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Prenatal perception is the study of the extent of somatosensory and other types of perception during pregnancy. In practical terms, this means the study of ; none of the accepted indicators of perception are present in . Studies of this type inform the abortion debate, along with certain related pieces of legislation in countries affected by that debate. As of 2022, there is not any scientific consensus on whether a fetus can feel pain.
In March 2010, the Royal College of Obstetricians and Gynecologists submitted a report, concluding that "Current research shows that the sensory structures are not developed or specialized enough to respond to pain in a fetus of less than 24 weeks",
The report specifically identified the anterior cingulate as the area of the cerebral cortex responsible for processing of pain. The anterior cingulate is part of the cerebral cortex, which begins to develop in the fetus at week 26. A co-author of that report reviewed the evidence in 2020, specifically the functionality of the thalamic projections into the cortical subplate, and posited "an immediate and unreflective pain experience...from as early as 12 weeks."
There is a consensus among developmental neurobiologists that the establishment of Human thalamus connections (at weeks 22–34, reliably at 29) is a critical event with regard to fetal perception of pain, as they allow peripheral sensory information to arrive at the cortex.Johnson, Martin and Everitt, Barry. Essential reproduction (Blackwell 2000), p. 235. Retrieved 2007-02-21.
Electroencephalography indicates that the capacity for functional pain perception in premature infants does not exist before 29 or 30 weeks; a 2005 meta-analysis states that withdrawal reflexes and changes of heart rates and hormone levels in response to invasive procedures are reflexes that do not indicate fetal pain.
Several types of evidence suggest that a fetus does not awaken during its time in the womb. Much of the literature concerning fetal pain simply extrapolates from findings and research of premature babies. The presence of such chemicals as adenosine, pregnanolone, and prostaglandin-D2 in both human and animal fetuses, indicate that the fetus is both sedation and anesthesia when in the womb. These chemicals are oxidized with the newborn's first few breaths and washed out of the tissues, increasing consciousness. If the fetus is asleep throughout gestation then the possibility of fetal pain is greatly minimized, although some studies found that the adenosine levels in third-trimester fetuses are only slightly greater than those in adults' blood.
Some caution that unnecessary use of fetal anesthetic may pose potential health risks to the mother. "In the context of abortion, fetal analgesia would be used solely for beneficence toward the fetus, assuming fetal pain exists. This interest must be considered in concert with maternal safety and fetal effectiveness of any proposed anesthetic or analgesic technique. For instance, general anesthesia increases abortion morbidity and mortality for women and substantially increases the cost of abortion. Although placental transfer of many opioids and sedative-hypnotics has been determined, the maternal dose required for fetal analgesia is unknown, as is the safety for women at such doses. Given the maternal risk involved and the lack of evidence of any potential benefit to the fetus, administering fetal anesthesia for abortion is not recommended.
Fetal pain legislation may make abortions more difficult to obtain, because abortion clinics lack the equipment and expertise to supply fetal anesthesia. Currently, anesthesia is administered directly to fetuses only while they are undergoing surgery.
Doctors for a Woman's Choice on Abortion state that the majority of surgical abortions in Britain are already performed with general anesthesia, which also affects the fetus. In a letter to the British Medical Journal in April 1997, they deemed the discussion "unhelpful to women and to the scientific debate" despite a report in the British Medical Journal that "the theoretical possibility that the fetus may feel pain (albeit much earlier than most embryologists and physiologists consider likely) with the procedure of legal abortion". Yet if mothers' general anesthesia were enough to anesthetise the fetus, all fetuses would be born sleepy after a cesarean section performed in general anesthesia, which is not the case. Dr. Carlo V. Bellieni also agrees that the anesthesia that women receive for fetal surgery is not sufficient to anesthetize the fetus.Bellieni, Carlo V. (2021-05). "Analgesia for fetal pain during prenatal surgery: 10 years of progress". Pediatric Research 89 (7): 1612-1618. . .
In 2013 during the 113th Congress, Trent Franks introduced a bill named the "Pain-Capable Unborn Child Protection Act" (H.R. 1797). It passed in the House on June 18, 2013, and was received in the U.S. Senate, read twice, and referred to the Judiciary Committee. Pain-Capable Unborn Child Protection Act of 2013 H.R.1797, 113th Cong., 1st Sess. (2013)
In 2004 during the 108th Congress, Sam Brownback introduced a bill named the "Unborn Child Pain Awareness Act" for the stated purpose of "ensuring that women seeking an abortion are fully informed regarding the pain experienced by their unborn child", which was read twice and referred to committee. Unborn Child Pain Awareness Act of 2005 , S.2466, 108t Cong., 2nd Sess. (2004)Weisman, Jonathan. " House to Consider Abortion Anesthesia Bill", Washington Post 2006-12-05. Retrieved 2007-02-06.
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