Professor Sir William Liley (1929–1983)
Professor Sir William Liley (1929–83): NZ Perinatal Physiologist

The Unborn Child as a patient

By Professor Sir William Liley (1929–83): NZ Perinatal Physiologist

US National Committee for a Human Life Amendment Inc. WASHINGTON D.C. 20036 (in 1974). The US Senate Judiciary Subcommittee on Constitutional Amendments held hearings on 7 May 1974 on proposed constitutional amendments to protect the unborn child. The full text of Dr. Liley's testimony submitted at that time is reproduced herein.

"My name is Albert William Liley. I am a registered medical practitioner in New Zealand. I hold the appointment of Research Professor in Perinatal Physiology at the Post-graduate School of Obstetrics and Gynecology of the University of Auckland, New Zealand. I have trained in neurophysiology, obstetrics, and pediatrics, and clinically I have worked as a fetal pediatrician for most of the last seventeen years.

 This work began with the development of techniques for the antenatal diagnosis of the severity of Rh hemolytic disease, and in 1963, I developed a method by which Rh babies beyond the aid of conventional therapy could be given transfusions in utero to tide them over to a deliverable maturity.

This situation has highlighted the fact that we are dealing with the same baby before and after birth, and our clinical approach to these children is simply a matter of whether we can look after them more safely and adequately in the uterus or out of it.

The techniques we developed for the diagnosis and supervision and treatment of Rh babies before birth have now been widely exploited for the investigation of other problems and, further, they have provided an opportunity to invade the privacy of the fetus and to make many observations of a variety of aspects of fetal life and behavior.

I would like to submit in written testimony an article entitled "The Foetus as a Personality" from the Australia-New Zealand Journal of Psychiatry. Aust.NZ.J.Psychiatry (1972) 6 99 - bit.ly/2W0AE96

Several important points emerge from the experience I have had in the field of perinatal medicine. Firstly, it is obvious that the fetus can need and receive diagnosis and treatment just like any other patient. As one who has to look after babies before birth, I would find it extraordinarily arbitrary to be asked to consider that one baby was important and should be cared for properly, and that another was unimportant and that his existence should be denied.

Secondly, physiological observations and investigations demonstrate that the fetus is not a placid, dependent, fragile, nerveless vegetable, but very much in command of his own environment and destiny with a tenacious purpose.

unborn baby

"I recall Professor Liley telling me on one occasion that the youngest baby he had transfused in the womb was 16 weeks." Ed.

It is the fetus who is responsible for the endocrine success of pregnancy, who solves the homograft problem in pregnancy, who determines how he will lie in pregnancy and present in labor, and who determines the duration of the pregnancy. Normally, the onset of labor is a unilateral decision by the fetus.

Thirdly, it is apparent that the classical picture of fetal life as a time of quiescence, of quietly and blindly developing structures in anticipation of a life and function to begin at birth is completely erroneous.

Development of structure and development of function go hand-in-hand; the fetal environment is not a dark and silent world, and the fetus does not live in a state of sensory deprivation. The picture we have built up of fetal environment and fetal behavior is described in the article which I have submitted for testimony.

My own practice in medicine makes it very dear that in modern obstetrics, we are caring for two individuals, mother and baby. Indeed, it may be more than two individuals, as in a multiple pregnancy, and in this situation, we have found it clinically necessary to identify unmistakably and keep track of each of the babies in a multiple pregnancy before birth.

Not only is it apparent that an illness such as Rh disease may represent the same problem for the same patient before and after birth, but a similar continuity is demonstrable for behavior traits. For instance, measurement of fetal swallowing rate in utero shows considerable variation from one baby to another, but these rates correlate closely with the independently assessed feeding performance of the newborn in the nursery.

Further, some babies suck their thumbs in utero and some do not; but we have never observed a baby who sucked his thumb in utero who was not also a thumbsucker after birth.

We have x-ray evidence of thumbsucking in utero at 24 weeks gestation, but thumbsucking has also been photographed in the 9-week abortus.

The fetus is also responsive to experimental modification of the taste of amniotic fluid. Injection of oily contrast media (a foul-tasting iodinated poppy seed oil) causes the fetus to quit drinking or swallowing; conversely, artificially sweetening the amniotic fluid with saccharine usually causes an approximate doubling of fetal swallowing rate, although a minority drink decidedly less after saccharine injection.

We are interested in following these children and checking saccharine tasting when they are older, as it is well known that to some people saccharine in concentration is not tasted as sweet, but intensely bitter.

The fetus is responsive to touch and pressure, and sustained pressure will produce evasive action which, in fact, can be utilized when we wish to modify fetal position for diagnostic or therapeutic purposes.

The fetus responds violently to painful stimuli, for instance, needle puncture and the intrafetal injection of cold or concentrated solutions.

Professor Liley at an anti-abortion rally in Wellington NZ,1974

Professor Liley at an anti-abortion rally in Wellington NZ,1974. Beside him are (from left) Dr Diana Mason, Ruth Kirk (wife of Prime Minister Norman Kirk) and Archbishop Reginald Delargey  bit.ly/2YyCe3w

Our observations of many of these aspects of fetal behavior have been made after 18 weeks gestation for two reasons: 1) this has been the time span when the clinical problems with which we deal have 2 permitted us to invade fetal privacy; and 2) many of our diagnostic techniques, for instance, x-ray and fetal electrocardiography, are applicable only in later pregnancy.

However, new techniques such as the use of ultra-sound, are enabling us to push these observations back into the first half of fetal life. In any case, the fact that these fetal responses were already intact by the time our former techniques of observation were applicable shows that these responses must have developed earlier, and indeed from brief observations on the early miscarried fetus, such as the classical studies in the United States by Davenport Hooker, we know that early fetal responsiveness was only quantitatively, and not qualitatively, different from the early to the later stages of pregnancy."

End.

Post script: Both Liley and his wife Helen were active pro-life activists. Professor Liley became distressed that amniocentesis became a tool for parents to decide to abort their unborn child. He was also concerned that doctors used the needle procedure he had pioneered for life-saving transfusions to administer saline for abortions.

Professor Liley, together with Dr Pat Dunn, Obstetric specialist and foundation member Ken Orr -now of Right to Life New Zealand)  formed the Society for the Protection of the Unborn Child (SPUCNZ) in 1970 in response to the creation of the Abortion Law Reform Association.  (NB. SPUCNZ is now Voice for Life).   

In 1978 Pope Paul VI recognized Professor Liley for his pro-life work and although not a Catholic, appointed him to the Vatican's Pontifical Academy of Sciences.

Sir William Liley died unexpectedly on 15 June 1983.  At his funeral, officiated by both Roman Catholic and Anglican churches' highest leaders he was recognized for his extraordinary contribution to saving the lives of the unborn with his pioneering medical techniques.  The President of the Society for the Protection of the Unborn Child NZ - Mr. Peter Barry-Martin – said at the time 'the world pro-life movement mourns the death of one of its most powerful advocates".


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