(1) Pain receptors (nociceptors) are present 
throughout the unborn child’s entire body and 
nerves link these receptors to the brain’s thalamus 
and subcortical plate by no later than 20 weeks after 
fertilization. 
(2) By 8 weeks after fertilization, the unborn 
child reacts to touch. After 20 weeks, the unborn 
child reacts to stimuli that would be recognized as 
painful if applied to an adult human, for example, 
by recoiling. 
(3) In the unborn child, application of such 
painful stimuli is associated with significant in-
creases in stress hormones known as the stress re-
sponse. 
(4) Subjection to such painful stimuli is associ-
ated with long-term harmful neurodevelopmental ef-
fects, such as altered pain sensitivity and, possibly, 
emotional, behavioral, and learning disabilities later 
in life. 
(5) For the purposes of surgery on unborn chil-
dren, fetal anesthesia is routinely administered and 
is associated with a decrease in stress hormones 
compared to their level when painful stimuli are ap-
plied without such anesthesia. In the United States, 
surgery of this type is being performed by 20 weeks 
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after fertilization and earlier in specialized units af-
filiated with children’s hospitals. 
(6) The position, asserted by some physicians, 
that the unborn child is incapable of experiencing 
pain until a point later in pregnancy than 20 weeks 
after fertilization predominately rests on the as-
sumption that the ability to experience pain depends 
on the cerebral cortex and requires nerve connec-
tions between the thalamus and the cortex. However, 
recent medical research and analysis, especially since 
2007, provides strong evidence for the conclusion 
that a functioning cortex is not necessary to experi-
ence pain. 
(7) Substantial evidence indicates that children 
born missing the bulk of the cerebral cortex, those 
with hydranencephaly, nevertheless experience pain. 
(8) In adult humans and in animals, stimula-
tion or ablation of the cerebral cortex does not alter 
pain perception, while stimulation or ablation of the 
thalamus does. 
(9) Substantial evidence indicates that struc-
tures used for pain processing in early development 
differ from those of adults, using different neural 
elements available at specific times during develop-
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ment, such as the subcortical plate, to fulfill the role 
of pain processing. 
(10) The position, asserted by some commenta-
tors, that the unborn child remains in a coma-like 
sleep state that precludes the unborn child experi-
encing pain is inconsistent with the documented re-
action of unborn children to painful stimuli and with 
the experience of fetal surgeons who have found it 
necessary to sedate the unborn child with anesthesia 
to prevent the unborn child from engaging in vig-
orous movement in reaction to invasive surgery. 
(11) Consequently, there is substantial medical 
evidence that an unborn child is capable of experi-
encing pain at least by 20 weeks after fertilization, 
if not earlier. 
(12) It is the purpose of the Congress to assert 
a compelling governmental interest in protecting the 
lives of unborn children from the stage at which sub-
stantial medical evidence indicates that they are ca-
pable of feeling pain. 
(13) The compelling governmental interest in 
protecting the lives of unborn children from the 
stage at which substantial medical evidence indicates 
that they are capable of feeling pain is intended to 
be separate from and independent of the compelling 
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governmental interest in protecting the lives of un-
born children from the stage of viability, and neither 
governmental interest is intended to replace the 
other. 
(14) Congress has authority to extend protec-
tion to pain-capable unborn children under the Su-
preme Court’s Commerce Clause precedents and 
under the Constitution’s grants of powers to Con-
gress under the Equal Protection, Due Process, and 
Enforcement Clauses of the Fourteenth Amendment. 
SEC. 3. PAIN-CAPABLE UNBORN CHILD PROTECTION. 
(a) IN GENERAL.—Chapter 74 of title 18, United 
States Code, is amended by inserting after section 1531 
the following: 
‘‘§ 1532. Pain-capable unborn child protection 
‘‘(a) UNLAWFUL CONDUCT.—Notwithstanding any 
other provision of law, it shall be unlawful for any person 
to perform an abortion or attempt to do so, unless in con-
formity with the requirements set forth in subsection (b). 
‘‘(b) REQUIREMENTS FOR ABORTIONS.— 
‘‘(1) ASSESSMENT OF THE AGE OF THE UN-
BORN
CHILD.—The physician performing or at-
tempting the abortion shall first make a determina-
tion of the probable post-fertilization age of the un-
born child or reasonably rely upon such a determina-
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tion made by another physician. In making such a 
determination, the physician shall make such inquir-
ies of the pregnant woman and perform or cause to 
be performed such medical examinations and tests 
as a reasonably prudent physician, knowledgeable 
about the case and the medical conditions involved, 
would consider necessary to make an accurate deter-
mination of post-fertilization age. 
‘‘(2) PROHIBITION ON PERFORMANCE OF CER-
TAIN ABORTIONS.— 
‘‘(A) GENERALLY FOR UNBORN CHILDREN 
20 WEEKS OR OLDER.—Except as provided in 
subparagraph (B), the abortion shall not be 
performed or attempted, if the probable post- 
fertilization age, as determined under para-
graph (1), of the unborn child is 20 weeks or 
greater. 
‘‘(B) 
EXCEPTIONS.—Subparagraph 
(A) 
does not apply if— 
‘‘(i) in reasonable medical judgment, 
the abortion is necessary to prevent the 
loss of life or severe injury (the substantial 
and irreversible physical impairment of a 
major bodily function, not including psy-
chological or emotional conditions) of a 
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