Womb alone
Issue 88 - 15 February 2022 (8-min read)
Two weeks ago when I was researching for our 86th issue on The Fertility Countdown, I came across a new technological development that made me realise it deserves an edition on its own. So, here goes.
Driven not just by an impending population collapse but also overall reproductive and neonatal health, scientists have made breakthroughs that could allow babies to grow completely outside the human body. This week, The Global Tiller takes a closer look at how biotechnology allows this to happen, how close are we to growing babies outside the womb and how would such developments impact our society.
Elon Musk’s tweet about the population collapse may have revived the debate around artificial wombs but this technology is not completely new. Swedish scientists published a paper in 1958 in which they worked with pre-viable human foetuses in a simulated uterine environment - or in simpler words, an artificial womb. Canadians have been experimenting with sheep since the 60s and the Japanese have done seminal work in the field as early as 1963.
What prompts research into this area is a noble cause: an attempt to save the 15 million babies that are born premature every year around the globe, a number that continues to rise. This research has transformed neonatal units in hospitals across the world, allowing doctors to now save babies born as early as 23-24 weeks.
However, the current incubator technology is limited by the fact that it requires babies to breathe on their own, a feat not easily possible for those born younger than 28 weeks. With artificial wombs, this problem could potentially be taken care of.
Scientists at the Children’s Hospital of Philadelphia have created a Biobag that is able to keep an extremely premature lamb foetus alive outside the mother’s body. These lambs were not grown entirely in the Biobag but were taken out of its mother’s body through caesarian section and then submerged into it. Once it reached full term, the bag was unzipped and a lamb was born.
If this works on a lamb, it could just as easily work on humans too. At least, scientifically. Artificial wombs that replicate the same environment as a woman’s uterus will have wide implications on our idea of pregnancy and childbirth and are, rightly, subjected to ethical considerations and limitations. Even the Biobag scientists are clear to market their success as a way to save premature babies and not an attempt to extend the limit of human viability, although their patent application holds no such qualms.
Could we live to see the first baby born completely outside its mother’s body? Depends on who you ask. While the scientists behind Biobag are hoping to put human babies inside their bags within a couple of years (pending FDA approval), their counterparts in Australia are less optimistic. “Anyone who tells you they are going to be doing this in two years either has a wealth of data that is not in the public domain or is being a bit sensationalist,” says Matt Kemp, who runs the perinatal lab at the Women and Infants Research Foundation in Western Australia, and has been working on artificial wombs since 2013.
Scientists would need to do a lot more research and clinical trials, and even push for changes in the law that currently restricts them from keeping embryos in a lab beyond 14 days. But we’ve seen with other kinds of innovations before, once the technology succeeds and large companies jump on board, the laws don’t stand in the way of widespread usage.
Silicon Valley is taking an interest in biotechnology, despite the setback from the recent Theranos debacle. Companies, such as Conception and IvyNatal, are promising to turn stem cells into human eggs — allowing women, or any other gender for that matter, to have biological children at any age. Chinese scientists have already created an AI nanny to look after embryos growing inside artificial wombs.
It seems that when it comes to artificial wombs and growing babies entirely outside the mother’s body, the questions is not if, but when. So it makes sense to be prepared on how our societies will adapt. Motherhood and childbirth are considered sacred acts across many cultures, sometimes at the cost of women’s health. When artificial wombs become viable, will we allow women the agency to choose how to bring new life into this world? Or will patriarchy perpetuate society’s regulation of women’s bodies by forcing them to choose one way or another?
Advancements in neonatal care eventually lowered the legal abortion limit in the UK, forcing women to deliver babies that may not survive infancy. Will artificial wombs give women more bodily autonomy or will they have knock-on effects that restrict them even more? Could companies force their female employees to go for artificial wombs so they don’t have to take a break from work life? Will Margaret Atwood imagine an antithesis of The Handmaid’s Tale where women are forcibly kept away from child birth?
Will we create a new class of society where successful women have access to artificial wombs while the rest are left to undergo the pains of labour? What happens to the role of women in society overall when, for centuries, they have been defined by their role as child-bearers.
Or will we see reproductive labour finally be redistributed more fairly in society? How many more kinds of families will be able to have biological children they couldn’t have before?
What are some other ways that you imagine this technology will change our society? Do let us know.
Until next week, take care and stay safe.
Hira - Editor - The Global Tiller
Dig deeper
What if women never had to give birth again?
BBC Reel Video by Izabela Cardoso & Fernando Teixeira
…and now what?
It’s hard to think about Biobags without thinking of the amazing film 'Blade Runner 2047'. Spoiler alert if you haven’t seen it yet but I highly recommend this masterpiece. In this movie, Niander Wallace, a tech guru, as we know many in today’s world, is suffering from a Demiurge syndrome and is trying to recreate the process of life through technology and plastic bags.
This vision, as depicted in the movie, can appear far-fetched or of a very far time in the future: weird lighting, unusual steam-punk outfits, everything put in a context that makes us think that it’s more fiction than science. But, as it seems, this future may actually be closer than we imagined.
Niander Wallace’s philosophy, as depicted in the movie, seems highly unethical and disturbing. It’s unacceptable to try to breed humans in a bag to ease the process of reproduction, for profit and power.
But there are other aspects to the ethical issues raised by this movie that I have had a chance to reflect on as I read the biography of Jennifer Doudna, one of the leading scientists behind the CRISPR revolution. Apart from telling us about the life of the scientist, author Walter Isaacson dedicates a good chunk of this book exploring the ethical questions raised by gene editing — a topic that we covered last year.
As with every ethical debate, there are no two clear sides to the issue. Our initial reaction to the idea of going to a clinic one day and asking for a kid to be delivered to us can be quite troubling, especially if you mix artificial wombs with CRISPR technology. Select the genes, put it in a womb-like machine and come back in nine months. One may run out screaming, this is unnatural!
But as Isaacson reminds us, there was a time when in-vitro fertilisation was seen as unnatural, as preposterous, as unethical. There was is a time when many people considered it unnatural for couples who can’t have kids (especially if they were homosexual couples) to adopt one. Yet, nowadays this is accepted (more or less). It is considered a sign of progress as it improves our happiness and well-being.
When it comes to the ethics of reproductive technological advancements, the discussions can be tricky. As Hira mentions, biobags and other similar technologies can be hugely beneficial for many people. They could be the last step to finally allow women to be seen not only through their reproductive biological functions.
Nevertheless, these debates are necessary and it is necessary to not oversimplify the conversation: do or don’t do, authorise or forbid. We may believe that pulling the plug now or putting our heads in the sand will help us avoid these developments but, these developments will happen. If not by us, then by someone else.
But what if the truth lies in the middle, as very often it does. What if the problem is not the tools, however unnatural they may seem, but the way we use them? What if the problem is the fact that with every new technology comes the unstoppable greed of some who just try to make profits out of it? Or use them as instruments of power, like Niander Wallace did?
Whether for CRISPR or those Biobags, it may just be enough to restrict their use to medical needs and put them under strict medical oversight. What is eventually necessary is to include everyone in the conversation who could benefit from or be harmed by these tools so that we create technologies that are beneficial for all, and not profitable for some.
And once this is done, we can decide if we’ll call those babies Replicants and what status they will bear in the 2047 future. But this will be for an other time, another opportunity to talk about the Blade Runner.
Philippe - Founder & CEO - Pacific Ventury