The study of fetal and neonatal pain is an evolving discipline. In 1987 a landmark article in the New England Journal of Medicine, “Pain and its effects on the human neonate and fetus,” forever changed the perception that newborn reaction to pain was just a “reflex” and reformed the practice of omitting anesthesia for newborn medical procedures.
When writing about fetal pain, the classic issue of the mind-brain problem is always present. It is impossible to prove what another being perceives and difficult to ascertain which anatomic structures and physiologic processes are necessary for the experience of pain. The authors who dismiss the possibility of fetal pain not only reiterate this point, but also attempt to relate pain to the brain structures that develop very late in gestation. . . .
The foremost authority in fetal and neonatal pain, K.J.S Anand, was a researcher at Harvard when he co-authored the 1987 landmark study on neonatal and fetal pain, and now holds an endowed chair in critical care medicine, pediatrics, anesthesiology, pharmacology, neurobiology and developmental sciences at the University of Arkansas. Anand was critical of the JAMA article, stating that even though it purported to be a “systematic multidisciplinary review,” the authors utilized ambiguous scientific methodology in selecting only the articles that supported their point of view.
Unlike the authors of the articles dismissive of fetal pain, Anand actually takes care of babies at the same gestational ages as the fetuses under discussion. He has done extensive research in the area, authoring dozens of articles, and has no axe to grind in the abortion debate. He has testified before Congressional committees in the debates on the Partial Birth Abortion Act and, more recently, in relation to the Unborn Child Pain Awareness Act.
The main point he makes is that pain perception is not a hard-wired system and has multiple layers. He believes that the structures for pain in fetuses are not the same as in older children and adults, and the lack of mature structures should not lead to the conclusion that fetuses do not feel pain. Anand states that pain is an integral part of the nervous system and that fetuses will use whatever structures are available.