In 1924, scientist J.B.S Haldane predicted that by 2074, 70 per cent of human fetuses would come to term, from fertilization to birth, completely outside a woman’s womb. This process, coined ectogenesis, might gain popularity in our age of vast and rapid technological advances and innovations.

But how long before all our descendants are born without traditional mothers and fathers? What will this mean for parents and families? And what will the greater societal implications of this biotechnology be?

QuantumRun looks at the history of ectogenesis, the likelihood of such a process becoming commonplace, and the potential repercussions of ectogenesis.

History of Ectogenetic Developments

There are two areas of biotechnology currently developing that could enable human ectogenesis or partial ectogenesis.

Rapid advancements in neonatal intensive care has made it possible for fetuses, human or animal, to survive outside of the womb earlier and earlier. The necessary time inside the womb has been reduced. In 2006, one of the world’s youngest premature infants was delivered and survived at just twenty-one weeks and six days, two weeks before the legal limit for terminations in the United Kingdom. This is, in and of itself, partial ectogenesis.

A neonatal intensive care unit, nowadays, is capable of supporting a premature infant as it develops outside the womb, as a normal fetus would within the uterus.

Artificial wombs have existed for decades, as evident in successful research projects with animal, and human fetuses, sustained and developed outside of the maternal body.

A series of experiments using ex vivo (out of the body) uterine environments, are able to support fetuses in early pregnancy for a period of time, presenting new techniques for creating and supporting life. These artificial wombs have been shown to supply nutrients and oxygen to fetuses, while also including an artificial placenta for fetal circulation of fluids and removal of wastes.

According to an article published in the Annals of the New York Academy of Sciences entitled “The Artificial Womb,” the first attempts at ex vivo human uteri and embryos were conducted in 1982 in Bologna, Italy and in 1983 at Mount Sinai Hospital in New York City. Such experiments raised ethical concerns and the experimental programs ceased due to strong opposition.

Mammalian fetuses have been the primary focus of these uterus model experiments. In the mid-1990s, goat fetuses were maintained for weeks in incubators containing artificial amniotic fluid. A BioEngineer article reports Tokyo researchers threaded catheters through vessels in the umbilical cords of goat fetuses, providing them with oxygenated blood.

There were complications with this artificial environment, including circulatory failure and other technical difficulties; none of the goat fetuses survived past three weeks. Complete artificial gestation is evidently still a work in progress.

Image found here.

Complete ectogenesis will require further solutions, including finding a way to replicate the complex and varying flow of blood, oxygen, nutrients and hormones that a mother’s womb provides for the fetus.

Researchers have attempted to reproduce the endometrium, a cell layer of the uterus that covers and nourishes the fetus during pregnancy, as a way to counter these difficulties. If successful, this would make it possible to transfer embryo into a system, containing a placenta and umbilical cord, giving the ability to supply nutrients and remove waste.

An artificial womb is yet to produce a single surviving offspring, either animal or human; but eventually, if technological advancements persist, human and mammalian embryos will no longer need a uterus in the early stages for survival.

Bioethics and Politics of the Womb

Ectogenetic technology will change the way we understand “birth”. In an age of motherless birth, a significant number of women could take advantage of an artificial womb. An Annals of the New York Academy of Sciencesarticle lists two major benefits of ex vivo uteri: an artificial uterus could enable women with damaged or diseased uteri to have offspring, and it could function as an incubator for infants who are delivered prematurely.

Ectogenesis could also reduce fetal mortality due to prematurity, and potentially prevent fetal malformations. Often, when children are born with malformations, damage is done to organ systems before birth. N. Scott Adzick, a surgeon-in-chief at the Children’s Hospital of Philadelphia, describes the need for a womb-like environment to perform fetal surgeries: “If you’d only gotten there earlier on, you could have prevented the damage. I felt it might make sense to treat certain life-threatening malformations before birth”.

BioEngineer chronicles the pregnancy of Felicia Rodriguez from West Palm Beach, Florida in the late 1990s, whose fetus, at twenty-two weeks, was diagnosed with a congenital malformation. Surgeons at the Children’s Hospital of Philadelphia performed a fetal surgery, first making a Caesarean-type incision before removing the mass. The pregnancy continued thereafter, and Rodriquez gave birth to a healthy baby boy.

Additionally, ectogenetic technology means it will be easier for infertile, gay and transgendered couples to have children; all one needs now is an embryo and the artificial womb, replacing the surrogate system and saving time and resources.

Ectogenesis could theoretically end abortion. As the Genetic Literacy Project points out, “If a developing embryo or fetus is not viable and the mother wants it out of her uterus, that’s her right. But what happens once we have the technology to remove it from her without killing it and let the pregnancy continue in an artificial womb?” The argument that ectogenesis will end abortion dates back to when the idea was invented.

Despite these potential benefits of artificial wombs, ethical and legal concerns have been brought up since the term “ectogenesis” was developed in the early twentieth century.

It is true that artificial wombs could provide opportunities for parents to conceive children, but ectogenesis lacks the advantages of a traditional birth. The sensation of a growing fetus inside a woman’s body is a kind of connection that cannot exist within an artificial womb. The natural processes of pregnancy and birth are considered essential for the bonding and attachment between mother and child, as stressed in several studies on maternal-fetal attachment.

In an exploratory study of women’s views towards artificial wombs, man-made uteri were reported to raise “feelings of shock, detachment, and possible harm to the mother-child relationship”.

The same study also showed that wombs were associated with femininity, comfort, support, affection, intimacy, and the beginning of motherhood, both physically and symbolically. Moreover, the womb helps prepare a woman for motherhood, as “even the timing of birth is determined by the fetus in a natural birth, and prepares her for her new role as a mother”.

The author of the study, Ruth Landau of the Paul Baerwald School of Social Work, describes what artificial wombs and pregnancies deprive women of: “Pregnancy with an artificial womb, without the expected culmination of birth, will essentially be a totally medicalized and mechanized process under the full control of physicians and engineers and without the active participation of the genetic mother. … [I]f an artificial womb were used, this would allow the future mother to live her life without an interference or demands from the developing fetus, thus allowing her to continue to perceive her own needs as central and not switch to focus on the child”.

But perhaps the most important question or questions to consider, from a familial stand point, is if a fetus develops in an artificial womb, whose child is it anyway? To whom does it belong? And what if during the pregnancy in the artificial womb, one parent decides to “pull the plug”? Who will have parental rights? Will the state have any rights, if the embryo develops outside a woman’s womb? Will fetuses in artificial wombs have the same status and rights as fetuses in women’s wombs? Will contracts concerning embryos in artificial wombs be enforceable?

Returning to abortion, theorists suggest that having ectogenesis as an alternative to surgical or chemical termination does not solve the abortion debate, but rather continues it; ectogenesis can be seen to still impede and pose a threat to a woman’s right to undergo an abortion. According to Sarah Langford, from the Department of Political Science at the University of Melbourne, being denied abortion and ectogenesis coupled with fetal adoption both end with the same result: an individual who is the genetic offspring of that woman being brought into the world.

Research has shown that women with unwanted pregnancies would still not opt for ectogenesis. Leslie Cannold interviewed women for her research published in the Journal of Applied Philosophy. She asked women what they would do if they were pregnant and did not want to raise the child, but had access to ectogenetic technology. Cannold reported that “women on both sides of the abortion debate rejected ectogenesis as a solution based on similar concepts of maternal responsibility. … [E]ctogenesis presented greater moral concern to this group than abortion, because women who chose ectogenesis over abortion not only abandoned their responsibility of raising the child but also of gestating the fetus”.

Another consideration is the physiological and psychological effects of children born through ectogenesis. As Jessica H. Schultz points out in the Chicago-Kent Law Review, the effects of ectogenesis on a fetus developing into a child “cannot be assessed in experiments on animals. … If it is unethical to attempt ectogenesis in humans until we have a reasonable assurance that it is safe, and we can have no reasonable assurance that it is safe until it is carried out, we seem to be in a classic ‘Catch 22’ situation. Work on ectogenesis will remain forever unjustifiable.”