Life before birth: The personhood of the unborn child

In a political gesture designed to advance the campaign to decriminalise abortion up to birth in England and Wales, the Royal College of Obstetricians and Gynaecologists issued a document on 25 January 2024 with the title, Involvement of the police and external agencies following abortion, pregnancy loss and unexpected delivery guidance for healthcare staff. This document, which was drafted with the input of the abortion industry, tells medical personnel that, regardless of the circumstances or stage of gestation, “it is never in the public interest to investigate a patient who is suspected of ending their own pregnancy”.1 It goes on to threaten disciplinary action against anyone who, without an adequate reason, informs the authorities of a potential case of unlawful abortion, stating:

“In considering whether there is a valid justification for breaching confidentiality to protect the safety of others, the ‘safety of the fetus’ is not a valid reason because in law the fetus does not have personhood status.”2

In an example of the cognitive dissonance that has taken hold of public life in the UK, just four weeks later, on 22 February, the Department of Health and Social Care launched a scheme to offer “baby loss certificates” to parents of children who had died before reaching 24 weeks of pregnancy. It was already possible to register as stillborn children who have miscarried after this stage. While a baby loss certificate is not a legal document, the scheme means that there is now official recognition throughout the whole of pregnancy “of a life lost”3 an obvious contradiction of the RCOG’s assertion that “the fetus does not have personhood status”.

Of course, this attempt to deny the humanity of unborn children is simply the latest example of semantics being used to justify deadly violence against a vulnerable group. Before the Nazi state declared Jews to be non-persons, the Weimar era jurist Karl Binding and psychiatrist Alfred Hoche jointly published Die Freigabe der Vernichtung lebensunwerten Lebens — The Permission to Destroy Life Unworthy of Life4 — which made a compassionate and economic case for invoking the term “mental death” to justify the killing of the profoundly disabled by labelling them “leere menschliche Ärmel” — “empty human sleeves”.5  The modern designation of “persistent vegetative state” is only marginally less dehumanising. While supposedly referring to their state of consciousness, it is frequently used as a description of the patient. In 1993, in the case that authorised doctors in Britain to starve and dehydrate their patients, Tony Bland’s medical team argued that the food and fluids being fed to him artificially was a futile medical treatment which was incapable of reversing the catastrophic injury to his brain. The House of Lords dutifully obliged, with Lord Justice Hoffman describing the 22-year-old Bland as “grotesquely alive”.6

Vexatious tests of “personhood” aside, when presented with the evidence, an impartial observer would have no difficulty recognising the fetus is fully alive, conscious and a fellow human being.

Intrauterine life

Regardless of the rhetoric of philosophers (such as Peter Singer, who views the unborn child and newborn infant as having the moral significance of a snail),7 it is well established that the child in the womb exhibits a wide range of characteristics associated with human consciousness. In their 2009 paper, “The emergence of human consciousness: from fetal to neonatal life”, Hugo Lagercrantz and Jean-Pierre Changeux state:

“A simple definition of consciousness is sensory awareness of the body, the self, and the world. The fetus may be aware of the body, for example by perceiving pain. It reacts to touch, smell, and sound, and shows facial expressions responding to external stimuli.”8

They then immediately dismiss these facts as insignificant arguing that, “these reactions are probably pre-programmed and have a subcortical non-conscious origin. Furthermore, the fetus is almost continuously asleep and unconscious partially due to endogenous sedation.” Despite the growing empirical evidence to the contrary, the assumption that the unborn is “autistic”, that is, non-interactive socially, persists. As psychoanalyst and family therapist, John Sonne notes this assumption has proved to be a serious impediment to the study of prenatal mentation and communication.9 But the image of the passive, soporific fetus is becoming more difficult to sustain as fetal science and medical technology continue to advance.

According to Croatian researchers, Aida Salihagić Kadić and Asim Kurjak, “more than 99 per cent of the human neocortex is formed during intrauterine life, resulting in the fascinating diversity of fetal functions and activities.”10 In their 2017 paper, “Cognitive functions of the fetus”, they note that, “the basic structures of the cerebral hemispheres and the diencephalon11 are formed by the end of gestational week eight, while the brain stem is developed around seven weeks.”  And when discussing the emotional development of the fetus they point out that, thanks to 4D ultrasound, a full range of facial expressions can be seen by the second and third trimesters. 

“In fact, smiling as well as screaming and crying can be induced by brainstem stimulation even with complete forebrain transection or destruction. However, according to the observations obtained by 4D ultrasound, the facial expressions and emotion-like behaviours may represent some kind of fetal emotion and awareness. … 

“The limbic forebrain is responsible for the expression and experience of emotions. One of the very important structures, the amygdala, mediates emotional memory, attention, arousal, and the experience of love, fear, pleasure and joy. It contains facial recognition neurons which discern the emotional significance of different facial expressions. The evaluation of faces in social processing is an area of cognition specific to the amygdala. The development of the amygdala begins in early embryonic life and reaches an advanced stage of maturity during the first postnatal year.”

Drawing conclusions almost diametrically opposed to those of Lagercrantz and Changeux, they argue that the fetus “lives in a stimulating matrix of motion as well as tactile, chemical and auditory sensory information. Moreover, the fetus is exposed to hundreds of specific and patterned stimuli each day. The structure and function of the brain are shaped by these stimuli.”

This “matrix” is quite literally the womb. Ludwig Janus poses the question, “What is the significance of spending nine months in the secret recesses of a woman’s body? What did I sense and feel and experience there?”12 John Sonne attempts to illustrate some of what this would entail.

“An argument could be made that the unborn baby knows his mother, his father, and their marriage long before he is known by them. He moves, feels the mother’s body and the mother’s movements long before the mother feels his. He probably feels the alternating rhythmic pressure changes of his mother’s systolic and diastolic pulse, but she does not feel his. He hears the mother’s heartbeat, her breathing and her borborygmus, but the mother does not hear his. He hears what is spoken to him, and may respond, but he cannot speak or make any audible vocal sound…”13

It has long been known that the sound of the mother’s heartbeat has a calming effect on an infant. Indeed, so marked is this response that Lee Salk observed that this might be why most mothers, quite unconsciously, learn to carry their child almost always on their left arm. He surmises that it was for this reason that in roughly four cases out of five, works of art in which a woman was holding a child, the infant was depicted on her left side. This he says is true in art from all parts of the world and all historic periods but “is particularly noticeable in paintings of the Madonna and Child.”14

The fetus’s sense of balance is complete by about sixteen weeks, and hearing by about twenty-five weeks. At about the same time, the senses of taste and sight and the registration of pressure, pain, and cold are all in place. Music has a pronounced effect on sixteen-to-twenty-week-old fetuses. According to David Chamberlain, babies have been shown to prefer Mozart and Vivaldi over Beethoven and Brahms, while the reaction of one fetus exposed to rock music was so violent that his mother returned home with a fractured rib.15

The baby reacts to loud noises with an increased heart rate and this response also occurs when his mother gets excited. The mother’s stress hormones cross the placenta and affect the baby.

“Message-carrying hormones can be found circulating through the body [of the baby] as early as day 30 after conception. Neuroendocrinologists have detected vasopressin, associated with memory traces, by day 49. The hypothalamus, which works closely with the endocrine glands in producing these substances, is fully differentiated by day 100.”16

When examined, the weight of the accumulated evidence shows that the unborn child, even at the earliest stages of mental and physiological development, is a fully human individual with the same innate dignity shared by all members of the human family. Why then does the scientific and medical community refuse to acknowledge this evidence? Peter Hepper, who has published extensively on fetal psychology acknowledges that his research lends itself to “political, and incorrect, interpretation depending on the individual’s views on the beginning of life, abortion etc.”17

“The presence or absence of a mind, and when this first appears, is important for issues which involve a time limit. For example, fixing the upper limit for abortions or for research on embryos may well be influenced by evidence pertaining to the existence of mind.”18

For someone taken in by the claim that the unborn child is merely a “cluster of cells”, the evidence of fetal sentience may be persuasive. For the abortionists in the RCOG, however, the pretext of personhood provides a set of goalposts that can easily be shifted so that inconvenient research can be brushed aside. For those who are ideologically opposed to the right to life, no amount of evidence would be convincing.

When he was presented with neuroimaging studies of PVS patients which suggested that they might have a greater level of consciousness than previously believed, Julian Savulescu — an outspoken advocate for infanticide and euthanasia — was dismissive.

“Even if [it is] … correct to claim that their brain-damaged patient is conscious in one sense, this finding might have no moral difference if she is not conscious in the relevant sense. Indeed, we cannot just assume that the consensus view about consciousness in neuroscience or philosophy of mind will converge on the morally relevant concept. It might be that the sense of consciousness most fruitful for scientific inquiry happens to be distinct from the one that makes a moral difference.”19

In an interview with America magazine in November 2022, Pope Francis acknowledged that the fetus is a human being but immediately added, “I do not say a person, because this is debated, but a living human being.”20 Such apparent reserve was unusual, as the Holy Father generally shows no hesitation in weighing into all kinds of debates. In reality of course there is no debate. It is a right of any member of the human family, for the unborn child, as well as the profoundly disabled adult, to be recognised as a “person” before the law.21 This is a fundamental principle and is not open to debate.


  1. RCOG Guidance, 25 January 2024, p 3.
  2. Ibid, p 4.
  3. See Department of Health and Social Care, “Government response to the independent pregnancy loss review: care and support when baby loss occurs before 24 weeks’ gestation”, 22 July 2023.
  4. Karl Binding and Alfred Hoche, Die Freigabe der Vernichtung lebensunwerten Lebens (1st publ Felix Meiner 1922, Guttenberg Press, 2014) p 59.
  5. Robert Lifton translates this phrase “empty shells of human beings” — Robert Lifton, The Nazi Doctors (Macmillan, 1986) p 47.
  6. Hoffmann LJ, in Airedale NHS Trust v Bland (1993), UKHL 17, 830.
  7. “For most mature humans, these forward-looking desires are absolutely central to our lives, so to kill a normal human against his or her wishes is to thwart that person’s most significant desires. Killing a snail does not thwart any desires of this kind, because snails are incapable of having such desires. (In this respect, however, human fetuses and even newborn infants are in the same situation as snails).” — Peter Singer, Practical Ethics (3rd ed) (CUP 2011) p 77.
  8. Hugo Lagercrantz and Jean-Pierre Changeux, “The emergence of human consciousness: from fetal to neonatal life” (2009), Pediatric Research, 65:3, p 25.
  9. J C Sonne, “The relevance of the dread of being aborted to models of therapy and models of the mind. Part II: mentation and communication in the unborn” (1994), Int J Prenatal and Perinatal Psychology and Medicine, 6:2, 247–75.
  10. A Salihagić Kadić, M Predojević, “Fetal neurophysiology according to gestational age”, Seminars in fetal neonatal med (2012) 17:5, 256–260, p 253.
  11. Dubbed the “interbrain”, the diencephalon functions as “a crucial relay and integration center, and modulates sensory, motor, and cognitive functions.” — Mallika Chatterjee and James Y H Li, “Patterning and Compartment Formation in the Diencephalon” (2012), Frontiers in Neuroscience, 6: 66, p 1.
  12. Ludwig Janus, Terence Dowling (trans), The enduring effects of prenatal experiencing: echoes from the womb (Mattes Verlag, Heidelberg, 2007), p xiv.
  13. Sonne, 1994.
  14. Lee Salk, “The role of the heartbeat in the relations between mother and infant” (1973), Scientific American, 228:5, 24–29 p 24.
  15. David B Chamberlain, “The cognitive newborn: a scientific update” (1987) British Journal of Psychotherapy, 4:1, p 37.
  16. Ibid, p 33.
  17. Peter Hepper, “Fetal Behaviour: Why so sceptical?” (1996) Ultrasound Obstet Gyenocol, 145–48, p 147.
  18. Peter Hepper and Sara Shahidullah, “The Beginnings of the mind — evidence from the behaviour of the fetus,” (1994) Journal of Reproductive and Infant Psychology, 12, 143–154, p 143.
  19.  Guy Kahane and Julian Savulescu, “Brain Damage and the Moral Significance of Consciousness” (2009) 34 JMP 6, p 10.
  20. “Exclusive: Pope Francis discusses Ukraine, US bishops and more”, America: The Jesuit Review, 28 November 2022.
  21. Universal Declaration of Human Rights, 1948, Article 6: Everyone has the right to recognition everywhere as a person before the law.