Behind the ‘smile’

‘A smile for the camera at 26 weeks.’ So said a newspaper headline last week, as hi-tech scans of fetuses in-utero hit the world’s headlines, accompanied by claims that fetuses can smile, cry and blink in the womb.

The pictures were generated with a new technology, 3D and 4D ultrasound scanning, which produces fetal images that are very clear – far more so than the grainy pictures most of us are familiar with. A London clinic, Create Health Centre for Reproduction and Advanced Technology, has reportedly pioneered the use of the new scanning technique, and provided the recent images to the media.

Opponents of abortion argue that the technology is likely to increase support for their cause. Paul Deacon of the Society for the Protection of Unborn Children (SPUC) argues that the images prove ‘abortion has no place in a civilised society’. In fact, they prove no such thing. That Deacon can draw this conclusion shows, rather, that those who oppose abortion are living on another planet.

The anti-abortionists’ response indicates just how out of touch with women’s experience of pregnancy they are. ‘This development [the new ultrasound technique] will show people the humanity of the unborn child’, said Deacon. What did he think pregnant women who have abortions think they are carrying? A frog? A baby pig? Pregnant women who have abortions (and those of us who unreservedly support their right to do so) know that fetuses are human.

We also understand, however, that it is still perfectly acceptable for a pregnancy to be ended by an abortion. This is because, while we know that a fetus is human (in a genetic and biological sense), we also appreciate that it is not a person. And the failure to make this distinction is the major flaw in the arguments of anti-abortionists.

Their response to the ultrasound images of the ‘smiling’ fetus indicates that they are unable to grasp some pretty simple aspects of human experience. As most people understand, the expression of emotions and feelings (a crucial aspect of what it means to be a person) requires some development of the self. Just because a fetus moves its facial muscles and curves its lips does not mean it is ‘smiling’ in any real sense of the word.

Smiling is an activity that has social connotations. To smile requires a degree of self-consciousness and experience of interacting with other people. You do not have to be a genius to work out that a fetus, or indeed a small baby, does not have this. Small babies often smile when they fart or poo in their nappies, and they do this in front of other people. Does this mean that they are experiencing the same kind of emotion that might make a child smile when she sees a clown, or anyone smile when they see a friend?

At the very least, these basic observations suggest that there is more to smiling than simply curving your mouth. We have now been shown that 25- or 26-week-old fetuses move their facial muscles – but that is all they are doing.

That we can now see fetuses making facial movements does not make one jot of difference to the case for abortion. It does not tell us that a fetus is a person, and it does not undermine in any sense the case for the legal provision of abortion.

The truth is that abortion is chosen by women, and is allowed by society, because it is widely considered that women should not be compelled to bear children that they do not want to have. What matters for most people – and this is reflected in the practice of abortion provision – is that women are given the ability to make decisions about when they consider it appropriate and sensible to have a child.

What would be truly uncivilised is the logical consequence of the view argued for by Deacon and others – to compel all women, no matter what the circumstances of the pregnancy or their feelings about it, to continue every pregnancy to term and give birth. And because the vast majority of people recognise this, it is wishful thinking on the part of those opposed to abortion to imagine that pictures of fetuses, however much they ‘smile’, ‘wave’, or even appear to dance the Highland fling, will lead to abortion being restricted by law or rejected by women.

The idea that fetuses ‘smile’ may, however, increase discomfort about abortion – especially among women who choose it. In other similar instances, for example when it has been argued that fetuses feel pain, women presenting for abortion have as a result ended up fretting about what will happen to the fetus during a termination. So while the coverage of the ‘smiling’ fetuses won’t stop abortion, it may make it a more difficult experience.

One fact that has been lost in all the coverage is that the ‘smiling’ fetus splashed across the newspapers was at least 26 weeks old. At this gestational stage, fewer than 100 abortions are performed in Britain each year. In so far as women do have abortions at this stage of pregnancy, they do so mostly because the fetus has been diagnosed with an abnormality. (Indeed, the purpose of the new ultrasound technology is to detect abnormalities, rather than smiles.) These are wanted pregnancies, and the woman and her partner have to undergo the ordeal of choosing to end it.

But much of the media coverage failed to highlight this fact – making it seem as if all abortions are of fetuses that ‘smile’ and look like little babies. Such misrepresentation could unnecessarily increase the anxiety of the thousands of women who abort pregnancies in early pregnancy (when the fetus looks nothing like a baby, and certainly does not ‘smile’) and exacerbate the distress of those who undergo the ordeal of a late termination for fetal abnormality.

Perhaps SPUC would have few qualms about these consequences. But some newspapers were also complicit in distorting the truth about abortion. The London Evening Standard’s Isabel Oakeshott wrote an article with the subhead ‘Stunning new images reopen debate over feelings of unborn children’ – and included comments only from those opposed to abortion (1). One would have hoped for a more balanced and informed piece from someone with the title ‘health correspondent’.

Perhaps most worrying of all, however, was the way that some scientists let their emotions (or desire to get in the media) get the better of them. Professor Stuart Campbell is the obstetrician at the Create Health Centre who has used the new scanning technique, and who spoke to the press about it. He seemed to think there was nothing problematic about stating that fetuses ‘smile’ in the womb, as if they are just like six-month-old babies or small children.

Campbell even made the rather bizarre comment that: ‘This may indicate a baby’s calm, trouble-free existence in the womb, and the relatively traumatic first few weeks after birth, when the baby is reacting to a new environment.’ In other words, according to Campbell, babies don’t smile until about six weeks after they have been born because they are so traumatised by being born. Until then, when they were in the womb, they are happy as could be, and understand they are happy.

This sounds like little more than sentimentality. Professor Campbell likes babies, especially when they are happy, and is therefore delighted when he sees one ‘smiling’ in the womb. But this is not science, and it is not evidence. It tells us nothing about what it means to be a person, and nothing about the development of human consciousness.

Campbell’s interpretation of his ultrasound pictures is reminiscent of the approach taken by some in discussion of ‘fetal pain’. Those who believe fetuses feel pain point out that babies screw their faces up during and just after birth (2). Babies really look like they are in pain and so, they argue, we have to consider that they may well be, and organise obstetric care (and the provision of abortion services) on this basis.

This superficial approach to a serious and important issue is troubling. It indicates that some who have a scientific training are letting their hearts rule their heads. Perhaps the most important demand we can make in response to the ‘smiling fetuses’ coverage is for scientists and clinicians to avoid this kind of sentimentalising, and to keep in view what it means to think scientifically.

Ellie Lee is coordinator of the Pro-Choice Forum, and a research fellow in the Department of Sociology and Social Policy at the University of Southampton. She is the author of Abortion, Motherhood, and Mental Health: Medicalising Reproduction in the United States and Great Britain, Walter de Gruyter, 2004 (buy this book from Amazon (UK) or Amazon (USA)). She is also the editor of Abortion: Whose Right?, Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)); Designer Babies: Where Should We Draw the Line?, Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)); and Abortion Law and Politics Today, Palgrave Macmillan, 1998 (buy this book from Amazon (UK) or Amazon (USA)).

Read on:

Defending abortion – in law and practice, by Ellie Lee and Ann Furedi

(1) Isabel Oakeshott, ‘Proof Babies Smile in Womb’, Evening Standard, 12 September

(2) Defending abortion – in law and practice, Pro-Choice Forum. For discussion of ‘fetal pain’, see The science and politics of fetal pain, by Dr Stuart Derbyshire, Pro-Choice Forum