Fetal Anesthesia Law Reignites Debate Over Fetal Pain


Utah’s fetal anesthesia law, which will go into effect next week, has reignited the debate as to whether a fetus is capable of feeling pain. According to S.B. 234, which was signed into law by Governor Gary R. Herbert in March, there is “substantial medical evidence… concluding that an unborn child who is at least 20 weeks gestational age may be capable of experiencing pain.” However, some doctors have rejected those claims.

As stated in the text of S.B. 234, Utah’s so-called fetal anesthesia law will require “a physician who performs an abortion of an unborn child who is at least 20 weeks gestational age to administer an anesthetic or analgesic to eliminate or alleviate organic pain to the unborn child,” beginning May 10.

Although the law allows exceptions for pregnancies that are the result of incest or rape, and in cases where two doctors agree the fetus will not survive, it will apply to every other abortion performed in Utah at or after 20 weeks gestation.

The subject of fetal pain may seem quite clear. However, there are differing opinions within the medical field.

As reported by New York Times, International Fetal Medicine and Surgery Society former president Dr. Nicholas Fisk claims fetal pain “is not possible at all” before six months gestation.

In a meta-study, which was published in the Journal of the American Medical Association in 2005, fetal anesthesiologist and surgeon Dr. Mark Rosen concluded a fetus cannot feel pain until 27 weeks.

“… pain sensation require[s] neural connections into the cortex. The cortex begins emerging around the 23rd week, is not functionally developed until the 26th or later… “

Children’s Hospital of Philadelphia fetal surgeon Dr. Scott Adzick said that the drugs are given for reasons other than fetal pain. Anesthesia is given to the mother, reaching the fetus. Fetuses receive muscle relaxants and narcotics. The drugs are administered to prevent maternal pain, immobilize the fetus and relax the uterus, in addition to preventing the potentially dangerous effects of a fetus’s hormonal stress response.

Although there are differing opinions about fetal pain and fetal anesthesia, many states prohibit abortion after 20 weeks gestation, with few exceptions, because it is widely believed that a fetus can feel pain between 20 and 22 weeks. However, Utah’s S.B. 234 is the first law to require fetal anesthesia.

Like many opponents, Salt Lake City obstetrician-gynecologist Dr. Leah Torres contends the law is not scientifically sound and could, therefore, risk women’s lives.

“You’re asking me to invent a procedure that doesn’t have any research to back it up… You want me to experiment on my patients.”

Torres, like many other doctors, will be forced to comply with the law whether they agree with it or not. New York Times reports doctors who violate the law will be fined thousands of dollars and could lose their license to practice medicine.

Despite the ongoing debate about fetal pain and fetal anesthesia, the law is not likely to affect an exceptionally high number of women because abortions are rarely performed at or after 20 weeks gestation.

In Utah, a total of 17 abortions were performed at or after 20 weeks in 2014, according to Planned Parenthood CEO Karrie Galloway. Salt Lake City maternal fetal medicine physician Dr. Alexandra Grosvenor Eller said a majority of late-term abortions are performed due to health risks to the fetus or the mother.

In Eller’s opinion, Utah’s fetal anesthesia law is unnecessary. She is one of 24 Utah physicians who signed a written objection to the law.

“This is an egregious attempt to tell us how to practice medicine… I can’t think of any other area where the Legislature tells us what medications to give to patients.”

The debate about fetal pain and fetal anesthesia is likely to continue, as doctors have differing opinions about whether fetuses can actually feel pain. Despite the difference in opinions, Utah’s fetal anesthesia law will go into effect next week.

[Image via Sebastian Kaulitzki/Shutterstock]

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