The End of Pregnancy
It’s 1985. Summer’s around the corner, but since it’s SoCal, it never really left. In the outdoor courtyard where I, my schoolmates and the seagulls have been eating lunch every day of the school year, I hear a new taunt that carries over the stale cheese pizzas, past the smushed PBJs and into my receptive ears. I’ve been a collector of novel disses most of my short life and this one is as fresh as the guano on the blacktop. I only catch the latter half of the altercation.
“Oh yeah,” says Brad, the surfer with the sundrenched bangs. He’s staring down a guileless boy who was a few inches shorter than him. “Well, you’re a test tube baby!”
Test tube baby, I think. Man, that’s serious. I wasn’t quite sure what it meant, but I did recall hearing a news report about how couples were now relying on cutting edge medicine to become pregnant. Back in the early days of in vitro fertilization, it was de riguer to belittle the procedure and treat it as an abomination. Over the years, though, the put-downs lost cachet when IVF no longer became a novelty.
Since Louise Joy Brown first entered the world on the 25th of July, 1978, more than 8 million babies have been born using IVF. As endocrine disrupters proliferate, as more women continue to postpone motherhood, and as success rates improve, the field will only grow. Such is the pull of parenthood that couples will empty their savings and subjugate themselves to hormones and invasive procedures in order to procure a child of their own.
A mere seven years after Louise was born, about the same time Brad was king of the monkey bars, the first surrogate baby was born using assisted reproductive technologies. Women often choose this option due to uterine abnormalities that do not permit successful pregnancies, essentially, an anatomic or physiologic reason for needing another women’s womb to bear the burden of gestation. But increasingly, a new movement has taken hold.
Social surrogacy is the outsourcing of gestation by women whose wombs may be perfectly fit to house a fetus. Perhaps the woman works in a cutthroat field where time off can be perceived as detrimental to her career. Or maybe she’s in front of the camera and does not want her viewers’ eyes trained on her bodily changes over 40 weeks. The reasons for social surrogacy are suddenly abundant, but I was surprised to find virtually no research on the experience of women who choose to have their babies using a surrogate mother. Why would that be interesting to uncover? Because these women may offer the best clue to what mothers of the future will experience when pregnancy as we know it will end.
In 2017, researchers in Philadelphia used artificial womb technology, or ectogenesis, to continue the growth of a small group of lamb fetuses that were about 60% into a full term pregnancy. The pre-term lambs were placed into artificial wombs and allowed to continue extra-uterine gestation for another 4 weeks before being “born” by the researchers. The study was successful and has provided insights on how extremely premature human infants can continue gestation outside of the mother’s uterus.
Dutch researchers have recently made progress on creating the first artificial womb and placenta for humans, boldly claiming that they are within 10 years of using their device to save millions of lives of premature babies. But once ectogenesis becomes reliable at saving premies, would women electively transfer their pregnancies mid-cycle to the artificial womb? If such a move was attainable, it might save countless women from the morbidity and mortality associated with full term child birth. It seems obvious that birth itself will be pushed further and further into the later years of life.
What if one day the entirety of gestation, from zygote to embryo through fetus to baby, occurs completely in an artificial environs? What will that mean for motherhood?
Ethicists and philosophers are beginning to debate whether outsourcing gestation will liberate women in a manner that brings greater parity between the sexes, but the answer to the question may already exist, though it strangely remains inadequately investigated. Women who adopt babies and those who have surrogate babies provide the clearest clues as to whether ectogenesis will shape motherhood in unforeseen ways, and whether it truly can be a tool for gender equality much in the way oral contraceptive pills were in the 1960s. I speculate that even if ectogenesis challenges gender norms, it may not significantly alter who does the burden of caring for the ex-utero life, the full eighteen years that follow in which women have always helmed the lion’s share of responsibilities. Healthier outcomes for mothers, not social progress for women, will perhaps be the greatest benefit of the artificial womb.