The Royal College of Obstetricians and Gynaecologists (RCOG) releases two Working Party reports today: Fetal Awareness and Termination of Pregnancy for Fetal Abnormality. The first updates the previous report published in 1997, while the latter replaces the 1996 report. Both documents were commissioned by the Department of Health, following recommendations by the House of Commons Science and Technology Committee in 2008.
A wide range of stakeholders including scientists, doctors, midwives and lay representatives were involved in producing these reports. Relevant international scientific studies published since the 1990s were considered by the respective working parties as was evidence submitted to the Science and Technology Committee. An online public consultation followed and the public were invited to submit their views. Both documents went through rigorous peer-review which included academics, ethicists and lawyers.
To reflect new research findings and the advances in clinical practice, both original documents have been completely rewritten. These two new reports contain information for clinicians, researchers and healthcare professionals and the report on Fetal Awareness includes a new chapter with practical information and advice to women and parents.
The main findings from each document are listed below.
- 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.
These two reports are meant to be read together as both subject matters are closely related.
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.”
To view Fetal Awareness, please click here.
To view Termination of Pregnancy for Fetal Abnormality, please click here.
For more information, please contact 020 7772 6446.