Sir, The Royal College of Obstetricians and Gynaecologists responded to the Dispatches programme on abortion, stating it was “unaware of the work of Dr Anand”. On October 23 the RCOG received 13 published articles referring to my work on foetal pain; 12 of these were published before the closing date for submissions to the Science and Technology Committee. Yet, it refers only to one article that appeared in October after the deadline.

Foetal pain requires a scientific appraisal, independent of the abortion controversy. Such an inquiry has practical implications for foetal surgery or intra-uterine procedures, perinatal management of preterm newborns and long-term effects on brain development.

The RCOG view ignores the development of foetal sensory processing, functional subplate zone (below the cerebral cortex), and sub-cortical mechanisms of consciousness that support foetal memory and learning. Three key flaws beleaguer their scientific rationale to rule out foetal pain.

First, pain is not transmitted by a hard-wired system, passively transmitting impulses until “perception” occurs in the cortex. Forty years of pain research have discarded this view. Secondly, foetal pain does not engage the same structures as those activated by adult pain. The foetus is not a “little adult” — foetal pain is mediated by mechanisms unique from adults. Thirdly, it ignores clinical data that ablation or stimulation of the sensory cortex does not alter adult pain perception, whereas thalamic ablation or stimulation does. The foetal thalamus develops in the second trimester, well before the cortex. If the sensory cortex is not essential for adult pain, why is foetal pain held to that standard?

I have no associations with either pro-life or pro-abortion lobbies; my interests are purely scientific. Current medical practices must acknowledge an emerging person in the womb, essentially nuanced by compassion for the mother’s situation and health.

Professor K. J. S. (“Sunny”) Anand
University of Arkansas for Medical Sciences

Sir, You state the need for national campaigns to promote “responsible contraception” to bring down the numbers of abortions (comment, Oct 25).

A parliamentary report issued this month showed that at least 70 per cent of general practices don’t offer women a full choice of contraceptive methods. A separate government audit shows the average spend on contraception for each woman is a pitiful £11. Contraceptive services, the Cinderella service of public health, have suffered years of disinvestment. Rather than demanding national campaigns calling for responsible contraceptive behaviour, perhaps we should demand that primary care trusts provide accessible contraceptive services.

Anne Weyman
Chief Executive, Family Planning Association

Explore Letters

• Feedback