Question: FILE - March 10, 2016 file photo Utah Gov. Gary Herbert speaks during an interview in Salt Lake City. The Utah governor is considering whether to sign a bill that would make Utah the first state to require... (Associated Press) 
  
 SALT LAKE CITY (AP) — The governor has signed a bill that makes Utah the first state to require doctors to give anesthesia to women having an abortion at 20 weeks of pregnancy or later. 
  
 The bill signed by Republican Gov. Gary Herbert Monday is based on the disputed premise that a fetus can feel pain at that point. 
  
 "The governor is adamantly pro-life. He believes in not only erring on the side of life, but also minimizing any pain that may be caused to an unborn child," Herbert spokesman Jon Cox said. 
  
 Many doctors in Utah and across the country are concerned that the requirement could increase the health risks to women by giving them unnecessary heavy sedation in order to protect a fetus from pain that it may or may not feel. 
  
 Dr. Sean Esplin of Intermountain Healthcare in Utah said anesthesia or an analgesic would need to go through the woman in order to reach the fetus. Doctors could give a woman general anesthesia, which would make her unconscious and likely require a breathing tube, or a heavy dose of narcotics. 
  
 No other U.S. state has passed this same law, said Elizabeth Nash, a policy analyst at the abortion-rights nonprofit Guttmacher Institute. Montana lawmakers passed a similar law in 2015 requiring fetal anesthesia before surgeries, including abortions, performed after 20 or more weeks of gestation, but its Democratic governor vetoed the measure. 
  
 Twelve states ban abortions after around 20 weeks of gestation, while a handful of other states give women the option of having anesthesia. 
  
 Previous Utah law gave women the choice to have anesthesia during an abortion. 
  
 The new law by Sen. Curt Bramble, R-Provo, targets a small subset of women who have elective abortions beginning at 20 weeks. State law normally allows abortions until viability, which is at about 22 weeks. 
  
 But it could affect women in many other medical situations. 
  
 Utah law defines abortions in part as "the intentional termination or attempted termination of human pregnancy after implantation of a fertilized ovum through a medical procedure carried out by a physician or through a substance used under the direction of a physician." 
  
 David Turok of the University of Utah's obstetrics and gynecology department said that could apply to instances in which a woman is past her due date so the doctor induces labor or there's a problem with the pregnancy, such as pre-eclampsia, so it's safer to deliver the baby early. These common procedures could now require general anesthesia, he said. 
  
 "You never give those medicines if you don't have to," Turok said. 
  
 Laura Bunker of the conservative group United Families International said if there is any chance a fetus feels pain at 20 weeks, doctors should do everything possible to make sure they are comfortable. 
  
 The new law would not apply to women who must have an abortion because their life is at risk or the fetus will not survive outside the womb. 
  
 Utah Medical Association CEO Michelle McOmber said her organization feels neutral toward the legislation. The association convinced Bramble to change its language from saying a fetus "is capable of experiencing pain," to it "may be capable of experiencing pain." She said the association would have preferred that the proposal stated it is inconclusive whether or not the fetus feels pain. 
  
 Bramble initially sought to ban abortions after 20 weeks entirely, but he changed course after the Legislature's attorneys warned him that any such measure would likely be unconstitutional. ||||| Weeks after last menstruation 
  
 Usually when fetus is deemed viable 
  
 When fetus is considered full term 
  
 Fertilization 
  
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 Mississippi’s law is based on the fetal pain assertion. In May 2013, a federal appellate panel struck down Arizona’s 20-week abortion law. 
  
 20 weeks 
  
 after the last menstrual period 
  
 2 states, 4% of U.S. population 
  
 NC 
  
 MS 
  
 Laws in Georgia and Idaho are blocked by courts, and Wisconsin’s law will take effect in February. 
  
 22 weeks 
  
 ND 
  
 10 states, 18% of U.S. population 
  
 NE 
  
 IN 
  
 KS 
  
 WV 
  
 OK 
  
 AR 
  
 TX 
  
 LA 
  
 AL 
  
 Laws in Iowa, South Carolina and Virginia ban abortion around the third trimester, which usually begins 24 weeks after the last menstruation. 
  
 24 weeks 
  
 SD 
  
 RI 
  
 7 states, 16% of U.S. population 
  
 IA 
  
 PA 
  
 VA 
  
 SC 
  
 FL 
  
 Under Supreme Court rulings, states may ban abortion once the fetus is viable, usually around 24 to 26 weeks after the last menstrual period. The rulings require that abortion be allowed during the time of viability when a woman’s life or health is endangered. 
  
 24-26 weeks, 
  
 ME 
  
 when a fetus is deemed viable 
  
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 21 states, 46% of U.S. population 
  
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 HI 
  
 GA 
  
 Nevada and New York ban abortion at 26 weeks and Massachusetts at 27 weeks. 
  
 26-27 weeks 
  
 MA 
  
 3 states, 9% of U.S. population 
  
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 NV 
  
 Seven states and the District of Columbia do not have specific laws prohibiting abortion after a certain point in pregnancy. 
  
 No restriction 
  
 AK 
  
 VT 
  
 NH 
  
 OR 
  
 NJ 
  
 7 states and D.C., 7% of U.S. population 
  
 CO 
  
 DC ||||| Context Proposed federal legislation would require physicians to inform women seeking abortions at 20 or more weeks after fertilization that the fetus feels pain and to offer anesthesia administered directly to the fetus. This article examines whether a fetus feels pain and if so, whether safe and effective techniques exist for providing direct fetal anesthesia or analgesia in the context of therapeutic procedures or abortion. 
  
 Evidence Acquisition Systematic search of PubMed for English-language articles focusing on human studies related to fetal pain, anesthesia, and analgesia. Included articles studied fetuses of less than 30 weeks’ gestational age or specifically addressed fetal pain perception or nociception. Articles were reviewed for additional references. The search was performed without date limitations and was current as of June 6, 2005. 
  
 Evidence Synthesis Pain perception requires conscious recognition or awareness of a noxious stimulus. Neither withdrawal reflexes nor hormonal stress responses to invasive procedures prove the existence of fetal pain, because they can be elicited by nonpainful stimuli and occur without conscious cortical processing. Fetal awareness of noxious stimuli requires functional thalamocortical connections. Thalamocortical fibers begin appearing between 23 to 30 weeks’ gestational age, while electroencephalography suggests the capacity for functional pain perception in preterm neonates probably does not exist before 29 or 30 weeks. For fetal surgery, women may receive general anesthesia and/or analgesics intended for placental transfer, and parenteral opioids may be administered to the fetus under direct or sonographic visualization. In these circumstances, administration of anesthesia and analgesia serves purposes unrelated to reduction of fetal pain, including inhibition of fetal movement, prevention of fetal hormonal stress responses, and induction of uterine atony. 
  
 Conclusions Evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester. Little or no evidence addresses the effectiveness of direct fetal anesthetic or analgesic techniques. Similarly, limited or no data exist on the safety of such techniques for pregnant women in the context of abortion. Anesthetic techniques currently used during fetal surgery are not directly applicable to abortion procedures. ||||| Gov. Gary Herbert (R-Utah) signed a bill that makes Utah the first state to mandate anesthesia use in abortions at 20 weeks or later. Supporters say it prevents the fetus from pain, but some decry the evidence as unfounded and say it could complicate procedures. (Jenny Starrs/The Washington Post) 
  
 A woman in Utah is allowed to have an abortion at 20 weeks. But does she have to give her fetus painkillers in the process? 
  
 Yes, the state said Monday, when it became the only state in the nation to require doctors to give anesthesia to women undergoing abortions at 20 weeks or later. 
  
 Advocates of the law say that the regulation prevents fetuses from suffering during abortions. But doctors in Utah and elsewhere say there’s no proof that fetuses are able to feel anything at that point in pregnancy, and that sedating women during the procedure puts them at risk of complications. 
  
 “You’re now mandating [women] take that risk, based on inconclusive and biased evidence. You don’t understand what you’re legislating,” Dr. Sean Esplin, a doctor with Intermountain Healthcare in Utah, testified at committee hearing on the bill earlier this month. 
  
 The bill’s sponsor, state Sen. Curt Bramble (R-Provo), said he initially hoped to ban abortions after 20 weeks, but he was told that such a law would probably challenged on constitutional grounds. This measure was next best option, he told the Salt Lake Tribune; it requires doctors to take steps to “eliminate or alleviate organic pain to the unborn child” except for in cases when the abortion is necessary to prevent the health of the mother, when the fetus suffers from a deadly congenital defect, or when the administration of anesthetic might put the mother at risk. 
  
 “In this quote ‘medical procedure,’ let’s call it what it is. It’s killing babies. And if we’re going to kill that baby, we ought to protect it from pain,” Bramble said. 
  
 This is a new twist on an old argument: For years, antiabortion advocates have used the fetal pain argument to justify bans on abortion 20 weeks after conception. According to the National Right to Life Committee, “pain-capable unborn protection” laws are currently on the books in 12 states (though they’re being challenged in two). 
  
 But the idea that 20-week-old fetuses can feel anything is disputed; a 2005 review of more than 300 studies published in the Journal of the American Medical Association concluded that fetal perception of pain is unlikely before the third trimester (28 weeks). 
  
 Utah generally does not allow abortions after the point of viability, around 22 to 24 weeks. 
  
 Esplin told the Associated Press that the new law means that any anesthetic or analgesic will have to be administered to the mother; women having abortions will either be placed under general anesthesia — meaning they’re unconscious and hooked up to a breathing tube — or sedated with a heavy dose of narcotics. Previously, women were given a choice to be anesthetized. 
  
 General anesthesia carries its own side effects and risks, and doctors say they try to avoid it except in cases where it’s absolutely necessary. 
  
 “You never give those medicines if you don’t have to,” David Turok of the University of Utah’s obstetrics and gynecology department told the AP. 
  
 Turok and some lawmakers have expressed concern that the rule could be interpreted as mandating that pregnant women be anesthetized for all procedures that happen after 20 weeks of pregnancy. Utah law defines abortions as “the intentional termination or attempted termination of human pregnancy” through a medical procedure carried out by or ordered by a physician — loosely interpreted, that could include instances of induced labor, such as when a woman is past her due date. 
  
 State Sen. Brian Shiozawa (R-Cottonwood Heights), who is also an emergency room doctor, told the Deseret News earlier this month that if the law was passed, “you can forget natural birth and labor” because there’s probably pain to a fetus coming down the birth canal as well. 
  
 In an interview with the Salt Lake Tribune, Shiozawa said he is “all for” changing the statutes on abortion. But this bill, he added, was “cumbersome” for women and their doctors. 
  
 The new law makes Utah the only state in the country where women must undergo anesthesia to have an abortion. The Montana legislature passed a similar law last year, but it was vetoed by the state’s democratic governor Steve Bullock. 
  
 Utah’s governor, Gary Herbert (R), who signed the bill into law Monday, said last month that rather than get into a debate about abortion, he just wanted to address the question: “If we’re going to have abortion, what is the most humane way to do it?” 
  
 “Fetuses have a heartbeat after about five weeks. And the idea of just being callous about that should cause all of humanity concern” regardless of their stance on abortion, he continued. 
  
 Though the new law is controversial, its impact will likely be limited, Karrie Galloway, executive director of Planned Parenthood of Utah, told the Salt Lake Tribune. In 2014, the last year for which data is available, only 17 Utah women had abortions after 20 weeks. Planned Parenthood is the only provider in the state that provides abortions during the window covered by the law. 
  
 But Galloway said the idea that lawmakers with no medical knowledge are dictating what women and their doctors can do “is what’s infuriating.” 
  
 “I mean, we have fetal medical specialists speaking and they were discounted by a citizen who said, ‘I read it on the Internet and therefore it must be true,'” she said. “That’s how we do policy here in Utah.” ||||| Thie March 10, 2016 file photo Utah Gov. Gary Herbert speaks during an interview in Salt Lake City. The Utah governor is considering whether to sign a bill that would make Utah the first state to require doctors to give anesthesia to women having an abortion at 20 weeks of pregnancy or later. (Photo: Rick Bowmer, AP) 
  
 Utah Gov. Gary Herbert signed a bill that requires doctors to give anesthesia to women having an abortion 20 weeks into their pregnancy or later — the first law of its kind in the USA. 
  
 Among other provisions, SB 0234 requires doctors who perform abortions to administer an anesthetic on women who are at least 20 weeks pregnant, suggesting it would reduce or eliminate pain a fetus may be feeling. 
  
 "The governor is adamantly pro-life," said Jon Cox, spokesman for the Republican governor, in an emailed statement. "He believes in not only erring on the side of life, but also minimizing any pain that may be caused to an unborn child." 
  
 At the center of the debate in the Legislature was the disputed premise that a fetus can feel pain at that point. 
  
 Other states have tried to enact similar provisions, but Utah is the first state to require anesthesia. Montana lawmakers passed a similar law in 2015 requiring fetal anesthesia before surgeries, including abortions, performed after 20 or more weeks of gestation, but the Democratic governor, Steve Bullock, vetoed the measure. 
  
 "The sanctity of life, protecting those who have no voice — that's what this (bill) is about," said Sen. Curt Bramble (R), the legislation's sponsor. "I think the message is clear that abortion is an abomination." 
  
 In this March 2, 2014, file photo, Sen. Curt Bramble, R- Provo, speaks during a news conference at the Utah State Capitol, in Salt Lake City. Utah's Senate on Friday, March 4, 2016, will debate a proposal that would require doctors to administer anesthesia before an abortion performed after 20 weeks gestation, based on the disputed premise that a fetus can feel pain at that point. State law currently gives women the choice to have anesthesia for the fetus to reduce potential pain during abortion. Anesthesia would be mandatory under the legislation sponsored by Republican Sen. Curt Bramble. (Photo: Rick Bowmer, AP) 
  
 Unlike several states, Utah does not ban abortions, but it has several provisions that pro-choice advocates say complicate the process for women seeking to terminate their pregnancies. A woman looking to get an abortion must get counseling in person before making the final decision and then wait 72 hours before getting the procedure done. Public funding is available for abortion in cases of rape, incest or when necessary to save the woman or prevent long-lasting damage to her physical health, according to the abortion-rights nonprofit the Guttmacher Institute. 
  
 The state Senate amended the bill before passing it earlier this month to make sure the anesthesia was not mandated in cases where it could hurt the mother. 
  
 Many doctors in Utah and throughout the country are concerned that the plan could pose a risk to women because fetal anesthesia is unnecessary. 
  
 “You’re telling women that they have to have something that’s going to increase their risk based on a conclusion that is not true,” Dr. Sean Esplin of Intermountain Healthcare in Utah told the Associated Press. 
  
 But supporters of the law say a fetus should be protected if there’s even a chance it can feel pain. Bramble believes the evidence suggesting a fetus can feel pain by 20 weeks outweighs opponents' arguments. 
  
 The law makes sense in Utah, he said, where convicts sentenced to death and animals facing euthanasia receive anesthetics. 
  
 "We go to extraordinary lengths in Utah to prevent the pain of an individual sentenced to death," he said. "With euthanasia, we make every effort to not inflict pain on that animal....(mandating anesthesia) it is consistent with other policies we have in the state of Utah." 
  
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What is a one-paragraph summary of the above article?
Answer: – Women who receive an abortion in Utah after they've reached the 20th week of their pregnancy can expect to do so heavily sedated: On Monday, Gov. Gary Herbert signed into law a bill requiring anesthesia for patients who reach this mark, USA Today reports. The "Protecting Unborn Children" mandate is the first of its kind to pass in the US, rekindling a debate as to whether a fetus can feel pain at that point in the gestational cycle. (The Washington Post notes a review of more than 300 studies shows the fetus likely doesn't perceive pain before 28 weeks.) The governor "believes in not only erring on the side of life, but also minimizing any pain that may be caused to an unborn child," a spokesman for Herbert said in a statement. The law wouldn't apply in cases where anesthesia could hurt the mother, if the abortion was needed to save the mother's life, or if the fetus suffered from a congenital defect that would prove fatal, per the AP and USA Today. Other states have tried for similar laws and failed; a dozen states ban abortion after between 20 and 22 weeks, while others offer the option of anesthesia. Critics note the law could be applied in cases where labor is induced, such as with pre-eclampsia or when a woman's due date has passed. State Sen. Curt Bramble, who sponsored the bill, argues anesthesia is used in other situations in Utah, such as for convicts put to death and animals being put down, so this law simply maintains consistency. "We go to extraordinary lengths in Utah to prevent the pain of an individual sentenced to death," he says.