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Motherless Births: A Futuristic Reality?

Authored by Emily Zhang


After ovaries are surgically removed from female volunteers, they are transported to the Bottling Room where they are incubated. This is the way babies are made in Aldous Huxley’s novel Brave New World. When Huxley first published his novel  in 1931, the future he imagined seemed highly implausible. However, a century later, this dystopian world may be closer to reality than we think. 


In 2017, a Children’s Hospital of Philadelphia (CHOP) research team led by Alan Flake designed the closest prototype we have to an artificial womb. The system consists of a “Biobag'' that is filled with electrolyte-laden fluid and connected to the umbilical cord of babies via intricate surgery. Artificial womb-technology focuses most on providing oxygen and removing carbon dioxide supply in premature babies until their organs are properly developed [1]


Since 2017, Flake and his team have tested this extra-uterine system on lambs as they are most developmentally similar to humans [1]. The team reported that they were able to keep eight lambs alive for up to four weeks with normal development of the brain and other organs. 


So far, experiments have only been performed on animal models. However, researchers at CHOP are pushing for FDA approval to start the first human trials of this technology. As of October of 2023, FDA administrators have met to discuss regulations, ethics, and possibilities of the implementation of artificial wombs [2]. 


In a world after Roe v. Wade, artificial wombs have large implications on reproductive rights. Researchers and scholars have argued that ectogenesis can prevent abortion by protecting bodily autonomy, as a fetus can be transferred to an artificial womb instead of being terminated [3]. In high risk pregnancies, the health harms could potentially be alleviated. 


Many ethical and social concerns also arise from this technology. How can we weigh the potential risks against the benefits? Should the burden of medical responsibility for these premature fetuses fall on overworked physicians? Without the gestational bond between women and infants, how could this impact maternal bonding? Most of these questions remain highly contested. 


In terms of health equity, artificial wombs can offer hope to infertile women who hope to have a child. It can also offer opportunities for transgender women, gay women, single women, single men, or gay men to become parents without a surrogate [4]. 


On the other hand, artificial wombs could exacerbate socioeconomic divides [5]. Wealthy prospective parents could opt for artificial wombs, while poorer families may have to continue relying on women to carry. “It should be anticipated that clinical availability of ectogenesis, possibly first as a way to save extremely premature fetuses, may spark demand for non-medical purposes, like avoiding physical and social burdens of pregnancy.” [6]


Currently, the science behind artificial wombs provides great promise for saving the lives of extremely premature neonates. However, integrating artificial wombs in medical practice is far more complex, requiring us to consider a plethora of health, social, and political implications.


So, how close are we to making motherless births a reality? 


References 


  1. Partridge, E., Davey, M., Hornick, M., et al. (2017). An extra-uterine system to physiologically support the extreme premature lamb. Nature Communications, 8, 15112. https://doi.org/10.1038/ncomms15112

  2. Whyte, L. (2023). Artificial Wombs for Premature Babies Are a Step Closer to Reality. The Wall Street Journal. Retrieved from https://www.wsj.com/health/fda-artificial-womb-rules-human-clinical-trials-fcb923a4

  3. Horn, C. (2021). Abortion Rights after Artificial Wombs: Why Decriminalization is Needed Ahead of Ectogenesis. Medical Law Review, 29(1), 80-105. doi: 10.1093/medlaw/fwaa042

  4. Horn, C. (2020). Gender, gestation and ectogenesis: self-determination for pregnant people ahead of artificial wombs. Journal of Medical Ethics, 46, 787-788.

  5. Lee, K. (2016). Ectogenesis. Voices in Bioethics, 2. doi: 10.7916/vib.v2i.5961.

  6. Segers S. (2021). The path toward ectogenesis: looking beyond the technical challenges. BMC medical ethics, 22(1), 59. https://doi.org/10.1186/s12910-021-00630-6

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