Unverifiable: Do fetuses feel the pain at the time of abortion?

(Editor’s Note: This story was originally published on May 13, 2022, and this revised version was published on September 15, 2023, with changes to reflect the updated scientific view around fetal pain, which is a dynamic, evolving topic of study. Our original report included a verdict and a headline that reflected the conclusion, which has also been updated.)

Claim

Fetuses can feel the pain at the time of abortion. 

What are the facts?

Scientists believe that precisely determining fetal pain in the first trimester is challenging. Several studies argue that pain, especially the emotional component, is only possible once the cortex is developed and connected to the sensory nerves in the body. These connections are established by 24 weeks, according to the American College of Obstetricians and Gynecologists (ACOG). 

The experience of pain requires conscious recognition of a noxious stimulus, and this capacity develops in the third trimester, as per Royal College of Obstetricians and Gynecologists’ (RCOG) fetal awareness review updated in 2022. The organization has reviewed the evidence around fetal awareness twice in the past – 1997 and 2010 – and had arrived at similar conclusions.   

According to the review, the cortex is necessary for pain perception. “Connections from the periphery to the cortex are not intact before 24 weeks of gestation, and thus it was reasonable to conclude that the fetus cannot experience pain in any sense prior to this gestation”. 

The review also highlights that the “distinction between touch and noxious evoked cortical activity, an important indicator of a sense of pain distinct from innocuous or benign stimulation, is unclear until 32–33 weeks and even at term differs from that seen in adults.” 

An article titled ‘the fetal pain paradox’ published in March 2023 in Frontiers, a publisher of peer-reviewed scientific journals, highlights the paradox and states, “Pain is acknowledged and treated in the earliest preterm neonates <24–28 weeks using validated pain assessment tools.” It states that fetal surgeons administer direct fetal analgesia and anesthesia as early as 15–16 weeks gestation, and fetal anesthesiologists recommend using fetal anesthesia from the second trimester. This is all in order to “inhibit the humoral stress response, decreased fetal movement, and blunt any perception of pain.”

However, scientists also believe that fetal pain does not have to be equivalent to a mature adult human experience. Therefore, there is a need to generate a better conversation on the possibility of fetal pain.