UK: Important new review on fetal awareness published

There is no new evidence to show fetuses feel pain in the womb before 24 weeks, a report by the Royal College of Obstetricians and Gynaecologists has stated.

The RCOG has released two Working Party reports, Fetal Awareness and Termination of Pregnancy for Fetal Abnormality. Both documents were commissioned by the Department of Health, following recommendations by the House of Commons Science and Technology Committee (STC) in 2008.

The issue of whether a fetus of 24 weeks or below can feel pain had been raised in the 2008 Parliamentary debate over whether the current time limit for abortion should be reduced, BBC News Online reports. An up-to-date analysis of evidence was recommended by the the STC’s report Scientific Developments Relating to the Abortion Act 1967.

The main findings from each of the RCOG’s new documents are:

Fetal Awareness

-- The fetus cannot feel pain before 24 weeks because the connections in the fetal brain are not fully formed

-- Evidence examined by the Working Party showed that the fetus, while in the chemical environment of the womb, is in a state of induced sleep and is unconscious

-- The Working Party concluded that because the 24 week-old fetus has no awareness nor can it feel pain, the use of analgesia is of no benefit

-- More research is needed into the short and long-term effects of the use of fetal analgesia post-24 weeks.

Termination of Pregnancy for Fetal Abnormality

-- The Working Party concluded that it is unrealistic to produce a definitive list of conditions that constitute ‘serious’ handicap since accurate diagnostic techniques are as yet unavailable. Likewise, the consequences of abnormality are difficult to predict

-- The Working Party recommends that the NHS Fetal Anomaly Screening Programme is centrally linked so that the outcome of pregnancies with specific congenital abnormalities are monitored over time.

-- Appropriate information and support should be offered to all women undergoing antenatal screening

-- In the case of a possible termination of pregnancy, all staff caring for the mother must adopt a non-directive, non-judgemental and supportive approach.

The RCOG notes that the two reports are meant to be read together as both subject matters are closely related.  The first updates the previous report published in 1997, while the latter replaces the 1996 report.

Professor Allan Templeton, chair of the Fetal Awareness Working Party, said:

‘These two reports represent an extensive review of the scientific and clinical literature, and I am grateful to the many people who contributed and in particular to the members of the two working parties. I believe we now have robust and updated guidance for healthcare professionals.’

Ann Furedi, chief executive of BPAS, said that, taken together, the two reports would provide a clear basis for difficult decisions.

‘Women and doctors need to be able to make informed decisions based on what science says, not what advocates, whether pro-choice or anti-choice, wish it said.’

But those campaigning for further limits on abortion say these reports do not reflect the full debate on the issue.

Josephine Quintavalle of the campaign group Comment on Reproductive Ethics said:

‘I think both reports tell us more about the RCOG’s willing acceptance of late abortion than the reality of the scientific and ethical issues at stake.’

A Downing Street spokeswoman said:

‘The Prime Minister’s view is that he will be led by the science.’ She added: ‘At the moment there are no plans to change the policy.’

In the last vote on abortion in Parliament in 2008, MPs rejected a proposal to reduce the time limit for abortion from 24 weeks.

Read on:

‘No foetal pain before 24 weeks’. BBC News Online, 24 June 2010

RCOG release: RCOG updates its guidance. Royal College of Obstetricians and Gynaecologists, 25 June 2010.

Download the documents (.pdf):

Fetal Awareness - Review of Research and Recommendations for Practice

Termination of Pregnancy for Fetal Abnormality in England, Scotland and Wales

Also read:

UK abortion law section, Abortion Review