Researchers challenge MCCL’s claims about fetal pain ‘consensus’

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Republican lawmakers and anti-abortion rights group Minnesota Citizens Concerned for Life are pushing a ban on abortions at 20 weeks of pregnancy and after conception, citing a medical and scientific “consensus” that fetuses feel pain at 20 weeks. But according to statements and research from leaders in the medical and scientific communities, no such consensus exists. In fact, researchers continue to debate whether fetuses feel pain at 20 weeks or at much later stages.

“This legislation would prohibit abortions on unborn children at the point the unborn child feels pain. The unborn feel pain specifically at 20 weeks after conception,” Andrea Rau of MCCL testified last week. “There is consensus that the unborn child at 20 weeks after conception can feel pain,” said Rau, pointing to the legislative findings portion of the bill.

Those findings contain a list of medical assertions concerning the ability of a fetus to feel pain and can be viewed in the original bill, SF649.

“And these findings have been backed up with abundant written documentation,” she said. “There are a number of facts that are not disputed in the medical community.”

But, in a March 30 letter to legislators, a team of experts in the field of gynecology and reproductive science evaluated the legislative findings promoted by MCCL and demonstrated that there is no medical or scientific consensus on fetal pain at any stage of development and that research continues to be contradictory.

“These findings are inconsistent with published science and thus should not be used to inform potential policy change,” wrote the letter’s authors, Prof. Philip Darney of the Department of Obstetrics Gynecology and Reproductive Sciences at the University of California – San Francisco and Dr. Mark Rosen, who is the Director of Obstetrical Anesthesia at UCSF. Both are part of the Bixby Center for Global Reproductive Health.

“[S]cientific evidence does not support the elimination of legal abortion at 20 weeks’ gestation based on concerns about the existence of fetal pain,” the letter concluded.

The letter points to two large studies of fetal pain that demonstrate that there is not agreement within the medical community. The first study, conducted in 2005, did an exhaustive review of existing research on fetal pain.

“This review concludes that based on the best available scientific evidence, a human fetus probably does not have the capacity to experience pain until the 29th week of pregnancy at the earliest.”

In 2010, another review undertaken by the Royal College of Obstetrics and Gynecology (RCOG) in the United Kingdom showed very similar results.

The letter’s authors found significant problems with the bill’s legislative findings and offered research that countered claims that a fetus at 20 weeks has the physical structures necessary to experience pain, that a fetus at 20 weeks reacts to stimuli, and that abortions at 20 weeks cause pain to a fetus.

But Rau and MCCL contend that those studies are biased.

“There have been a small handful of medical literature reviews that indicate that the unborn child may not be capable of feeling pain until later in the pregnancy, but these appear to contain biases,” said Rau. “Most, including the fetal surgeons who do these surgeries, agree with the consensus that the unborn child is capable of feeling pain by at least 20 weeks post conception.”

Rau is referring to the 2005 study that included an obstetrics researcher who performed abortions as part of her practice. It was published in the Journal of the American Medical Association, which was headed at the time by a Catholic who opposed abortion. According to the Chicago Tribune at the time:

Dr. Catherine DeAngelis, the journal’s editor-in-chief, said she wasn’t concerned by [Dr. Eleanor Drey]’s failure to indicate she performed abortions. “That’s part of [an obstetrician’s] scope of practice. They don’t have to reveal that.”

A Roman Catholic who opposes abortion, DeAngelis said she has been swamped this week with critical e-mails about the fetal-pain study from “people with no medical background, no science background, religious fanatics, people who are mean-spirited.” She stressed that the report was reviewed by several outside experts and thoroughly examined by her own staff.

“It is a peer-reviewed article,” DeAngelis said. “They are not reporting their own findings. It’s a review article based on what’s in the literature. … The references are there. Anybody who doubts the veracity can go to the original article and say they misinterpreted it.”

By MCCL’s account, its own research is biased. Of the experts the group mentions on its website about fetal pain, most are active within the anti-abortion rights movement.

For instance, Dr. Steve Calvin of the University of Minnesota has been involved with the American Association of Pro-Life Obstetricians and Gynecologists. The late Dr. Robert J. White testified before Congress that he opposed abortion, and Dr. Paul Ranalli is a well-known anti-abortion activist.

In 2010, when Nebraska became the first state in the country to pass a fetal pain law (Idaho and Kansas have since passed such measures), Discovery News ran a feature on the debate. Stuart Derbyshire, a fetal pain expert at the University of Birmingham in the United Kingdom, said, “Basing laws on this is really unreasonable. Abortion is not a scientific question. It is a moral and political question. To try and make science answer a moral question like that is just wrong. It’s cowardice on the part of lawmakers.”

In Minnesota, only 2 percent of all abortions are performed after 20 weeks of pregnancy, and in many cases those are the result of fetal abnormalities or a threat to the health of the mother. In 2009, fewer than 80 of the 12,300 abortions performed were after 20 weeks and none were later than 23 weeks.

The bill has passed committee in the House and awaits a vote in that body before being sent to Gov. Mark Dayton. In the Senate, the bill has advanced through one committee.

The letter that was sent to legislators is below.