, and another author was a well-known practitioner of late-term abortions. With a few exceptions, that information is usually omitted by mainstream media outlets.

Another equally important point is that there was no new laboratory research reported in this article it is merely a commentary on a highly selective list of existing medical literature.

The authors’ conclusion is disputed by experts with far more extensive credentials in pain research than either of the authors. These independent authorities say that there is substantial evidence from multiple lines of research that unborn humans can perceive pain during the fifth and sixth months (i.e., by 20 weeks).

In light of this evidence, can Nebraska’s Pain-Capable Unborn Child Protection Act withstand a legal challenge? Opponents of the law argue that no state may assert any compelling interest in the unborn that is not based on viability.

They overlook the statement by U.S. Supreme Court Justice Anthony Kennedy, author of the decision upholding the partial-birth abortion ban, that “it is inappropriate for the Judicial Branch to provide an exhaustive list of state interests implicated by abortion” and that states have “an important constitutional role in defining their interests in the abortion debate.”

The Supreme Court has not yet had occasion to consider the validity of what Nebraska has done to assert an interest sufficient to justify protecting those unborn children who can feel pain and there are strong grounds to expect that when it does, it will uphold Nebraska’s reliance on that interest.

Justice Kennedy has described what happens in a dilatation and evacuation (D&E) abortion the most common methodology at the stage at which an unborn child can feel pain:

“No one can dispute that, for many, D&E is a procedure itself laden with the power to devalue human life. ... Friction causes the fetus to tear apart. For example, a leg might be ripped off the fetus. ... The fetus, in many cases, dies just as a human or adult child would: It bleeds to death as it is torn limb from limb.”

Whatever one’s views on abortion, all but its most extreme advocates should at least be able to agree that 20 weeks into a pregnancy, absent a genuine medical emergency, we ought to be able to protect unborn children who suffer pain from subjection to that sort of dismemberment.

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