Summary of a presentation given by Dr. Paul Ranalli on "Pain, Fetal Development, and Partial-birth abortion".
The fetus can feel pain at 20 weeks. This is probably a conservatively late estimate, but it is scientifically solid. Elements of the pain-conveying system (spino-thalamic system) begin to be assembled at 7 weeks; enough development has occurred by 12-14 weeks that some pain perception is likely, and continues to build through the second trimester. By 20 weeks, the spino- thalamic system is fully established and connected.

There are three different indicators providing evidence that the fetus feels pain.

Anatomical
- pain receptors spread over the body in stages: 8-16 weeks
- pain impulse connections in the spinal cord link up and reach the thalamus (the brain's reception center): 7-20 weeks (summarized by Anand, K.J.S., Atlanta)

Physiological/Hormonal
- fetuses withdraw from painful stimulation
- two types of stress hormones, normally released by adults subjected to pain, are released by adults subjected to pain, are releases in massive amounts by the fetus subjected to a needle puncture to draw a blood sample:
(a) from 19 weeks onward (N. Fisk; London, England)
(b) from 16 weeks onward (J. Partch; Kiel, Germany)

Behavioral
- withdraw from pain
- change in vital signs
A 20-30 week old fetus actually will feel more pain than an adult. The period between 20-30 weeks is a uniquely vulnerable time, since the pain system is fully established, yet the higher level pain-modifying system has barely begun to develop.

Posted by Barbara on December 17, 2004 09:08 AM Link to comment

If we can kill 'em without hurtin' 'em will that be okay?

Posted by Buck on December 17, 2004 09:31 AM Link to comment

Barbara, thanks for the facts and figures about fetal pain. I'm wary of them for the simple reason that the person who presented them used the non-medical term "partial birth abortion" in the presentation title. Normally that is a sign that the person is pursuing a political - not medical - agenda. However, that doesn't mean the facts he cites are wrong, and I suspect they are close.

Buck - We are a society that doesn't like causing pain (as evidenced by the existence of our humane societies, our anasthesiologists, and our manufacturers of anasthetic medicines)... but we are also a society that inflicts pain regularly anyway, without outlawing it in most cases (as evidenced by the booming meat and poultry business and NFL).

I used to be a vegetarian on the theory that we should never knowingly make another being suffer, but now I feel that a better ethic has to take into account the moral status of the being who is caused suffering, the reasons we have when we do choose to cause suffering, and how much care we take to avoid it when it isn't necessary.

Under that viewpoint it is difficult to say the potential pain of an early term fetus outweighs a woman's right to determine whether to have it continue to gestate in her womb - which is part of the reason I am pro-choice.

Posted by smijer on December 17, 2004 10:18 AM Link to comment

This is from the AMA not from an individual.
you can finish reading the rest of the article at....http://www.cirp.org/library/pain/anand/
I just thought the other would be easier for most to read without being in the medical field.

The neural pathways for pain may be traced from sensory receptors in the skin to sensory areas in the cerebral cortex of newborn infants. The density of nociceptive nerve endings in the skin of newborns is similar to or greater than that in adult skin.24 Cutaneous sensory receptors appear in the perioral area of the human fetus in the 7th week of gestation; they spread to the rest of the face, the palms of the hands, and the soles of the feet by the 11th week, to the trunk and proximal parts of the arms and legs by the 15th week, and to all cutaneous and mucous surfaces by the 20th week.25,26 The spread of cutaneous receptors is preceded by the development of synapses between sensory fibers and interneurons in the dorsal horn of the spinal cord, which first appear during the sixth week of gestation.27,28 Recent studies using electron microscopy and immunocytochemical methods show that the development of various types of cells in the dorsal horn (along with their laminar arrangement, synaptic interconnections, and specific neurotransmitter vesicles) begins before 13 to 14 weeks of gestation and is completed by 30 weeks.29

Lack of myelination has been proposed as an index of the lack of maturity in the neonatal nervous system30 and is used frequently to support the argument that premature or full-term neonates are not capable of pain perception.9-19 However, even in the peripheral nerves of adults, nociceptive impulses are carried through unmyelinate (C-polymodal) and thinly myelinated (A-delta) fibers.31 Incomplete myelination merely implies a slower conduction velocity in the nerves or central nerve tracts of neonates, which is offset completely by the shorter interneuron and neuromuscular distances traveled by the impulse.32 Moreover, quantitative neuroanatomical data have shown that nociceptive nerve tracts in the spinal cord and central nervous system undergo complete myelination during the second and third trimesters of gestation. Pain pathways to the brain stem and thalamus are completely myelinated by 30 weeks; whereas the thalamocortical pain fibers in the posterior limb of the internal capsule and corona radiata are myelinated by 37 weeks.33

Development of the fetal neocortex begins at 8 weeks gestation, and by 20 weeks each cortex has a full complement of 109 neurons.34 The dendritic processes of the cortical neurons undergo profuse arborizations and develop synaptic targets for the incoming thalamocortical fibers and intracortical connections.35,36 The timing of the thalamocortical connection is of crucial importance for cortical perception, since most sensory pathways to the neocortex have synapses in the thalamus. Studies of primate and human fetuses have shown that afferent neurons in the thalamus produce axons that arrive in the cerebrum before mid-gestation. These fibers then "wait" just below the neocortex until migration and dendritic arborization of cortical neurons are complete and finally establish synaptic connections between 20 and 24 weeks of gestation (Fig. 1).36-38

Just for the record....gestational age means the age or time from the mother's last menstrual period.

Also, Buck, in my mind at least, the fact that the baby/fetus has the nerves and enough of a brain to feel pain makes it very, very already human to me. If it will retract from pain as early as 7 weeks gestation?? I don't know about you, but that tells me that (especially) anything after that is a "no-no."

Posted by Barbara on December 17, 2004 12:47 PM Link to comment

Barbara, lots of things can respond to or retract from pain. I don't understand why, if that is your criteria for deciding what is and isn't a human being, you aren't a vegetarian.

Thanks again for the medical facts, especially those that are sourced to the AMA.

Posted by smijer on December 17, 2004 01:14 PM Link to comment

This is not just any 'thing' we are talking about as an end product. As an end product, it is a human which is capable of feelings and thought and a lot of other things that animals that we eat are not capable of. Also, when we kill livestock for food it is usually a swift, quick death. We don't kill them by ripping them apart with machines. Maybe I'm not educated enough to know exactly how animals suffer, but I do know about the abortion process.

Posted by Barbara on December 17, 2004 02:24 PM Link to comment

Furthermore, what is the criteria that changes the idea that an abortion can be carried out at one point and not another? I think that the study cited by the American Medical Association shows clearly that the Central Nervous System and the brain is well developed at a very early gestational age. Do you realize the minute details of the brain and CNS that they are describing above? It's amazing! It carries a lot of weight when trying to decide what gestational age is appropriate or inappropriate for abortion if abortion should be considered at all.

Posted by Barbara on December 17, 2004 02:55 PM Link to comment

Well, that's kind of what the question is... What is a fetus? Is it "a human which is capable of feelings and thought and a lot of other things", and therefore something that we should protect with the same laws we protect ourselves with? If you think it is, then you have to explain why - what is it about people that you think we should have laws protecting them? The only criterion we've talked about it is pain - but I think we all agree that the ability to experience or react to pain isn't what makes something a person... So what does make something a human being, according to you? What is it that anybody, including a judge can look at and see that will make them say "this is a human being". What kinds of things should the law recognize as "protected"?

Posted by smijer on December 17, 2004 03:01 PM Link to comment

I guess we were posting at the same time, and I missed replying to your second post. It is amazing that the development of the CNS is known at such minute detail. Unfortunately, I can't really use that information to piece together a picture of whether the early term fetus has developed cognitive function closely matching what we expect from anyone we unequivocally consider to be a thinking, experiencing human being, and even more unfortunately, this seven week snapshot only tells us about the CNS at that early stage of development, so we can't get information about what happens later on in development from there.

this link from a philosophy page helps one see what a difficult set of questions we must answer before we can decide what kind of organism is more important than a woman's sovereignty over her body.

Posted by smijer on December 17, 2004 03:35 PM Link to comment

Please define or explain in your own words, 'sovereignty over a woman's own body.' I'm really interested to see just what you think that is.

Posted by Barbara on December 17, 2004 04:23 PM Link to comment

You say....
this seven week snapshot only tells us about the CNS at that early stage of development, so we can't get information about what happens later on in development from there.
Actually....
The article gets into detail about development well after that and I can give you other medical articles that tell more about the development as well. We play stupid about this when we have proof hand over fist.

Posted by Barbara on December 17, 2004 04:44 PM Link to comment

Sovereignty means "rule" or "authority". It is because you have sovereignty over your body that the government cannot force you to give blood or donate a kidney. And according to my view, it is your choice (because you are sovereign over your body) whether to allow a fetus use of your body for gestation or not. Unless that fetus is a person, right and proper, with a right to life that is equal to and in opposition to your right to sovereignty, then it isn't the government's right to force you to use your body for that purpose.

On the other hand, restrictions on late-term abortions can make sense to me since there is time in the early term for a woman to exercise that sovereignty. The only reason such restrictions don't makes sense is that most women who are choosing to abort the pregnancy do so in the early term - most of those that go late are done for medical reasons to begin with, and further restrictions on those are not necessarily going to create a much better situation. So there's room for debate there, too.

Posted by smijer on December 17, 2004 04:44 PM Link to comment

The article gets into detail about development well after that and I can give you other medical articles that tell more about the development as well. We play stupid about this when we have proof hand over fist.

I did go on and look at the other stuff about development... I guess I wish I understood more about what it meant, but I don't think even then it would really answer the relevant questions. Because of a thing called infant amnesia it is almost impossible for us to relate stages in CNS development to types of cognitive experience - nobody remembers the cognitive experiences of a newborn - much less that of a fetus in one of the various states of development...

So, nobody is "playing stupid" - there are really a lot of big questions that aren't answered here - and the important ones are more philosophical than medical, though medical science can be a very important aid in making those decisions. I would say that anybody who thinks they have all the answers is "playing smart". I posted my "opinion" - as opinion - that there is no justification for considering a fetus in first or early second trimester to be a human being that should be protected under the law, because the nervous system is just being to operate and is not even up to the more primitive tasks of controlling movement, so we wouldn't expect it to be capable of the more sophisticated cognitive tasks of emotion and personality. I do have to recognize that it can respond to pain at this point, but I don't think anybody thinks that the ability to respond to pain makes you human... even an insect can do that. So, I think it's a dialogue we need to have, and I think we need to find a consensus about when and where it makes sense to restrict abortion, and when and where it makes sense to protect a woman's sovereignty over her own body.

Posted by smijer on December 17, 2004 05:00 PM Link to comment

I guess that is where we differ. I feel like women have the sovereign right not to let it get there in the first place. We can exercise our sovereignty by birth control or abstinence. I know A LOT of women that use abortion for birth control. I've personally met people that do it or have done it several times for that reason. If we make it easier to do, then there will be more of it for that reason.
I agree that there are circumstances that warrant it, though we probably disagree what those are too. I don't know what kind of system we could put into place to protect the women that NEED protecting and the unborn 'babies' that need protecting, but there has got to be a way. To rid yourself of a pregnancy because you don't want stretch marks makes me want to puke though. I have honestly heard women make those remarks too....in their second trimester. That is the kind of people that will be 'using' the laws.

Posted by Barbara on December 17, 2004 05:07 PM Link to comment

See, I don't see why people feel that women automatically lose sovereignty over their body once an egg cell meets a sperm cell inside of it, regardless of how much control she might have been able to exert in an attempt to keep that from happening. Can you explain to me why you feel that she no longer has a say over what goes on in her body after those two cells meet and dance the dance of fertilization?

Posted by smijer on December 17, 2004 05:15 PM Link to comment

I'm not trying to play smart or trying to do anything more than state my opinion. Nor did I state any different anywhere in my comments. It is you that keep insisting that I base my argument 'only' on pain because that is all that I mentioned when that is not what I stated at all. There are other 'things' besides pain that lead me to believe that a very early gestational period should be the minimum point if at all.You are alos making it sound like I am saying that the explanation is all medical and I never said that either. Sure philosophy plays a part, but so does ethics and with most people (but not you) religion. But if we argued all aspects instead of picking one little peice at a time, neither of us would get anything else done.

Posted by barbara on December 17, 2004 05:30 PM Link to comment

I was just pointing out that receptivity to pain was the only reason you gave -- hoping to get you to outline your reasons in a systematic way.

You said that X "disgusts" you or "makes you want to puke"... I think sometimes we allow the visceral emotions too much influence over our thought process. There are plenty of things people do that are within their rights that disgust me, too -- but that doesn't mean I can take their rights away. All I'm trying to do here is point out that before you make laws that restrict people's rights to control their own body, it's a good idea to have a clear understanding of what your ethical basis for doing it is.

There are a lot of emotions tied up in a discussion like this - and that's one reason that it never gets anywhere... people often get too emotional to have a civil and fruitful dialogue about it. And so you have each side glaring distrustfully across the fence at the other. At some point, we're going to have to get our emotions under wraps - as a nation - and have some serious discussions about this issue.

Posted by smijer on December 17, 2004 05:36 PM Link to comment

We all have to suffer the consequences for our actions. We teach our children everyday that there are consequences for things they do without thinking. Why should a baby have to die so a woman doesn't have to do the same thing? Have you not paid the consequences all of your life for the bad choices that you have made? We all have and do!! If she doesn't want the baby, then there are plenty of people that do. Have it and give it up. Think about birth control and other preventive measures before sex the next time. Are we supposed to be responsible in every aspect of our lives except our sex lives? Because we have that quick fix if we need it?

Posted by Barbara on December 17, 2004 05:37 PM Link to comment

You sir, are living in a dream world. As long as there are babies, people who want babies and can't have them, people who have had babies and lost them, and people who beleive the Bible and that 'God knew us even when we were conceived,' then we will always be glaring over the fence at each other distrustfully.

Posted by Barbara on December 17, 2004 05:43 PM Link to comment

Responsibility normally only applies to somebody. If a woman gets pregnant, who is she responsible to? Can you be responsible to a fetus?

If not, isn't "responsibility" just the same thing as "she should be punished for opening her legs"? - That "responsibility" argument without ever making the case that the fetus is a person with rights is what fuels the suspicion from those "uber-feminists" I mentioned above. If you tell them that they have to be responsible for their actions by having to carry a pregnancy for term, and you haven't bothered to identify a person to whom you have created a debt or responsibility, then all they hear is self-righteous moralizing.

If there is a person there, then of course it has rights, and the woman's right to self-determination have to be weighed in the balance... but if the thing there - no matter how adorable we find it, or how repulsive we find the notion of killing it - if it isn't a person, then the rights of a person have to come first.

I think the same thing applies to the religious view that "God knew us even when we were conceived"... whatever you interpret that to mean, and no matter how firmly you believe it, it is your religious belief, and so it only governs your actions. Our judges are only empowered to enforce man's laws: not presume to know and enforce God's laws on His behalf.

Posted by smijer on December 17, 2004 06:01 PM Link to comment

Well, I guess it is just 'opinion' what constitutes enough evidence to prove that the 'thing' is a baby or not, huh? So it will always be an argument right? So we are all wasting our breath because none of us remember what it is like to be in the womb. Isn't that what you said? So it will all always be medical and philossophical theory and we can argue until we are blue in the face and get nowhere.

Posted by Barbara on December 17, 2004 07:01 PM Link to comment

I suppose if you are satisfied with your opinion and have no interest in understanding the opinions of others on the matter, and if you feel you opinion entitles you to legislate what a woman must do with her body, then no - there isn't much need to debate. There are others, however, who may see room for a healthy national dialogue on this issue...that's why I brought it up...

Posted by smijer on December 17, 2004 07:13 PM Link to comment

I am merely saying that there is no means to an end or a compromise based on your rules. One side or another has to give somewhere. We are very representative of those staring across the fence. I don't want to budge on anything and you don't either. We still keep throwing up the same arguments that everyone throw up, and don't come up with any better solutions because there are none as long as emotions are involved...and they are!
You always say that I tell you what you think. You always twist what I say to make it seem that I think something else besides what I said. Which is better.....or worse?

Posted by Barbara on December 17, 2004 10:41 PM Link to comment

I'd say that there isn't any room for a fruitful dialogue between me and you on the issue right now, based on the tone of these last few comments. However, I do think that there is a need for people to set aside some of the emotion, try to help the other side understand where they are coming from, and try to understand why the other side feels the way they do. I was hoping to get a little bit of that started myself with this post. I don't suppose I succeeded this time. Maybe next time.

Posted by smijer on December 18, 2004 08:26 AM Link to comment

Now this has been lots of fun! This is definitely a subject that cannot be discussed without emotion and nobody is going to budge an inch. It is only fair for me to take a stand on the issue if I am going to throw my two cents worth into the discussion. I have always been pro choice. The reason is that it is impossible to treat every individual case as unique unless the option of choice is left open.

I think that there would be far less unwanted pregnancy if father's were held more accountable for their actions. It is not fair to put it all off on the woman but in our society more often than not the man impregnates the woman and then whistles off into the night while she is left to determine whether or not to keep the baby.

Now, any woman who wants to terminate a pregnancy because she does not want stretch marks needs not to procreate anyway. I am glad she is aborting. It can only help clear up the gene pool. We should encourage that kind of thinker to do society a favor and go ahead and get her tubes tied.

I think that irresponsible men should be highly encouraged to get a vasectomy. It is practically painless and absolutely meaningless because everything still works just as it always did. I know men who have fathered children by three different women and married none of the women. It is inexcusable and if the taxpayers are going to raise these kids then the taxpayers should have some say in how big they want their family to be.

I know that the Democrats are looking for issues that they can tweak in order to pull in the few hundred thousand Ohio votes they need in 2008 to win the next election. I just don't think that this is the issue to choose. A conservative, right wing Republican that slips out of town to get her abortion is still going to rant and rave against abortion in public because she is expected to.

And anyway, when Laura Bush was asked about abortion didn't she say "I think it should be rare"? How does that differ from the position of the Democrats?

Posted by Buck on December 18, 2004 01:25 PM Link to comment

Hello Buck! :o) Welcome to our fun! I'm going to work backwards...just because.

First of all...just because I oppose abortion doesn't mean that I am full-fledged republican. I like a lot of the ideas from both sides. I really liked Howard Dean's approach. However, he didn't just run his mouth about it, he actually had done something about it in his state to reduce the number of pregnancies as governor. That is what we need. We need the government to educate, get involved, and be proactive before abortion becomes an option.

Vasectomy practically painless? Not for some men, but I can't speak from personal experience. I have, however, heard men complain a lot about the pain after having one done. Anyway, I agree about men taking more responsibility. I would love to read the law that could make that happen.

Many of us that are not pro-choice are just barely not pro-choice. I beleive, like you, that it should be considered on a case by case basis. However, I think that I feel probably more strictly than you. I am just afraid that if given 'pure choice,' then the law will be severely taken advantage of and used inappropriately. Why not have it Pro life except for certain provisions on a case by case basis?

Posted by Barbara on December 19, 2004 05:08 PM Link to comment

Any truth to any of this?

I, Glen, am a Christian ethicist, and trained in statistical analysis. I am consistently pro-life. My son David is one witness. For my family, "pro-life" is personal. My wife caught rubella in the eighth week of her pregnancy. We decided not to terminate, to love and raise our baby. David is legally blind and severely handicapped; he also is a blessing to us and to the world. Gary Krane is an investigative journalist.

We look at the fruits of political policies more than words. We analyzed the data on abortion during the Bush presidency. There is no single source for this information -- federal reports go only to the year 2000, and many states do not report -- but we found enough data to identify trends. Our findings are disturbing.

Abortion was decreasing. When President Bush took office, the nation's abortion rates were at a 24-year low, after a 17.4 percent decline during the 1990s. This was a steady decrease averaging 1.7 percent per year. (The data come from Minnesota Citizens Concerned for Life using the Guttmacher Institute's studies.)

Enter George W. Bush in 2001. One would expect the abortion rate to continue its consistent course downward, if not plunge. Instead, the opposite happened.

We found four states that have posted three-year statistics: Kentucky's increased by 3.2 percent from 2000 to 2003. Michigan's increased by 11.3 percent from 2000 to 2003. Pennsylvania's increased by 1.9 percent from 1999 to 2002. Colorado's rates skyrocketed 111 percent. We found 12 additional states that reported statistics for 2001 and 2002. Eight states saw an increase in abortion rates (14.6 percent average increase), and four saw a decrease (4.3 percent average).

Under Bush, the decade-long trend of declining abortion rates appears to have reversed. Given the trends of the 1990s, 52,000 more abortions occurred in the United States in 2002 than would have been expected before this change of direction.

For anyone familiar with why most women have abortions, this is no surprise:

Two-thirds of women who have abortions cite "inability to afford a child" as their primary reason (Minnesota Citizens Concerned for Life). In the Bush presidency, unemployment rates increased half again. Not since Herbert Hoover had there been a net loss of jobs during a presidency until the current administration. Average real incomes decreased, and for seven years the minimum wage has not been raised to match inflation. With less income, many prospective mothers fear another mouth to feed.

Half of all women who abort say they do not have a reliable mate. And men who are jobless usually do not marry. In the 16 states, there were 16,392 fewer marriages than the year before, and 7,869 more abortions. As male unemployment increases, marriages fall and abortion rises.

Women worry about health care for themselves and their children. Since 5.2 million more people have no health insurance now than before this presidency -- with women of childbearing age overrepresented in those 5.2 million -- abortion increases.

My wife and I know -- as does my son David -- that doctors, nurses, hospitals, medical insurance, special schooling and parental employment are crucial for a special child. David attended the Kentucky School for the Blind, as well as schools for children with cerebral palsy and other disabilities. He was mainstreamed in public schools as well. We have two other sons and five grandchildren, and we know that every mother, every father and every child needs public and family support.

What does this tell us? Economic policy and abortion are not separate issues; they form one moral imperative. Rhetoric is hollow, mere tinkling brass, without health care, insurance, jobs, child care and a living wage. Pro-life in deed, not merely in word, means we need a president who will do something about jobs, health insurance and support for mothers.

Just wondering

Posted by Buck on December 20, 2004 04:22 PM Link to comment

Hi everyone, thought I'd throw my two cents in. To me, the argument about abortion has been blown into a thousand fragments when I'm only concerned about one.

inability to afford a baby - irrelevant
whether the baby can feel pain - irrelevant
Obligation for either the man or the woman to take responsibility - irrelevant

All of these are good arguments to take up, they just have nothing to do with abortion. I feel that the true issue here is whether the baby is a "person" or has a "soul." Beside the issue of killing another person, all other arguments are non-issues. In my mind killing an embryo would be permissible if it did not yet have a soul. I am a Christian, so I do believe that God endows us with a soul. However I don't think it happens at conception, based on the fact that the embryo can split into twins. The basis of my pro-life stance lies in the fact that we just don't know when the embryo transforms into a person. Abortion may or may not be murder, but in my mind if we don't know, we just shouldn't do it.

Posted by AFN on December 27, 2004 12:02 AM Link to comment