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The speciousness of “fetal pain”

What is “fetal personhood”? What role does poverty and welfare policy play in shaping reproductive rights? Questions about reproductive rights are just as complex–and controversial–as they were in the Roe v. Wade-era. The following is adapted from Rickie Solinger’s Reproductive Politics: What Everyone Needs to Know.

Since 1980, the concept of “fetal pain” has been politically useful to anti-abortion advocates, never mind its medical speciousness. In that year, Dr. Bernard Nathanson, a former abortion-performing physician, decided to make a film, “The Silent Scream,” to illustrate the horrors of abortion after hearing President Ronald Reagan speak to a gathering of religious broadcasters about the “long and agonizing pain” of the unborn child while they are being “snuffed out.” Dr. Nathanson wanted his film to focus on and generate sympathy for the unborn child, not the unwillingly pregnant woman. In an effort to accomplish this, Nathanson focused on the alleged pain even a twelve-week gestational age fetus suffered in the process of an abortion. The film was first aired on the TV show Jerry Falwell Live, and has been a hugely successful mainstay of anti-abortion education since then. The enduring impact of “The Silent Scream” has been bold and clear this week as Representative Trent Franks’ bill to enact a federal 20-week abortion ban freely jettisons science and political integrity , making the same old discredited claims about “fetal pain.”

Many obstetricians and others have pointed out that whatever scientists ultimately conclude about fetuses and pain, “The Silent Scream” is effective propaganda but not an adequate or accurate vehicle for education about abortion. In the film, the two-inch-long fetus is magnified massively. Dr. Nathanson, as the commentator within the film, stands next to a TV screen showing an abortion in progress. He interprets what the viewer is seeing, while holding in his arms a baby-sized doll to explain the position and movements of the fetus. Both the doll and the magnified fetus suggest, visually, that the twelve-week fetus, which Dr. Nathanson refers to as “the child,” is the equivalent of a live baby. Nathanson explains that the fetus is recoiling in pain as the abortion instrument makes contact with it. He says, “We see the child’s mouth open in a silent scream.”

Neonatologists and other scientists have objected to Nathanson’s specific identification of fetal body parts that at twelve weeks cannot be visually differentiated in the way Nathanson indicates, and to the doctor’s commentary about the meaning of the fetus’s movements. Scientists have also objected to his association of pain with a fetus which, in the first trimester, has yet to develop a brain or the neural pathways that are necessary for perceiving and responding to pain. Nevertheless, the film has been very influential, perhaps primarily because of the emotional impact of its association of abortion and fetal pain. Some viewers have argued that no matter what the scientific accuracy of the film, “The Silent Scream” is valuable because it forces viewers to deal with moral questions raised by abortion. Politically, the film continues to be important to the anti-abortion movement because of the ways it explicitly links the movement to compassion for the fetus and implicitly associates abortion providers with deadly violence.

Fetal face profile at 22 weeks. Public domain via Wikimedia Commons.

Fetal face profile at 22 weeks. Public domain via Wikimedia Commons.

A generation after the release of “The Silent Scream,” many states have enacted laws requiring women seeking abortions after twenty-two weeks, or even earlier, to be provided with specific information, using prescribed language, informing them that a fetus of twenty weeks’ gestation “has all the physical structures necessary to experience pain,” that the fetus will recoil from pain, and that “unborn children who are 20 weeks gestational age or older who undergo prenatal surgery” are routinely administered anesthesia.

These “informed consent” laws break with tradition, as most informed consent laws generally allow the physician to determine what relevant information to impart to the patient. Here legislatures and health departments provide the scripts, and physicians are constrained to deliver them in order to fulfill what the statutes identify as the state’s obligation to a woman’s “right to know” the facts. In this way, the informed consent laws identify the anti-abortion movement, not reproductive rights, with women’s rights.

The laws also challenge the “informed consent” standard articulated in Planned Parenthood of Southeastern Pennsylvania v. Casey, which requires all information imparted to be both “truthful and not misleading.” After all, the question of fetal pain remains unresolved, a subject of scientific study and debate. Indeed, neonatologists agree that certain anatomical structures must be in place before a fetus can experience pain, and that science has not resolved questions about fetal consciousness or awareness of bodily responses. In addition, experts acknowledge that anesthesia is administered for fetal surgery for a number of reasons independent of questions of fetal pain, including to inhibit fetal movement, to prevent uterine contractions, and to prevent hormonal stress responses.

Rickie Solinger is a historian and curator. She has written and edited a number of books about reproductive politics, including Reproductive Politics: What Everyone Needs to Know; Wake Up Little Susie: Single Pregnancy and Race before Roe v. Wade; and Beggars and Choosers: How the Politics of Choice Shapes Adoption, Abortion, and Welfare in the U.S. Solinger has organized exhibitions that have traveled to 140 college and university galleries over the past eighteen years. She lives in the Hudson Valley and New York City.

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