Advancing artificial womb technology

Next Nature Network and Maxima Medical Centre’s speculative artificial womb design, presented at the Chronic Health Exhibition during Dutch Design Week. Image Credit: Bram Saeys.

Over the last decade, reproductive assistance has taken a major leap forward, and one emerging new technology in this field is the artificial womb. When we think about the word ‘artificial’, it is not uncommon to associate words such as ‘fake’ and ‘unnatural’. Some have even compared this technology to the battery farms in The Matrix, or the hatcheries in Brave New World. These descriptions bring a lot of misunderstanding about what an artificial womb is and how the technology may be beneficial in the future.

It’s a very thin line between a dream come true and a horrific science fiction film” – Sanne, talking to the BBC.

In 2017, researchers at the Children’s Hospital in Philadelphia successfully transferred foetal lambs, aged between 105 and 115 days of gestation, into a ‘Biobag’ (artificial womb). This Biobag was filled with amniotic fluid, and after several weeks inside, the lambs had developed normally. Further developments came in 2019 when an Australian and Japanese research team kept lambs alive in a different system from an even younger age. Most recently, a group of researchers based at the University of Technology in Eindhoven announced they had received Horizon 2020 funding to build their artificial womb prototype. Their hope is that the artificial womb will be ready for use in clinics within 5 years, which would be a world first.

Artificial womb technology is in demand to improve neonatal intensive care. Currently, around 1 in 13 pregnancies in the UK are delivered prematurely. The latest figures show that babies born before 22 weeks have almost no chance of survival, while at 22 weeks the chance is only 10%. But, two weeks later the survival rate rises to about 60%.  This means that babies who are born prematurely can be put into an artificial womb until they grow to an age where they have a higher probability of survival.

The most common problem for premature babies is breathing, as the lungs do not fully develop until late in pregnancy. The model being developed at the Eindhoven University of Technology would provide babies with artificial respiration. Unlike current incubators which use air ventilation and are more intrusive for these pre-term babies, the artificial womb would closely mimic biological conditions. Instead of air, the baby would be surrounded by fluids and receive oxygen and nutrients through an artificial placenta, connected to their umbilical cord. By providing more natural gestation conditions, the pre-term baby can grow as if the pregnancy had not ended.

In the future, it is appealing to imagine a world where artificial wombs can support premature babies, reducing the risks of pregnancy and premature birth. “This technology would also allow people who can’t safely carry a pregnancy to do so”, states Dr Elizabeth Yuko, a bioethicist at Fordham University in New York. These benefits are speculative as the technology continues to be developed, but with research advancing quickly, we need to consider the legal and ethical implications of this technology now so that the legislation is in place for the future and clinical use can start sooner.

In England and Wales a foetus and a new-born are treated differently in law, so the recognition and legal protections for a foetus gestating in an artificial womb need to be outlined. Another important thing to consider is how reproductive rights may change. Elizabeth Chloe Romanus, a lawyer and bioethicist from the University of Manchester, raises the question of whether having the baby could be deemed out of the woman’s hands if a foetus can gestate outside a woman’s body. 

She also raises the issue that our legal rights are predicated on having been born alive; gestation in an artificial womb may not meet that requirement. Most of the arguments against artificial wombs centre more on religious or traditional ideas about pregnancy and motherhood. These anxieties are preventing us from evaluating artificial wombs as they are being conceived. 

The question remains, is the artificial womb unnatural or is it too close to natural that it complicates life as we know it? As it stands this technology is far from complete and scientists admit that they know little about its short and long term implications. One thing is clear: the practical and ethical questions raised by this technology should be addressed before it can be used widely by the public.

Written by Kate Summerson and edited by Ailie McWhinnie.

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