Ronald Reagan, The Silent Scream and the Slow Rise of Fetal Pain

A generation after Ronald Reagan planted the idea, states embrace a scientifically dubious concept as a way to limit abortion, reports Allison Yarrow.

Ric Feld / AP Photos

A generation after President Ronald Reagan and the film The Silent Scream opened a new front in the abortion war by introducing the American public to the emotionally charged if scientifically dubious idea that fetuses could feel pain, the concept has returned with a vengeance.

While there’s no way to prove a negative, it’s “unlikely” a fetus can perceive pain before the third trimester since that’s when nerve fibers reach the cerebral cortex, where consciousness is understood to reside. Before that connection is made, what appears to be a pain response, like a fetus pulling back from a scalpel, is merely blind reflex, according to Fetal Pain: A Systematic Multidisciplinary Review of the Evidence, a 2005 article in the Journal of the American Medical Association that reviewed 2,000 previously published medical journal studies articles on the subject and reflects the consensus among doctors and scientists on the issue. That paper was written as a direct response to the Unborn Child Pain Awareness Act first introduced by Kansas Republic Senator Sam Brownback in 2004, and intended “[t]o ensure that women seeking an abortion are fully informed regarding the pain experienced by their unborn child.”

While that bill never became law, states have taken up the pain awareness fight and advanced it past mandating that doctors give women seeking an abortion information about fetal suffering into an outright ban on abortion after about 20 weeks—undermining the Supreme Court’s Roe v. Wade decision allowing for abortion through at least 24 weeks. Six other states and Washington D.C. are considering similar bills.

It’s a revival of a line of argument that briefly hit the American mainstream a generation ago, after Ronald Reagan ascended to the presidency looking to undo the wrong he thought he had done a decade and a half earlier by legalizing abortion as California governor, and Dr. Bernard Nathanson released a small film called The Silent Scream.

Reagan first broached the idea of fetal suffering in 1983, in an article for the Human Life Review, where he asked: “Who is the patient if not that tiny unborn human being who can feel pain when he or she is approached by doctors who come to kill rather than to cure?” That article was reprinted later in the year in Abortion and the Conscience of a Nation, a slim volume that was the first and remains the only book published by a sitting president.

The idea of fetal pain, new to most Americans, and outside of the medical mainstream, attracted broader attention the following January, when Reagan raised it in a high-profile speech to the Annual Convention of Religious Broadcasters, his first address after formally announcing his bid for reelection.

“There's another grim truth we should face up to,” said Reagan. “Medical science doctors confirm that when the lives of the unborn are snuffed out, they often feel pain, pain that is long and agonizing,”

The chief speechwriter in the Reagan White House, Bentley Elliott, who worked on that speech, said in an interview with The Daily Beast that the gathering of religious broadcasters, among them Pat Boone and Pat Robertson, was the ideal occasion for the president to air his antiabortion views. “I certainly tried not to be obnoxious about it, say it five times in a speech, but on important occasions when the president would be expected to talk about social issues, we were willing to go to the mat for it,” Elliott said.

Fetal pain was a much-discussed subject in pro-life circles at the time, said Elliott, and many on the White House staff wanted Reagan to trumpet that life-affirming message.

Many who worked in the administration remember the speech, but not where those exact lines, or the idea of fetal pain, came from. The day after the speech, The New York Times reported that the White House attributed the idea to a 1981 article in Human Life Review.

The president—who Elliott says took a “beating” afterward from the pro-choice community and the press—received a letter about two weeks later signed by 26 doctors and professors praising his “drawing attention to the capability of the human fetus to feel pain” and assuring him that he “stand(s) on firmly established ground.”

After Reagan primed the pump, the concept exploded as a topic of debate the next year when Nathanson, a former abortion practitioner and the cofounder of NARAL Pro-choice, released The Silent Scream. The doctor narrates “from the victim’s perceptive,” as he put it, as an abortion is performed on a screen next to him. He calls the fetus a child, and asserts its open mouth is shrieking with pain during the procedure. As the fetus thrashes about, Nathanson says it is trying “to escape the inexorable instruments that the abortionist is using.”

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This film, widely seen and far more widely discussed, became a cultural touchstone. Doctors disputed Nathanson’s contention that a fetus could sense pain as early as 12 weeks, and opponents condemned the movie as emotional propaganda and pseudoscience. Many women felt antagonized, and some demanded to know: where was the woman whose ultrasound footage this was?

A cri de coeur of the pro-life cause, the film reportedly converted many to abandon their support of legal abortion and gave a new sense of momentum and direction to anti-Roe activists, who felt their message was at last being received by a wider audience.

“It gave the movement a shot in the arm at the time. There were a lot of intense internal battles, but it had a therapeutic effect,” said political science professor Michael New of the University of Michigan-Dearborn.

The film was screened for workers in the Reagan White House, stoking tension among the ranks. Reagan himself endorsed the film as a must-see, and aides pursued a plan to distribute copies to Washington lawmakers but stopped when that brought them up against rules on soliciting members of Congress.

The Chicago Tribune speculated in 2011 that Nathanson, who died last year, had been inspired by Reagan’s remarks to film an abortion for theatrical release. “That’s possible,” says Elliott, who added that abortion foes “took courage” from the president’s remarks.

The response to The Silent Scream, says New, helped the antiabortion movement—which has been split over whether to pursue a nationwide ban or to push the issue in state legislatures—settle successfully on the latter course.

And it was at the state level that fetal pain reemerged as a major theme in anti-abortion counseling materials around 2005, says policy analyst Elizabeth Nash of the Guttmacher Institute, a reproductive-rights advocacy group. Those pamphlets encouraged doctors to counsel prospective abortion patients that "the unborn child has the physical structures necessary to experience pain," and that "unborn children seek to evade certain stimuli in a manner that in an infant or an adult would be interpreted to be a response to pain." That literature in turn became the basis for the state laws banning abortions after about 20 weeks, says Nash.

Those laws have leaned heavily on the handful of medical professionals who have testified in favor of them, opining that pain is possible for a fetus at 20 weeks, or even less. Gynecologist Anthony Levatino, testified in favor of the Washington fetal pain bill, giving a peek into the horrors of the abortions he once performed.

“You know you have it right when you crush down on the clamp and see whitegelatinous material coming through the cervix. That was the baby’s brains. Many times a little face may come out and stare back at you. Congratulations!”

Nebraska’s law for instance passed in 2010, states that its purpose is “to protect pain-capable unborn children.” Its legislative findings state that “the unborn child reacts to stimuli that would be recognized as painful if applied to an adult human, for example, by recoiling.”

“Since abortion opponents have not been able to ban abortion outright, they have turned to using dubious science to limit abortion access,” Nash said.

Reagan, said New, “would be happy” about the laws built on the idea of fetal pain that the president introduced into the American mainstream.

“He would never take personal credit, but he would say when people have the facts, they make the right decisions,” Elliott said.