When does the unborn baby feel pain?

And does it matter for abortion opposition?


Published: 22 July 2010(GMT+10)
Thanks to Janine Suter
4D ultrasound image of human baby in the womb, taken at 20 weeks.

A UK government-funded study1 recently concluded that the unborn baby (‘fetus’) cannot feel pain in the first 24 weeks (a similar American study2 placed the threshold at 29 or 30 weeks). Pro-aborts have claimed this is bad news for the pro-life lobbies which want to reduce the age limit for abortions. This is because fetal scans show that the connections in the brain are not fully formed by that time. Before the connections are formed, the pre-born baby is claimed to be able to react to pain stimuli, but not to feel pain like post-natal babies do.

Furthermore, the study found that the womb sedates the baby so that even after 24 weeks, the unborn child is in a state of “continuous sleep-like unconsciousness or sedation” induced by the womb. As a Scientific American article3 described in relation to research done on sheep(!):

What is fascinating is the discovery that the fetus is actively sedated by the low oxygen pressure (equivalent to that at the top of Mount Everest), the warm and cushioned uterine environment and a range of neuroinhibitory and sleep-inducing substances produced by the placenta and the fetus itself: adenosine; two steroidal anesthetics, allopregnanolone and pregnanolone; one potent hormone, prostaglandin D2 ; and others.

The role of the placenta in maintaining sedation is revealed when the umbilical cord is closed off while keeping the fetus adequately supplied with oxygen. The lamb embryo now moves and breathes continuously. From all this evidence, neonatologists conclude that the fetus is asleep while its brain matures.

So, according to this research, the baby does not “wake up” until birth. If true, this suggests that the ability of premature babies to experience pain may not reflect the ability of the child in the womb at the same stage of development.

This discovery is said to have several implications. For instance, one doctor argues4 that this shows that abortions and in utero surgeries that take place before 24 weeks should not anesthetize the fetus, because the baby does not feel pain, and this would remove the risk of harming the fetus with anesthetics during in utero surgery (an ironic concern, given that abortion is designed to harm the baby fatally). And the trauma of abortion might wake the baby up as it is being scalded by saline solution or torn limb from limb.

The discovery is also said to harm the chances of England pro-life lobbyists succeeding in their attempt to lower the current 24-week limit on abortions in England to 20 weeks. Reports also predict that it will raise the chances of a Nebraska state law, passed in April, being overturned which banned abortions after 20 weeks (with the usual exceptions for life and health of the mother, and extreme fetal deformity) on the basis that the fetus would feel pain.

This research is not uncontested; Dr Kanwaljeet “Sunny” Anand, an expert in Pediatric Critical Care Medicine and Anesthesiology, is outspoken in his opposition to the conclusions of UK study (as outlined in a letter published in the Sunday Times).

In 2005, he testified before Congress that a fetus as early as 20 weeks would experience abortion as “painful, unpleasant, noxious stimulation.” He argues that while the brain is still developing, the fetus receives pain signals in the subcortex. The main criticism of his work is that it is based on premature neonates, and it might not apply to fetuses at the same gestational age in the womb. His position is all the more important because he professes neutrality on the abortion issue, while most research in this area has been undertaken from either a pro-life or a pro-abortion stance.

But even if we were to grant that the fetus cannot feel or experience anything in the way we do until he is born, it would not strengthen the case for abortion. Murder is still murder, even if the victim is unconscious and anesthetized at the time.

The pro-life definition of life beginning at conception is not dependent on consciousness. Killing a baby in the womb is murder by the biblical definition (even if not by a legal definition) even if the fetus is not self-aware.

The threshold—viability or the ability to feel pain, or neither?

Currently, both US and UK law has viability as the cut-off point for the ‘right’ to abortion (in theory—the exceptions for “life and health” of the mother in practice make abortion legal practically up to birth, since a girl’s inability to fit into her prom dress can be deemed a serious threat to her physical or mental health). The Nebraska law is the first one to challenge the viability standard, instead arguing that abortion should be illegal when the fetus might suffer because of it.

The law is being challenged because it goes against the Supreme Court’s statement that viability should be the threshold, and it seems likely that this law will be overturned on those grounds, helped along by the two studies. Viability is in any case no standard at all, since the advance of prenatal and neonatal care means that previously “unviable” babies are being saved, at younger and younger ages (see for example One in a million: Baby born at 23 weeks is now a thriving toddler all set for pre-school).5

It is a comment about the state of medicine, not the nature of the patient. Also, some hospitals will be working furiously to save a very premature baby in one room, while in another, they are aborting a baby the same age. So “viability” is a red herring, and abortionists don’t let it hinder their very lucrative business.

But pro-life arguments have never been about the consciousness of the baby, or her ability to experience being ripped limb from limb in an abortion, nor about her ability to survive birth, though we are happy to use those arguments to bolster our case.

The central argument of the pro-life movement is that the baby, from conception, is a distinct human life with the rights of a distinct human being. The foremost of these rights is the right to life—without this right all the others are moot.

Indeed, the foremost pro-abortion ethicists recognize that the fetus is a distinct human life. David Boonin writes:

On the desk in my office … there are several pictures of my son, Eli. In one, he is gleefully dancing on the sand along the Gulf of Mexico, the cool ocean breeze wreaking havoc with his wispy hair. In the second, he is tentatively seated in the grass in his grandparents’ backyard, still working to master the feat of sitting up on his own. In a third, he is only a few weeks old, clinging firmly to the arms that are holding him and still wearing the tiny hat for preserving body heat that he wore home from the hospital. Through all these remarkable changes that these pictures preserve, he remains unmistakably the same little boy.
In the top drawer of my desk, I keep another picture of Eli. This picture was taken on September 7, 1993, 24 weeks before he was born. The sonogram image is murky, but it reveals clearly enough a small head tilted backward slightly, and an arm raised up and bent, with the hand pointing back toward the face and the thumb extended out toward the mouth. There is no doubt in my mind that this picture, too, shows the same little boy at a very early stage in his physical development. And there is no question that the position I defend in this book entails that it would have been morally permissible to end his life at this point. [emphasis added]6

Ethicists do not argue that the unborn baby is not human; medically it is established that the unborn child is genetically and biologically distinct from its mother. The ethicists instead argue that the fetus does not yet have a right to live, or that its right to live does not outweigh the mother’s right to autonomy.

This shows that the humanity of the unborn is a necessary but not sufficient condition for a logically sound pro-life argument. We also need a premise that murder is wrong, but a secular, evolutionary mindset can’t provide that since it is predicated on death of the unfit.

A religious argument?

It is common to argue that the pro-life point of view is a religious view, and as such, pro-life laws would violate the separation of church and state. It is true that Christians view it as an issue of the sanctity of life; God created human beings in His image, so to kill a human being, from conception until natural death, is an assault on the image of God. But it does not follow that abortion cannot be outlawed because of this; there are laws against murder of post-natal human beings, but Christians oppose their murder for the exact same reason. As Ramesh Ponnuru argues:

In truth, it is no more “religious” to claim that six-month-old fetuses should not be killed than it is to claim that teenagers should not be killed. A government that acts on the claim about fetuses is no more “theocratic,” by virtue of its having done so, than a government that acts on the second claim. A government that generally bans abortion does not thereby take a position on whether the fetus has a soul, any more than it takes a position on whether thirty-five-year-olds have souls by banning their killing.7

Just because Christians (and members of some other religions, for that matter) have religious motivations for trying to prevent the killing of unborn babies does not mean that the government may not have non-religious motivation for the same goal. There may be economic motivation (more babies born would equal more workers and taxpayers, and therefore more revenue for the state), for example. Or if the unborn baby of a citizen were seen to be a citizen, then the government would have an interest in protecting the pre-born citizen from violence, just as there are laws to protect post-natal citizens.

Furthermore, it is important to note that all laws impose morality; the only question is whose? Laws allowing abortion impose the pro-aborts’ morality on the unborn baby. See also Questions regarding abortion and ethics.

Since even the pro-aborts admit that the unborn baby is a human being, there is no basis for denying citizenship. There is a very dangerous precedent for denying citizenship to any class of human beings who are deemed “unwanted”. Dr Leo Alexander was a doctor and expert witness at the trial of the Nazis, in particular of their eugenics and euthanasia policies, and wrote on the lessons we needed to learn:

Whatever proportions these crimes finally assumed, it became evident to all who investigated them that they had started from small beginnings. The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually, the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans. But it is important to realize that the infinitely small wedged-in lever from which this entire trend of mind received its impetus was the attitude toward the nonrehabilitable sick.8

Now, the “life not worthy to be lived” category is unwanted unborn babies, but is already being extended to infanticide and euthanasia.

Is abortion ever permissible?

Although the pro-life position opposes the vast majority of abortions that happen, where the baby is healthy and an undisturbed pregnancy would result in a living mother and baby, there are cases where most pro-life people would reluctantly allow for abortion. These are cases where the mother’s life is put at risk, and especially cases where both mother and baby would die if an abortion is not performed, which is the vast majority, e.g. ectopic pregnancies. But as explained in What about abortion to save the mother’s life? the intent is to remove the baby from its position of endangering the mother, while the intent of an abortion is a dead baby.

Such a case made news9 recently when a nun was declared to be excommunicated over an abortion she approved. In November 2009 a pregnant woman with pulmonary hypertension was admitted to St. Joseph’s Hospital and Medical Center. It was determined that her severe health problems were caused by her pregnancy, and if the pregnancy proceeded, both mother and baby would certainly die. Because of the certainty of the death of both parties, Sister Margaret McBride authorized an exception to the Catholic hospital’s ban on abortion. When Bishop Thomas J. Olmsted found out about her approval of the procedure, he declared her along with all the other people involved in the abortion, including the mother, to be excommunicated, as abortion is an automatically excommunicable offense in the Catholic church.

But most Christians would allow an abortion in this circumstance under the principle that evil should be minimized whenever possible. The mother’s life is just as valuable as the baby’s, and both would have been lost. Although we would be saddened by the loss of a young human life, we would argue that it is better for one life to be saved than to lose two lives. The same principle applies in the case of ectopic pregnancies and other such complications.


The study about whether and when the fetus is capable of feeling pain is interesting and controversial, but ultimately means little for pro-life or pro-abortion arguments. The central issue is still whether it is permissible to kill an individual before birth. The Christian position has always been that it is a great evil to kill any innocent10 person intentionally, before or after they are born. The only exception to the Christian anti-abortion position has historically been in cases where both mother and baby face certain death if the pregnancy continues.

Published: 22 July 2010

References and notes

  1. Fetal Awareness: Review of Research and Recommendations for Practice, Royal College of Obstetricians and Gynaecologists, rcog.org.uk, June 2010. Return to text.
  2. Lee, S.J., et al., Fetal Pain. A Systematic Multidisciplinary Review of the Evidence, JAMA 294(8):947-954, 2005 | doi:10.1001/jama.294.8.947. Return to text.
  3. Koch, C., When Does Consciousness Arise in Human Babies?, scientificamerican.com, September 2009. Return to text.
  4. Coghlan, A., 24-week fetuses cannot feel pain, newscientist.com, June 2010. Return to text.
  5. Levy, A., One in a million: Baby born at 23 weeks is now a thriving toddler all set for pre-school, dailymail.co.uk, July 2010. Return to text.
  6. Boonin, D., A Defense of Abortion, Cambridge University Press, xiii–xiv, 2002. Return to text.
  7. Ponnuru, R., The Party of Death, Washington, D.C.: Regnery, p. 101, 2006. Return to text.
  8. Alexander, L., Medical science under dictatorship, New England J. Medicine 241(2):39–47, 1949. Return to text.
  9. Giardina, G., Abortion and Excommunication: An E-Z Cartoon Lesson 4 Kidz, politicstodayonline.blogspot.com, June 2010. Return to text.
  10. The word “innocent” in this case does not mean “sinless” but its etymological meaning of in nocens or “not harming” Return to text.