The Biobag: A Brave New World, Part 2

Though reminiscent of science fiction, recent advances in ectogenesis (the ability to sustain a human fetus in an artificial, external womb known as a “biobag”) have raised biological, psychological, and ethical questions that could upend the traditional lines of argumentation and transform the entire abortion debate.  Conscience invited neuroscience researcher Stuart Derbyshire and religion and gender studies professor Sheila Briggs to reflect on the potential ramifications of ectogenesis. This is Part 2 of our exploration. Click here to read Part 1.

n the 1970s, a debate about ectogenesis raged among early second-wave feminists. One side saw ectogenesis as liberating women from their allotted role in a patriarchal society as the bearers of children and the limitations imposed on them to ensure they fulfilled their biological destiny as mothers. Other feminists, however, believed that ectogenesis would make women’s reproductive functions obsolete and, therefore, women in a patriarchal society redundant and dispensable. Fifty years later, we are at a point at which scientific research holds out the real possibility of at least partial ectogenesis within the next decade.

Ectogenesis does not in and of itself threaten womens autonomy, but to see it as an “end to the abortion debate” undermines not only a womans right to abortion but also her reproductive rights in general. 

At the outset, I should be clear that medical advances are not promising a fully ex utero alternative to pregnancy. At no time soon will a couple be able to have an IVF treatment after which the embryo is placed, not in the woman’s womb, but in a Biobag, from which they collect their newborn (?) baby nine months later. Indeed, the scientific publications make clear that the goal of this research is to reduce the mortality and morbidity of extremely premature newborns. An artificial womb would allow a fetus at a 20-week gestation point to not only survive but also to develop without the severe health (especially neurological) deficits that afflict extremely premature newborns. As such, it will save many women the heartbreak of the loss of a much-wanted pregnancy and allow them to have healthy children, However, some have argued that beyond the projected medical use, Biobags could spell the “end of abortion.” Such claims ignore women’s reproductive rights and, I will also argue, the rights of children born.

A woman’s right to abortion is grounded in her autonomy as a human person. This autonomy is bodily, but it is also more than physical: It is the autonomy of an embodied person. As embodied persons, humans possess moral autonomy, i.e., the right to make moral decisions about the conditions that constitute them fundamentally as human persons. The great advances in reproductive technology since the late 19th century make it possible for women to choose when and if they become mothers. Reproductive rights have been essential to the emancipation of women in modern society. They are closely connected to the recognition of women as full citizens with equal rights to participation in society, including education and work. Ectogenesis does not in and of itself threaten women’s autonomy, but to see it as an “end to the abortion debate” undermines not only a woman’s right to abortion but also her reproductive rights in general.

The idea that ectogenesis could abolish the need for abortion relies on a very narrow view that abortion can only be justified when a fetus is not physically viable outside the mother’s womb. Therefore, remove the fetus from a woman’s womb, and she no longer has an unwanted pregnancy! That such a procedure could be a solution to abortion depends heavily on the assumption that what is ethically at stake here is a “conflict of rights” between the right to life of a fetus and a woman’s right to bodily integrity. Here also at work (as in all anti-choice arguments) is the morally dangerous conflation of a fetus with a born child. In contrast, I acknowledge that a woman may choose to abort a fetus for the sake of the child who would otherwise be born. Consider the case of parents who decide to terminate a much-wanted pregnancy in the third term because they have learned that their child would be born severely disabled. They are losing a child they had hoped for and made a place for in their lives. They may grieve their lost child but do not regret the decision to abort the fetus. Not all life is worth living, and the physical viability of a fetus does not guarantee that the child it would become would have a minimally meaningful human life.

The practical effects of coerced ectogenesis as an alternative to abortion would have devastating effects on women and their families. 

Consider also the consequences of ectogenesis becoming an alternative to abortion. To look at the easiest case, in which a woman decides not to have an abortion, to continue the pregnancy and give the child up for adoption, then ectogenesis relieves her of the burden of an unwanted pregnancy. The moral objections to ectogenesis arise when it is no longer consensual. A woman denied an abortion and forced to place her child in an artificial womb may not have to continue an unwanted pregnancy, but she will be faced with decisions about her unwanted child. The practical effects of coerced ectogenesis as an alternative to abortion would have devastating effects on women and their families.

Adoption cannot guarantee that a birth mother can sever all contact with her child. Once-sealed adoption records can now be opened in most jurisdictions, usually without the consent of the birth mother. Many reunions between adoptees and birth mothers are joyful, but some are not. A woman may want an abortion precisely to prevent having a biological child with whom she does not wish to have contact. The “conflict of rights” is not between a fetus and the woman who wants to terminate an unwanted pregnancy, but rather between the adoptees who desperately want contact with their birth mothers and those birth mothers who may equally desperately not want contact with their biological children. In this age of DNA testing, technology has made the privacy and anonymity of birth mothers obsolete.

Linked to this question of adoption is the question: What happens if ectogenesis replaces unwanted pregnancies with unwanted children, born in Biobags? At the lowest estimate, there are annually more than 600,000 abortions in the United States. Adoption agencies would be overwhelmed if even a minority of these children were put up for adoption. Child welfare services (already lacking resources) and foster-care provision (already insufficient) would be overwhelmed. Who would assume responsibility for the children born in Biobags? Children have a right to care; this is essential for their physical and mental health and their development into mature and autonomous individuals. Would governments try to force the women, who wished to terminate their pregnancies to raise the babies of their involuntary ectogenesis? Would they demand that parents pay “child support” to the state for the children they do not want to or cannot raise themselves? Such measures would be ruinous to women and their families when one considers that three-quarters of abortions are performed on poor and low-income women. Children have a right to care, and this is most reliably provided by mothers and families who want them.

It is not only in the case of abortion that ectogenesis must not be allowed to undermine women’s autonomy and reproductive freedom. What happens if the process of transferring a fetus to and its gestation inside an artificial womb becomes very safe and inexpensive? If the risks to a mother and child are lower through delivery in a Biobag than through childbirth, then one can imagine that some might see ectogenesis as “the solution” to pregnancy and childbirth. In 2018, the respected medical journal The Lancet reported on the global epidemic of unnecessary C-sections. In the United States, caesarean births have risen by 60 percent within a generation. This increase has brought benefits of convenience and cost-efficiency to physicians and hospitals, but none to women. One can envisage a similar scenario playing out, in which the same motivations induce medical providers to pressure women into ectogenesis. In affluent countries (where ectogenesis would be first available), childbirth is already extremely safe, with very low rates of mother and infant mortality. Of course, there are situations—as I mentioned at the beginning—in which ectogenesis would allow a pregnancy that is no longer viable to be carried to term outside the mother’s womb. I also see its value as an option for women who want a child but are fearful of pregnancy and childbirth. However, most women would still probably desire what today is a normal pregnancy and birth. Despite the physical discomfort and pain of late pregnancy and birth, most women see these experiences as essential to how they come to feel like mothers. They bond with the fetus as the child to whom they will give birth, and this may have physiological benefits for the developing fetus. In short, ectogenesis should not be used to take away from women the experiences of motherhood that they find vital to their well-being and that of their child.

Women’s autonomy and reproductive freedom do not compete with the right of children to care; instead, the former is necessary for the latter. Ectogenesis and all reproductive technologies should be used to support women’s reproductive choices and not to diminish them.

Sheila Briggs is an associate professor of religion and gender at the University of Southern California.

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