LITTLE ROCK — The doctor whose research is the basis of a bill banning abortion at 20 weeks said Wednesday that he disapproves of his work being used to restrict abortion in Arkansas. The state House of Representatives is scheduled to consider the bill today.
Rep. Andy Mayberry, RHensley, has said the medical reasoning for House Bill 1037 is based on the research of Memphis physician Dr. Kanwaljeet “Sunny” Anand and others like him.
Anand said that fact makes him uncomfortable.
“The law needs to stay out of a woman’s uterus, period. It’s between a patient and the health-care provider andthat’s where it needs to stay,” he said.
Mayberry said Anand’s comments don’t change anything.
“The bill is based on the fact that the child feels pain at that particular juncture,” Mayberry said. “If he’s talking about what his personal views are with re-gards to life, then no, that really doesn’t [change anything.]”
Anti-abortion advocates around the world have promoted Anand’s research as unequivocal proof that a fetus can feel pain as early as 20 weeks. Groups such as National Right to Life have cited his work as a key reason to prohibit abortion weeks before U.S. Supreme Court precedent says states can. Anand has testified before Congress and England’s House of Commons. He has been interviewed about fetal pain by a range of publications, including The New York Times.
“The human fetus possesses the ability to experience pain from 20 weeks of gestation, if not earlier,” Anand said in written testimony for the U.S.Justice Department during the Supreme Court hearing on the Partial-Birth Abortion Ban Act of 2003. Speaking of the ban, he said, “the fetus would be subjected to intense pain occurring prior to fetal demise.”
Anand is chief of the pediatric critical-care medicine division at LeBonheur Children’s Medical Center in Memphis. He is also a professor of pediatrics, anesthesiology and neurobiology at the University of Tennessee Health Science Center. Anand previously served as the director of critical care medicine in the pediatrics department of the University of Arkansas for Medical Sciences. There, he studied the effects of repetitive pain in early development.
At least seven states have passed laws similar to the measure being considered in Arkansas, arguing that the state has a prevailing interest in protecting fetuses from pain. A federal appellate court is considering Arizona’s law after it was upheld by a federal judge. The Arizona law refers to Anand and his research by name.
“I think people pick up information and use it for their own personal reasons, their own personal ends,” Anand said. “I feel like the information is really being misused.”
Anand has researched pain in premature babies and infants since the 1980s, when he studied how using anesthetic during surgery on pre-term infants increased their survival rate.
Wednesday he stressed that his interest and research is on how to provide pain relief to babies undergoing surgery or in a clinical setting and that he does not specialize in abortion.
He said his research is “really not relevant” to the abortion debate.
“I have not done any research on the fetal development of pain,” he said. “Regardless of whether the fetus feels pain or not, you can avoid pain while doing an abortion.”
For instance, some doctors have advocated using an anesthetic before removing the fetus.
A 2005 Arkansas law already requires doctors performing an abortion after 20 weeks to inform the woman whether the fetus can feel pain. If the woman consents, the doctor can use anesthetic or analgesic when performing the abortion.
HB1037, scheduled to be considered today, bans abortions 20 weeks after fertilization except in cases of rape, incest or to save the life of the mother.
According to the Arkansas Department of Health, 48 abortions, or 1.2 percent of the state’s 4,033 abortions in 2011, occurred at or after 20 weeks.
That number has stayed somewhat consistent. Since 2001, 1.34 percent or 796 of the 59,254 abortions that occurred in Arkansas were at or after 20 weeks, according to data from the Health Department.
At the heart of Mayberry’s bill is one method of performing an abortion called dilation and evacuation. To abort the pregnancy, a doctor dilates, or opens, the cervix and removes the fetus and placenta in pieces.
When testifying before a Senate Committee Feb. 12, Mayberry referred to the process as “excruciatingly painful.”
“I won’t go into gruesome details, but it’s dismemberment where a utensil is used to literally tear the child apart piece by piece,” he said.
According to the department, dilation and evacuation or vacuum aspiration was used in 45 of the 48 abortions performed at or after 20 weeks in 2011. Vacuum aspiration involves suctioning the fetus and placenta out of the uterus. It is normally only used in the first three months of pregnancy.
Mayberry said the state has a compelling interest in protecting the fetus from feeling pain through the abortion.
“We’re talking about children at this point,” he said. “This is a very well-developed child.”
Mayberry’s bill specifies that doctors performing an abortion under an exemption must terminate the pregnancyin a way that provides the best opportunity for the fetus to survive. The bill doesn’t describe that process.
Mayberry said Wednesday that regardless of Anand’s feelings about abortion, the research is still valid.
“The research is the research and if the research shows that a baby feels pain at that particular point in time, and if he stands behind that, then no, it doesn’t change my view about the bill itself,” Mayberry said. “Here’s a person who has conducted this research and who doesn’t feel the same way toward the issue of abortion and so I think that gives more credibility to the research itself. It’s not being pushed from a political agenda.”
Anand said after reading the bill that if he still lived in Arkansas he would be contacting his lawmakers.
“I would call them and say the language of this bill worries me a lot as a physician and as a citizen who deeply cares for what is the greater good of the society we live in,” he said. “I just have a personal opinion that these are draconian measures and really need to be debated before they become the law of the state, need to be reconsidered even.”
While he has stood by his research while testifying about fetal pain, he has consistently tried to separate his research from the larger abortion debate.
Testifying before the Congressional Committee on House Judiciary’s Subcommittee on the Constitution in 2005, he said, “The topic of fetal pain deserves a scientific appraisal that is independent from the highly controversial and partisan issues surrounding abortion, women’s rights, or philosophical projections about the beginning of human life.”
Anand said he hasn’t testified before legislative bodies as a supporter of an abortion restriction.
“I was asked to present the scientific evidence... I simply wanted to make a contribution as a scientist to lay out what the facts are,” he said. “It’s a scientific debate.”
The medical community hasn’t settled at what point a fetus can feel pain or when it is conscious enough to be aware of pain.
Anand’s research has shown a fetus has pain receptors and moves away from painful stimuli by 20 weeks. He has said that painful stimulation can increase hormonal stress levels at that point.
His research shows a fetus can feel more pain than a child or adult because it has a higher density of pain receptors per inch because of its size and because the skin is thinner. At the same time, the fetus does not have the mental ability to modulate or reduce the pain until late in the pregnancy, he said.
He has also argued that perception of pain can occur without the cerebral cortex - which is responsible for language, processing information and consciousness. It is fully developed by around 28 weeks gestation.
The American College ofObstetricians and Gynecologists and a 2005 article by researchers at the University of California, San Francisco in the Journal of the American Medical Association disagree, saying that a fetus does not feel pain before the last three months.
In reviewing more than 100 pieces of existing research into fetal pain, the University of California researchers said that pain is subjective and it requires consciousness to recognize unpleasant stimulus. The review also states that neither the reflex to withdraw from painful stimulus or increased hormonal stress levels “prove the existence of fetal pain,” because nonpainful stimuli can cause the same reactions.
It states that the relationship between the thalamus and cerebral cortex necessary to feel pain doesn’t begin to appear until 23 to 30 weeks after gestation and that studies of electrical activity in the fetal brain suggest the capacity for perceiving pain does not exist before 29 or 30 weeks.
The review acknowledges that sensory receptors and synapses in the spinal cord necessary to sense pain develop before the connection between the thalamus and the cerebral cortex has developed, but said the fetus cannot recognize pain without that connection.
In their review, the University of California researchers question the use of such paindulling medications on a fetus, saying their unknown benefit to the fetus does not outweigh the increased risk of death to the pregnant woman.
The American College of Obstetricians and Gynecologists has weighed in on similar legislation proposed in other states, but has not come out publicly against Mayberry’s bill. In a June 2012 statement to Congress, the college opposed a similar federal bill that would have limited abortions.
Front Section, Pages 1 on 02/21/2013