Providing Life Outside of the Womb

Theme: Ethics and Controversy

Carlotta Ceccarelli

The thought of growing a baby without physically requiring a mother or a Female holder is breathtaking, almost startling when you think this might be possible in only just a decade. Ectogenesis is the development of embryos in artificial conditions outside of the uterus, a procedure first outlined in a science fiction essay written by J.B.S Haldane in 1923 [1]. As a matter of historical course, it is said there is no use arguing the possibility of Ectogenesis being a viable process, technology is so close at the present it is described as inevitable. This is demonstrated by the most prominent experiment conducted, where Japanese pioneers raised a kid in a Biobag in the 1990s. And no- not a human child, a young goat. What we may see as just a plastic bag, could quite literally serve its purpose for a lifetime.

At Tokyo University’s medical department, a goat fetus was placed in an artificial womb after 4 months gestation, approximately 75% fully grown in everyday terms. The bio bag contained a synthetic amniotic fluid to its mother’s, where it was fed recycled, nutrient-rich and well-oxygenated blood via a catheter. To mimic the mother’s womb even further, a constant temperature was kept at 39.5 degrees celsius, by streaming the tempered water between two layers of the rubber sealing. All these factors contributed to a successful and safe delivery almost 3 weeks later, although there was an unprecedented issue that gave the baby goat some side effects shortly after it was born. The 42-litre sac utilized was much bigger than a regular goat womb, allowing the little one to be much more active than usual given all of the space it now had. These conditions put the fetus at risk of consuming too much oxygen and ingesting too much amniotic fluid, which could cause its environment to become increasingly toxic and for it to retain more fluid than anticipated. As a result of this, they had to sustain the fetus with sedatives to tranquilize it and slow down its activity. Yoshinori Kuwabara, the gynecologist of this procedure has since reported the kid to have been ‘doing well’ one month postpartum [2].

This is an example of the artificial womb being utilized for Neonatal Intensive Care purposes, where the mechanization is used to substitute a traditional incubator, which technically consists of two births. Implementing this technology to humans could prove extremely useful for premature babies. This replacement could resolve common conditions treated at a NIC unit, respiratory issues including but not subject to: Pneumonia, Respiratory Distress Syndrome and Bronchopulmonary Dysplasia- complications stemming from immature lungs [3]. For premature babies under 26 weeks, after their very first breath, their lungs stop developing. Placing them in a more substantial environment for growth could potentially inhibit long-term health problems, offering a bridge between the natural womb and the outside world to give babies more time to develop their delicate lungs [4].

However the ‘birth in the bag’ technology can be applied in a different way, instead of serving its purpose as a NIC pouch, it could substitute for a real womb from the very beginning after fertilization. Quoting Anna Smajdor, a professor at the University of Oslo, “it could be an option to address the injustice that the female uterus is still a necessary part of reproduction”. One could question the term of ‘injustice’, but perhaps the polarity of power in society today really could be resolved, not easily, with the idea of releasing women from the essential requirement of sex and pregnancy. For J.B.S Haldane, this is an immaculate example of how science can influence societal norms. This could allow pregnancy to become uncoupled, opening doors for homosexual couples outside of surrogacy, giving hope to the infertile couple and presenting a chance for the woman with reproductive organ deformities [5].

Aside from the fact that ‘Ecto-babies’ could liberate women from inconvenience, pain and risk, there are benefits presented to the fetus as well. By employing an artificial uterus, growth environments can be completely controlled and calibrated; this involves sterility, hormonal/ nutritional dispensation and easy access in case of emergencies. The baby could be immune to unhealthy habits posed by the mother [6]. Pregnancy could be a world without sacrifices, without forgetting the fact that the fetus would be protected from environmental factors such as air pollution. While there has been evidence of psychological and emotional bonds formed in pregnancy, as highlighted by Zuairia in our previous article The “Mommy Brain”, traumatic childbirth could sever it along with other issues such as postpartum depression- or at least to a larger extent than growing a baby outside of your womb. There is still a possibility for both physical and emotional connection, otherwise, we would be disproving the love of adoptive parents and fathers too [7].

The quick development of this procedure is fascinating, what we may have thought is so out of reach today might not be in a few years, it's not even a matter of time anymore. Yet it is interesting how such a solution could potentially cause so many problems: Patients in countries like Nigeria still consider C-section births as wrongdoing, imagine births without wombs [8]. There is a myriad more elements that contribute to the ethics and proposal of Ectogenesis, for the sake of article length I have not touched base on another crucial strand: Abortion. By all means, discuss your views on this in the comments below… we are more than happy to talk, it's an open space!

Glossary:

• Ectogenesis- The development of embryos in artificial conditions outside the uterus.

• Gestation- The process or period of developing inside the womb between conception and birth.

• Amniotic fluid- The fluid surrounding a fetus within the amnion.

• Catheter- A flexible tube inserted through a narrow opening into a body cavity.

• Sedatives- A drug taken for its calming or sleep-inducing effect.

• Neonatal Intensive Care/NIC- Intensive care to dangerously ill or premature newborn babies.

• Incubator- An enclosed apparatus in which premature or unusually small babies are placed and which provides a controlled and protective environment for their care.

• Premature- Born before the end of the full term of gestation, especially three or more weeks before.

• Pneumonia- Lung inflammation caused by bacterial or viral infection, in which the air sacs fill with pus and may become solid.

• Respiratory Distress Syndrome- A condition in newborn babies in which the lungs are deficient in surfactant, which prevents their proper expansion and causes the formation of hyaline material in the lung spaces.

• Bronchopulmonary Dysplasia- A form of chronic lung disease that affects newborns.

• Calibrated- Marked with a scale of readings.

• Sterility- The quality or condition of being sterile.

References:

1. Zhan Wei, E., 2017. 1923- Term 'Ectogenesis' Coined. [online] Nextnature. Available at: <https://nextnature.net/2017/05/1923-term-ectogenesis-coined> [Accessed 5 May 2020].

2. Hadfield, P., 1992. Japanese Pioneers Raise Kid In Rubber Womb. [online] NewScientist. Available at: <https://www.newscientist.com/article/mg13418180-400-japanese-pioneers-raise-kid-in-rubber-womb/> [Accessed 5 May 2020].

3. March of Dimes. 2014. COMMON CONDITIONS TREATED IN THE NICU. [online] Available at: <https://www.marchofdimes.org/complications/common-conditions-treated-in-the-nicu.aspx#> [Accessed 5 May 2020].

4. Youtube. 2017. Scientists Grow Lamb Fetus Inside Artificial Womb. [online] Available at: <https://www.youtube.com/watch?v=dt7twXzNEsQ&frags=pl%2Cwn> [Accessed 6 May 2020].

5. Schwartz, O., 2019. On The History Of The Artificial Womb. [online] JSTOR. Available at: <https://daily.jstor.org/on-the-history-of-the-artificial-womb/> [Accessed 6 May 2020].

6. Hudson, A., 2019. Human Babies Born Using An Artificial Womb 'Possible In A Decade'. [online] Metro.co.uk. Available at: <https://metro.co.uk/2019/05/14/human-babies-born-using-an-artificial-womb-possible-in-a-decade-8156458/> [Accessed 6 May 2020].

7. Kirkey, S., 2018. Artificial Wombs Intended To Save Premature Babies — For Now. Next Step Could Be 'Immaculate Gestation'. [online] National Post. Available at: <https://nationalpost.com/health/artificial-wombs> [Accessed 7 May 2020].

8. Bryce, E. and Udobang, W., 2019. Why Are Women Declining This Surgery?. [online] BBC. Available at: <https://www.bbc.com/future/article/20190612-caesarean-sections-in-africa-stigma-and-maternal-mortality> [Accessed 5 May 2020].