Providing for Consideration of H.R. 1947, Federal Agriculture Reform and Risk Management Act of 2013; and Providing for Consideration of H.R. 1797, Pain-Capable Unborn Child Protection Act

Floor Speech

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Ms. FOXX. Mr. Speaker, the question before the House is: Should the House now consider H. Res. 266? While the resolution waives all points of order against consideration of the bill, the Committee on Rules is not aware of any violation of the Unfunded Mandates Reform Act. This is a dilatory tactic.

In order to allow the House to continue its scheduled business for the day, I urge Members to vote ``yes'' on the question of consideration of the resolution, and I reserve the balance of my time.

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Ms. FOXX. Mr. Speaker, House Resolution 266 provides for a closed rule providing for consideration of H.R. 1797, the Pain-Capable Unborn Child Protection Act, and general debate for H.R. 1947, the Federal Agriculture Reform and Risk Management Act.

Mr. Speaker, the rule before us today provides for general debate of H.R. 1947, the Federal Agriculture Reform and Risk Management Act, also known as the FARRM Bill. This legislation provides for a 5-year authorization of Federal agriculture and nutrition policy.

H.R. 1947 makes necessary reforms and updates to the Supplemental Nutrition Assistance Program, previously known as food stamps, as well as Federal agriculture policy. It is important to make commonsense changes to these programs to ensure their viability and that they remain targeted to those most in need of assistance. This year's version of the farm bill has gone through regular order, including numerous hearings at the Agriculture Committee, a full committee markup and amendment process.

Additionally, the Rules Committee has received hundreds of amendments from Members seeking to further improve the bill during floor consideration. House Republicans remain committed to an open, transparent process; and I am pleased to say we're continuing that commitment with the consideration and process for the FARRM Bill.

With that, Mr. Speaker, I reserve the balance of my time.

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Ms. FOXX. Mr. Speaker, I suspect that my colleague from New York knows this, but I will make sure it gets into the Record.

In the 2007 case of Gonzales v Carhart, the Supreme Court made clear that there is a ``legitimate interest of the government in protecting the life of the fetus that may become a child.'' The Supreme Court has also made clear that ``the government may use its voice and its regulatory authority to show its profound respect for the life within the woman,'' and that Congress may show such respect for the unborn through ``specific regulation because it implicates additional ethical and moral concerns that justify a special prohibition.''

Mr. Speaker, I am really troubled by the fact that so many of my colleagues simply refuse to acknowledge that we're dealing with human life in this situation, in the situation of abortion. My heart goes out to any woman who is facing a situation where they're considering abortion. I think every member of our conference feels that way--men and women. Nobody takes the issue of abortion lightly. Unfortunately, not enough attention is being paid to the unborn child.

Mr. Speaker, I would like to yield, now, 3 minutes to the distinguished gentleman from Louisiana, Dr.--Congressman--FLEMING.

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Ms. FOXX. Madam Speaker, this bill is not borne of ignorance but of extremely deep-felt concern for unborn children who suffer pain as they are being murdered.

Madam Speaker, I fear for the conscience of our Nation because the termination of unborn children for any reason is tolerated in some parts of our country throughout pregnancy, even though scientific conclusions show infants feel pain by at least 20 weeks' gestation. That means literally that a baby at the halfway point of a pregnancy will experience pain during the violence of a dismemberment abortion, the most common second-trimester abortion wherein a steel tool severs limbs from the infant and its skull is crushed.

Madam Speaker, it's even difficult for me to describe this procedure without getting emotional. These procedures are horrific, and in terms of pain, like torture to their infant subjects. As a country, we should leave this practice behind. That's why I'm a cosponsor of the underlying legislation to prohibit elective abortions in the United States past 20 weeks. Since 1973, approximately 52 million--52 million, Madam Speaker--children's lives have been tragically aborted in the United States. It is unconscionable that in America, where we fight for life, liberty, and the pursuit of happiness, we tolerate the systemic extermination of an entire generation of the most vulnerable among us.

H.R. 1797 rejects that hypocrisy and provides commonsense protections for unborn children who feel pain, just as you and I do. My colleague and friend from Arizona, Representative Trent Franks, is a champion for the unborn, and I commend him for authoring this legislation, which prohibits an abortion of an unborn child that has surpassed 20 weeks after fertilization.

In light of the recent conviction of Philadelphia-based, late-term abortionist Kermit Gosnell, who was found guilty of first-degree murder in the case of three babies born alive in his clinic and then killed through a procedure he called ``snipping,'' which involved Gosnell inserting a pair of scissors into the baby's neck and cutting its spinal cord, a procedure that was reportedly routine in his clinic, we cannot stand idly by.

Madam Speaker, some would have us think that Gosnell is an anomaly or an outlier. However, after his conviction, more individuals have stepped forward to expose similar practices in other States. Americans should be asking how different are these snipping procedures from abortions performed throughout clinics in the country. Unfortunately, there is little difference between these procedures. The practice of murdering viable, unborn children who can feel pain must end. I urge my colleagues to join me in speaking for those who cannot speak for themselves and vote in favor of this rule and the underlying bill.

I reserve the balance of my time.

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Ms. FOXX. Madam Speaker, even Kermit Gosnell's own defense attorney, having gone through all the evidence at trial, said:

I've come out of this case realizing that 24 weeks is a bad determiner. It should be more like 16, 17 weeks. That would be a far better thing, and I think the law should be changed to that. I think pro-choice would have still the right to choose, but they've got to choose quicker.

We are talking here, Madam Speaker, about the beginning of the 6th month of pregnancy. Nothing in this bill has any impact on abortion during the first 20 weeks.

With that, I reserve the balance of my time.

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Ms. FOXX. Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, as advances in medical science result in improved treatments and personalized medicine, the development of unborn children is further understood. Doctors can perform lifesaving surgeries on babies still in the womb at earlier points in the pregnancy than ever before.

When a baby is born prematurely, medical innovation is increasing the likelihood of that baby's survival. Babies born as early as 20 weeks post-fertilization are being cared for in neonatal units across the country.

By 8 weeks after fertilization, the unborn child reacts to touch. By 20 weeks post-fertilization, the unborn child reacts to stimuli that would be recognized as painful if applied to an adult human. The baby responds the same way you and I respond to pain, by recoiling from it.

As Dr. Anand, at the University of Tennessee, who is considered the leading expert in the field of fetal pain, stated in a report accepted by a Federal judge as expert testimony:

It is my opinion that the human fetus possesses the ability to experience pain from 20 weeks of gestation, if not earlier, and the pain perceived by a fetus is possibly more intense than that perceived by term newborns or older children.

Surgeons entering the womb to perform corrective procedures on unborn children have seen those babies flinch, jerk, and recoil from sharp objects and injections. Recognizing this discomfort, surgeons routinely administer anesthesia to unborn children in the womb before performing surgeries.

According to Planned Parenthood, the largest abortion provider in America, babies aborted at 14 weeks or later are often subjected to a painful dismemberment abortion, which involves inserting a long steel tool into the woman and grabbing, usually an arm or a leg, tearing it from the baby's body and pulling it out of the mother. The procedure is repeated as the baby is torn, limb from limb, until his or her entire body has been removed and the head is finally crushed and removed. The dismemberment abortion is the most common method of abortion in the second trimester.

Another abortion procedure involves injecting digoxin and/or potassium chloride into the baby's heart, which induces cardiac arrest, and the baby's killed.

Madam Speaker, it's important that the American people understand exactly what happens when they hear the word ``abortion.'' It is a heart-wrenching, painful procedure that tears a baby limb from limb before crushing his or her head, or it is a poisonous chemical injection.

A March 2013 poll conducted by a polling company found that 64 percent of the public supports a law like the Pain-Capable Unborn Child Protection Act, prohibiting an abortion after 20 weeks when an unborn baby can feel pain, unless the life of the mother is in danger.

Supporters included 47 percent of those who identified themselves as pro-choice in the poll. The poll also found that 63 percent of women believe that abortion should not be permitted after the point where substantial medical evidence says that the unborn child can feel pain.

Madam Speaker, Congress cannot sit idly by while this grotesque and brutal procedure which rips the tiny baby apart limb by limb in the womb is performed in our country. That is why it is necessary for Congress to pass H.R. 1797 and protect the lives of these unborn children from this excruciating pain.

Madam Speaker, I would like to submit for the Record a summary of the evidence of the unborn pain research.

Madam Speaker, I now reserve the balance of my time.

Fetal Pain: The Evidence

[From www.doctorsonfetalpain.org, Mar. 14, 2011]
The eleven points below summarize the substantial medical and scientific evidence that unborn children can feel pain by 20 weeks after fertilization.

1: Pain receptors (nociceptors) are present throughout the unborn child's entire body by no later than 20 weeks after fertilization and nerves link these receptors to the brain's thalamus and subcortical plate by no later than 20 weeks after fertilization.
DOCUMENTATION

a. Pain receptors (nociceptors) are present throughout the unborn child's entire body by no later than 20 weeks.

1. Myers, 2004, p.241, para.2, ``The first essential requirement for pain is the presence of sensory receptors, which first develop in the perioral area at approximately 7 weeks gestation and are diffusely located throughout the body by 14 weeks.\95\''

Myers LB, Bulich LA, Hess, P, Miller NM. Fetal endoscopic surgery: indications and anaesthetic management. Best Practice & Research Clinical Anaesthesiology. 18:2 (2004) 231-258.

\95\Smith S. Commission of Inquiry into Fetal Sentience. London: CARE, 1996.

2. Derbyshire, 2010, p.7, para.2, ``For the foetus, an existence of `pain' rests upon the existence of a stimulus that poses a threat to tissue, being detected by a nervous system capable of preferentially responding to stimuli that pose a threat to tissue. The entire experience is completely bounded by the limits of the sensory system and the relationship between that system and the stimulus. If pain is conceived of in this manner then it becomes possible to talk of foetal pain anytime between 10 and 17 weeks GA [gestational age] when nociceptors develop and mature, and there is evidence of behavioural responses to touch.''

Note: Derbyshire's other published works indicate that he believes pain requires subjective human experience, not possible until after birth; nonetheless, he acknowledges this finding.

Derbyshire SW, Foetal pain? Best Practice & Research Clinical Obstetrics and Gynaecology 24:5 (2010) 647-655.

3. Anand, 1987, p.2, para.2, ``Cutaneous sensory receptors appear in the perioral area of the human fetus in the 7th week of gestation; they spread to the rest of the face, the palms of the hands, and the soles of the feet by the 11th week, to the trunk and proximal parts of the arms and legs by the 15th week, and to all cutaneous and mucous surfaces by the 20th week. 25,26''

Anand KJS, Hickey PR. Pain and its effects in the human neonate and fetus. New England Journal of Medicine. 317:21 (1987) 1321-1329.

\25\Humphrey T. Some correlations between the appearance of human fetal reflexes and the development of the nervous system. Progress in Brain Research. 4 (1964) 93-135.

\26\Valnaan HB, Pearson JP. What the fetus feels. British Medical Journal. 280 (1980) 233-234.

4. Vanhatalo, 2000, p.146, col.2, para.2, ``First nociceptors appear around the mouth as early as the seventh gestational week; by the 20th week these are present all over the body.''

Vanhatalo S, van Nieuwenhuizen O. Fetal Pain? Brain & Development. 22 (2000) 145-150.

5. Brusseau, 2008, p.14, para.3, ``The first essential requirement for nociception is the presence of sensory receptors, which develop first in the perioral area at around 7 weeks gestation. From here, they develop in the rest of the face and in the palmar surfaces of the hands and soles of the feet from 11 weeks. By 20 weeks, they are present throughout all of the skin and mucosal surfaces.\19\

Brusseau R. Developmental Perpectives: is the Fetus Conscious? International Anesthesiology Clinics. 46:3 (2008) 11-23.

\19\Simons SH, Tibboel D. Pain perception development and maturation. Seminars on Fetal and Neonatal Medicine. 11 (2006) 227-231.

6. Rollins, 2012, p.465, ``Immature skin nociceptors are probably present by 10 weeks and definitely present by 17 weeks. Nociceptors develop slightly later in internal organs. Peripheral nerve fibers that control movement first grow into the spinal cord at about 8 weeks of gestation.''

Mark D. Rollins, Mark A. Rosen, ``Anesthesia for Fetal Intervention and Surgery'', in Gregory's Pediatric Anesthesia, ed. George A. Gregory & Dean B. Adropoulos (West Sussex: Wiley-Blackwell, 2012), 444-474, 465.

b. nerves link these receptors to the brain's thalamus and subcortical plate by no later than 20 weeks after fertilization.

1. Van Scheltema 2008, p.313, para.1--``The connection between the spinal cord and the thalamus (an obligatory station through which nearly all sensory information must pass before reaching the cortex) starts to develop from 14 weeks onwards and is finished at 20 weeks.''

Van Scheltema PNA, Bakker S, Vandenbussche FPHA, Oepkes, D. Fetal Pain. Fetal and Maternal Medicine Review. 19:4 (2008) 311-324.

2. Glover, 1999, p.882, col.1, para.1, ``Most incoming pathways, including nociceptive ones, are routed through the thalamus and, as stated above, penetrates the subplate zone from about 17 weeks... These monoamine fibres start to invade the subplate zone at 13 weeks and reach the cortex at about 16 weeks. This puts an early limit on when it is likely that the fetus might be aware of anything that is going on in its body or elsewhere.''

Glover V. Fetal pain: implications for research and practice. British Journal of Obstetrics and Gynaecology. 106 (1999) 881-886.

3. Lee, 2005, p.950, col.1, ``In contrast to direct thalamocortical fibers, which are not visible until almost the third trimester, thalamic afferents begin to reach the somatosensory subplate at 18 weeks' developmental age (20 weeks' gestational age)\16\ and the visual subplate at 20 to 22 weeks' gestational age. These afferents appear morphologically mature enough to synapse with subplate neurons.\17\''

Note: Lee et al. believe that pain requires conscious cortical processing, which they deem unlikely until 29 or 30 weeks; nonetheless, they acknowledge this finding.

Lee SJ, Ralston HJP, Drey EA, Partridge, JC, Rosen, MA. A Systematic Multidisciplinary Review of the Evidence. Journal of the American Medical Association. 294:8 (2005) 947-954.

\16\Kostovic I, Rakic P. Developmental history of the transient subplate zone in the visual and somatosensory cortex of the macaque monkey and human brain. Journal of Comparative Neurology. 297 (1990) 441-470.

\17\Hevner RF. Development of connections in the human visual system during fetal mid-gestation: a Diltracing study. Journal of Experimental Neuropathology & Experimental Neurology. 59 (2000) 385-392.

4. Gupta, 2008, p.74, col.2, para.1, `` Peripheral nerve receptors develop between 7 and 20 weeks gestation ..... Spinothalamic fibres (responsible for transmission of pain) develop between 16 and 20 weeks gestation, and thalamocortical fibres between 17 and 24 weeks gestation.''

Gupta R, Kilby M, Cooper G. Fetal surgery and anaesthetic implications. Continuing Education in Anaesthesia, Critical Care & Pain. 8:2 (2008) 71-75.

5. Van de Velde, 2012, p 206, para.3, ``To experience pain an intact system of pain transmission from the peripheral receptor to the cerebral cortex must be available. Peripheral receptors develop from the seventh gestational week. From 20 weeks' gestation [= 20 weeks post-fertilization] peripheral receptors are present on the whole body. From 13 weeks' gestation the afferent system located in the substantia gelatinosa of the dorsal horn of the spinal cord starts developing. Development of afferent fibers connecting peripheral receptors with the dorsal horn starts at 8 weeks' gestation. Spinothalamic connections start to develop from 14 weeks' and are complete at 20 weeks' gestation, whilst thalamocortical connections are present from 17 weeks' and completely developed at 26-30 weeks' gestation. From 16 weeks' gestation pain transmission from a peripheral receptor to the cortex is possible and completely developed from 26 weeks' gestation.''

Marc Van de Velde & Frederik De Buck, Fetal and Maternal Analgesia/Anesthesia for Fetal Procedures. Fetal Diagn Ther 31(4) (2012) 201-9.

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.
DOCUMENTATION

a. By 8 weeks after fertilization, the unborn child reacts to touch.

1. Gupta, 2008, p.74, col.2, para.2, ``Movement of the fetus in response to external stimuli occurs as early as 8 weeks gestation.....''

Gupta R, Kilby M, Cooper G. Fetal surgery and anaesthetic implications. Continuing Education in Anaesthesia, Critical Care & Pain. 8:2 (2008) 71-75.

2. Glover, 2004, p.36, para.4, ``The fetus starts to make movements in response to being touched from eight weeks, and more complex movements build up, as detected by real time ultrasound, over the next few weeks.''

Glover V. The fetus may feel pain from 20 weeks; The Fetal Pain Controversy. Conscience. 25:3 (2004) 35-37.

3. Myers 2004, p.241, para.6, ``A motor response can first be seen as a whole body movement away from a stimulus and observed on ultrasound from as early as 7.5 weeks' gestational age. The perioral area is the first part of the body to respond to touch at approximately 8 weeks, but by 14 weeks most of the body is responsive to touch.''

Myers LB, Bulich LA, Hess, P, Miller, NM. Fetal endoscopic surgery: indications and anaesthetic management. Best Practice & Research Clinical Anaesthesiology. 18:2 (2004) 231-258.

4. Derbyshire, 2008, p.119, col.2, para.4, ``Responses to touch begin at 7-8 weeks gestation when touching the peri-oral region results in a contralateral bending of the head. The palms of the hands become sensitive to stroking at 10-11 weeks gestation and the rest of the body becomes sensitive around 13-14 weeks gestation. 35''

Note: Derbyshire's other published works indicate that he believes pain requires subjective human experience, not possible until after birth; nonetheless, he acknowledges this finding.

Derbyshire SW. Fetal Pain: Do We Know Enough to Do the Right Thing? Reproductive Health Matters. 16: 31Supp. (2008) 117-126.

35 Fitzgerald M. Neurobiology of fetal and neonatalpain. In:Wall P, Melzack R, editors. Textbook of Pain. Oxford Churchill Livingstone, 1994. p.153-63.

5. Kadic, 2012, page 3, ``The earliest reactions to painful stimuli motor reflexes can be detected at 7.5 weeks of gestation (Table 2).''

Salihagic Kadic, A., Predojevic, M., Fetal neurophysiology according to gestational age, Seminars in Fetal & Neonatal Medicine. 17:5 (2012) 1-5, 3.

b. After 20 weeks following fertilization, the unborn child reacts to stimuli that would be recognized as painful if applied to an adult human, for example by recoiling.

1. Gupta, 2008, p. p.74, col.2, para.2, ``Behavioural responses..... Response to painful stimuli occurs from 22 weeks gestation [= 20 weeks post-fertilization].''

Gupta R, Kilby M, Cooper G. Fetal surgery and anaesthetic implications. Continuing Education in Anaesthesia, Critical Care & Pain. 8:2 (2008) 71-75.

2. Giannakoulopoulos, 1994, p.77, col.2, para.3, ``We have observed that the fetus reacts to intrahepatic vein needling with vigorous body and breathing movements, which are not present during placental cord insertion needling.''

Giannakoulopoulos X, Sepulveda W, Kourtis P, Glover V, Fisk NM. Fetal plasma cortisol and b -endorphin response to intrauterine needling. Lancet. 344 (1994) 77-81.

3. Lowery, 2007, p.276, col.2, para1, ``Fetuses undergoing intrauterine invasive procedures, definitely illustrative of pain signaling, were reported to show coordinated responses signaling the avoidance of tissue injury. 15''

Lowery CL, Hardman MP, Manning N, Clancy B, Hall RW, Anand KJS. Neurodevelopmental Changes of Fetal Pain. Seminars in Pernatology. 31 (2007) 275-282.

15 Williams C. Framing the fetus in medical work: rituals and practices. Social Science & Medicine. 60 (2005) 2085-2095.

4. Mellor, 2005, p.457, col.1, para.2, ``For instance, the human fetus responds to intrahepatic needling (versus umbilical cord sampling) by moving away and with an increase in the levels of circulating stress hormones. . . 71,72,74,75''

Note: Mellor et al. believe that the unborn child is kept `asleep' in utero, and therefore does not perceive pain; nonetheless, they recognize this finding.

Mellor DJ, Diesch TJ, Gunn AJ, Bennet L. The importance of `awareness' for understanding fetal pain. Brain Research Reviews. 49 (2005) 455-471.

71 Giannakoulopoulos X, Sepulveda W, Kourtis P, Glover V, Fisk NM. Fetal plasma cortisol and b-endorphin response to intrauterine needling. Lancet. 344 (1994) 77-81.

72 Giannakoulopoulos X, Teixeira J, Fisk N. Human fetal and maternal noradrenaline responses to invasive procedures. Pediatric Research. 45 (1999) 494-499.

74 Gitau R, Fisk NM, Teixeira JM, Cameron A, Glover V. Fetal hypothalamic-pituitary-adrenal stress responses to invasive procedures are independent of maternal responses. Journal of Clinical Endocrinology and Metabolism. 86 (2001) 104-109.

75 Gitau R, Fisk NM, Glover V. Human fetal and maternal corticotrophin releaseing hormone responses to acute stress. Archives of Disease in Childhood--Fetal Neonatal Edition. 89 (2004) F29-F32.

5. Bocci, 2007, page 31-32, ``By week 14, the repertoire of movements is complete. Fetal movements may be spontaneous, reflecting individual needs of the fetus, or may be evoked, reflecting fetal sensitivity to its environment.''

C. Bocchi et al, Ultrasound and Fetal Stress: Study of the Fetal Blink-Startle Reflex Evoked by Acoustic Stimuli. Neonatal Pain, ed. Giuseppe Buonocore & Carlo V. Bellieni (Milan: Springer, 2007), 31-32.

3: In the unborn child, application of such painful stimuli is associated with significant increases in stress hormones known as the stress response.
DOCUMENTATION

1. Tran, 2010, p.44, col.1, para.7, ``Invasive fetal procedures clearly elicit a stress response .....''

Tran, KM. Anesthesia for fetal surgery. Seminars in Fetal & Neonatal Medicine. 15 (2010) 40-45.

2. Myers, 2004, p.242, para.2, ``Human fetal endocrine responses to stress have been demonstrated from as early as 18 weeks' gestation. Giannakoulopoulos et al 99 first demonstrated increases in fetal plasma concentrations of cortisol and b-endorphin in response to prolonged needling of the intrahepatic vein (IHV) for intrauterine transfusion. The magnitude of these stress responses directly correlated with the duration of the procedure. Fetuses having the same procedure of transfusion, but via the non-innervated placental cord insertion, failed to show these hormonal responses. Gitau et al 100 observed a rise in b-endorphin during intrahepatic transfusion from 18 weeks' gestation, which was seen throughout pregnancy independent both of gestation and the maternal response. The fetal cortisol response, again independent of the mother's, was observed from 20 weeks' gestation. 100 Fetal intravenous administration of the opioid receptor agonist, fentanyl, ablated the b-endorphin response and partially ablated the cortisol response to the stress of IHV needling, suggesting an analgesic effect. 101 A similar, but faster, response is seen in fetal production of noradrenalin to IHV needling. This too is observed in fetuses as early as 18 weeks, is independent to the maternal response and increases to some extent with gestational age. 102 Thus, from these studies one can conclude that the human fetal hypothalamic-pituitary-adrenal axis is functionally mature enough to produce a b-endorphin response by 18 weeks and to produce cortisol and noradrenalin responses from 20 weeks' gestation.''

Myers LB, Bulich LA, Hess, P, Miller, NM. Fetal endoscopic surgery: indications and anaesthetic management. Best Practice & Research Clinical Anaesthesiology. 18:2 (2004) 231-258.

99 Giannakoulopoulos X, Sepulveda W, Kourtis P, Glover V, Fisk NM. Fetal plasma cortisol and b-endorphin response to intrauterine needling. Lancet. 344 (1994) 77-81.

100 Gitau R, Fisk NM, Teixeira JM, Cameron A, Glover V. Fetal hypothalamic-pituitary-adrenal stress responses to invasive procedures are independent of maternal responses. Journal of Clinical Endocrinology and Metabolism. 86 (2001) 104-109.

101 Fisk NM, Gitau R, Teixeira MD, Giannakoulopoulos, X, Cameron, AD, Glover VA. Effect of Direct Fetal Opioid Analgesia on Fetal Hormonal and Hemodynamic Stress Response to Intrauterine Needling. Anesthesiology. 95 (2001) 828-835.

102 Giannakoulopoulos X, Teixeira J, Fisk N, Glover V. Human fetal and maternal noradrenaline responses to invasive procedures. Pediatric Research. 45(1999) 494-499.

3. Derbyshire, June 2008, p.4, col.1, para.5, ``Another stage of advancing neural development takes place at 18 weeks, when it has been demonstrated that the fetus will launch a hormonal stress response to direct noxious stimulation.''

Note: Derbyshire believes that pain requires subjective human experience, not possible until after birth; nonetheless, he acknowledges this finding.

Derbyshire SW. Fetal Pain: Do We Know Enough to Do the Right Thing? Reproductive Health Matters. 16: 31Supp. (2008) 117-126.

4. Gupta, 2008, p.74, col.2, para.3, ``Fetal stress in response to painful stimuli is shown by increased cortisol and b-endorphin concentrations, and vigorous movements and breathing efforts. 7,9 There is no correlation between maternal and fetal norepinephrine levels, suggesting a lack of placental transfer of norepinephrine. This independent stress response in the fetus occurs from 18 weeks gestation. 10''

Gupta R, Kilby M, Cooper G. Fetal surgery and anaesthetic implications. Continuing Education in Anaesthesia, Critical Care & Pain. 8:2 (2008) 71-75.

7 Boris P, Cox PBW, Gogarten W, Strumper D, Marcus MAE. Fetal surgery, anaesthesiological considerations. Current Opinion in Anaesthesiology.17 (2004) 235-240.

9 Giannakoulopoulos X, Teixeira J, Fisk N. Human fetal and maternal noradrenaline responses to invasive procedures. Pediatric Research. 45 (1999) 494-499.

10 Marcus M, Gogarten W, Louwen F. Remifentanil for fetal intrauterine microendoscopic procedures. Anesthesia & Analgesia. 88 (1999) S257.

5. Fisk, 2001, p.828, col.2, para.3, ``Our group has shown that the human fetus from 18-20 weeks elaborates pituitary-adrenal, sympatho-adrenal, and circulatory stress responses to physical insults.'' p.834, col.2, para.2, ``This study confirms that invasive procedures produce stress responses.....''

Fisk NM, Gitau R, Teixeira MD, Giannakoulopoulos, X, Cameron, AD, Glover VA. Effect of Direct Fetal Opioid Analgesia on Fetal Hormonal and Hemodynamic Stress Response to Intrauterine Needling. Anesthesiology. 95 (2001) 828-835.

6. Kadic, 2012, page 3, ``As early as 16-18 weeks, fetal cerebral blood flow increases during invasive procedures. 26,27 An elevation of noradrenaline, cortisol, and beta-endorphin plasma levels, in response to needle pricking of the innervated hepatic vein for intrauterine transfusion, was registered in a 23-week-old fetus [= 21 weeks post-fertilization].'' (Table 2).''

Salihagic Kadic, A., Predojevic, M., Fetal neurophysiology according to gestational age, SEMINARS IN FETAL & NEONATAL MEDICINE (2012) 1-5, 3, doi:10.1016/j.siny.2012.05.007.

26 Teixeira JM, Glover V, Fisk NM. Acute cerebral redistribution in response to invasive procedures in the human fetus. Am J Obstet Gynecol 1999;181:1018e25.

27 Smith RP, Gitau R, Glover V, et al. Pain and stress in the human fetus. Eur J Obstet Gynecol Reprod Biol 2000;92:161e5.

4: Subjection to such painful stimuli is associated with long-term harmful neurodevelopmental effects, such as altered pain sensitivity and, possibly, emotional, behavioral, and learning disabilities later in life.
DOCUMENTATION

1. Van de Velde, 2006, p.234, col.1, para.3, ``It is becoming increasingly clear that experiences of pain will be `remembered' by the developing nervous system, perhaps for the entire life of the individual. 22,33, These findings should focus the attention of clinicians on the long-term impact of early painful experiences, and highlight the urgent need for developing therapeutic strategies for the management of neonatal and fetal pain.''

Van de Velde M, Jani J, De Buck F, Deprest J. Fetal pain perception and pain management. Seminars in Fetal & Neonatal Medicine. 11 (2006) 232-236.

22 Vanhalto S, van Nieuwenhuizen O. Fetal Pain? Brain & Development. 22 (2000) 145-150. 33 Anand KJS. Pain, plasticity, and premature birth: a prescription for permanent suffering? Nature Medicine. 6 (2000) 971-973.

2. Vanhatalo, 2000, p.148, col.2, para.4, ``All these data suggest that a repetitive, or sometimes even strong acute pain experience is associated with long-term changes in a large number of pain-related physiological functions, and pain or its concomitant stress increase the incidence of later complications in neurological and/or psychological development.''

Note: Vanhalto & Niewenhuizen believe that pain requires cortical processing; nevertheless, they acknowledge that, ``noxious stimuli may have adverse effects on the developing individual regardless of the quality or the level of processing in the brain ..... after the development of the spinal cord afferents around the gestational week 10, there may be no age limit at which one can be sure noxae are harmless.'' (p.149, col.1, para.2).

Vanhalto S, van Nieuwenhuizen O. Fetal Pain? Brain & Development. 22 (2000) 145-150.

3. Gupta, 2008, p.74, col.2, para.3, `` There may be long-term implications of not providing adequate fetal analgesia such as hyperalgesia, and possibly increased morbidity and mortality.''

Gupta R, Kilby M, Cooper G. Fetal surgery and anaesthetic implications. Continuing Education in Anaesthesia, Critical Care & Pain. 8:2 (2008) 71-75.

4. Lee, 2005, p.951, col.1, para.3, ``When long-term fetal well-being is a central consideration, evidence of fetal pain is unnecessary to justify fetal anaesthesia and analgesia because they serve other purposes unrelated to pain reduction, including ..... (3) preventing hormonal stress responses associated with poor surgical outcomes in neonates 71,72; and (4) preventing possible adverse effects on long-term neurodevelopment and behavioral responses to pain. 73-75.''

Note: Lee et al. believe that pain requires conscious cortical processing, which they deem unlikely until 29 or 30 weeks; nonetheless, they acknowledges this finding.

BREAK IN TRANSCRIPT

Ms. FOXX. Madam Speaker, as our colleagues on the other side of the aisle know full well and as our colleague from Connecticut has acknowledged, the House has passed a bill to take care of the issue of student loan rates doubling on July 1; however, the Senate has refused to act on the bill. What we passed was what the President asked for in his budget, and he has suddenly flip-flopped on the issue and doesn't support it anymore.

The House has done its job. We're now waiting for the Senate and the President to acknowledge that they have a responsibility in this area. We've not been frivolous about this. We are not ignoring the issue.

With that, I reserve the balance of my time.

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Ms. FOXX. Madam Speaker, I yield myself such time as I may consume.

I would like to point out that none of the Members on the other side of the aisle have even acknowledged the pain that unborn children feel or the fact that half of those babies that are being murdered are little girls.

Madam Speaker, life is the most fundamental of all rights. It's sacred and God-given. But millions of babies have been robbed of that right in this, the freest country in the world. This is a tragedy beyond words and a betrayal of what we, as a Nation, stand for.

Before liberty, equality, free speech, freedom of conscience, pursuit of happiness, and justice for all, there has to be life. And yet, for millions of aborted infants--many pain-capable and many discriminated against because of gender or disability--life is exactly what they've been denied. An affront to life for some is an affront to life for every one of us.

One day, we hope it will be different. We hope life will cease to be valued on a sliding scale. We hope the era of elective abortions, ushered in by an unelected court, will be closed and collectively deemed one of the darkest chapters in America's history. But until that day, it remains a solemn duty to stand up for life.

Regardless of the length of this journey, we will continue to speak for those who cannot, and we will continue to pray to the One who can change the hearts of those in desperation and those in power who equally hold the lives of the innocent in their hands.

May we, in love, defend the unborn. May we, in humility, confront this national sin. And may we mourn what abortion reveals about the conscience of our Nation.

Madam Speaker, we go to extraordinary lengths to save not only human beings, but even animals because we value life so much. However, there are many who do not hold the unborn in the same esteem, and that is tragic for more than 1 million unborn babies every year.

There is nothing more important than protecting voiceless, unborn children and their families from the travesty of abortion. Therefore, I urge my colleagues to vote for life by voting in favor of this rule and the underlying bill.

The material previously referred to by Ms. Slaughter is as follows:

An Amendment to H. Res. 266 Offered by Ms. Slaughter of New York

At the end of the resolution, add the following new sections:

SEC. 3. Immediately upon adoption of this resolution the Speaker shall, pursuant to clause 2(b) of rule XVIII, declare the House resolved into the Committee of the Whole House on the state of the Union for consideration of the bill (H.R. 1595) to amend the Higher Education Act of 1965 to extend the reduced interest rate for Federal Direct Stafford Loans. The first reading of the bill shall be dispensed with. All points of order against consideration of the bill are waived. General debate shall be confined to the bill and shall not exceed one hour equally divided and controlled by the chair and ranking minority member of the Committee on Education and the Workforce. After general debate the bill shall be considered for amendment under the five-minute rule. All points of order against provisions in the bill are waived. At the conclusion of consideration of the bill for amendment the Committee shall rise and report the bill to the House with such amendments as may have been adopted. The previous question shall be considered as ordered on the bill and amendments thereto to final passage without intervening motion except one motion to recommit with or without instructions. If the Committee of the Whole rises and reports that it has come to no resolution on the bill, then on the next legislative day the House shall, immediately after the third daily order of business under clause 1 of rule XIV, resolve into the Committee of the Whole for further consideration of the bill.

SEC. 4. Clause 1(c) of rule XIX shall not apply to the consideration of H.R. 1595 as specified in section 3 of this resolution.

THE VOTE ON THE PREVIOUS QUESTION: WHAT IT REALLY MEANS

This vote, the vote on whether to order the previous question on a special rule, is not merely a procedural vote. A vote against ordering the previous question is a vote against the Republican majority agenda and a vote to allow the Democratic minority to offer an alternative plan. It is a vote about what the House should be debating.

Mr. Clarence Cannon's Precedents of the House of Representatives (VI, 308-311), describes the vote on the previous question on the rule as ``a motion to direct or control the consideration of the subject before the House being made by the Member in charge.'' To defeat the previous question is to give the opposition a chance to decide the subject before the House. Cannon cites the Speaker's ruling of January 13, 1920, to the effect that ``the refusal of the House to sustain the demand for the previous question passes the control of the resolution to the opposition'' in order to offer an amendment. On March 15, 1909, a member of the majority party offered a rule resolution. The House defeated the previous question and a member of the opposition rose to a parliamentary inquiry, asking who was entitled to recognition. Speaker Joseph G. Cannon (R-Illinois) said: ``The previous question having been refused, the gentleman from New York, Mr. Fitzgerald, who had asked the gentleman to yield to him for an amendment, is entitled to the first recognition.''

The Republican majority may say ``the vote on the previous question is simply a vote on whether to proceed to an immediate vote on adopting the resolution ..... [and] has no substantive legislative or policy implications whatsoever.'' But that is not what they have always said. Listen to the Republican Leadership Manual on the Legislative Process in the United States House of Representatives, (6th edition, page 135). Here's how the Republicans describe the previous question vote in their own manual: ``Although it is generally not possible to amend the rule because the majority Member controlling the time will not yield for the purpose of offering an amendment, the same result may be achieved by voting down the previous question on the rule ..... When the motion for the previous question is defeated, control of the time passes to the Member who led the opposition to ordering the previous question. That Member, because he then controls the time, may offer an amendment to the rule, or yield for the purpose of amendment.''

In Deschler's Procedure in the U.S. House of Representatives, the subchapter titled ``Amending Special Rules'' states: ``a refusal to order the previous question on such a rule [a special rule reported from the Committee on Rules] opens the resolution to amendment and further debate.'' (Chapter 21, section 21.2) Section 21.3 continues: ``Upon rejection of the motion for the previous question on a resolution reported from the Committee on Rules, control shifts to the Member leading the opposition to the previous question, who may offer a proper amendment or motion and who controls the time for debate thereon.''

Clearly, the vote on the previous question on a rule does have substantive policy implications. It is one of the only available tools for those who oppose the Republican majority's agenda and allows those with alternative views the opportunity to offer an alternative plan.

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