Analysis Maternity and Birthing

What Do Artificial Wombs Mean for Women?

Soraya Chemaly

Would you chose external gestation if you could? What do artificial wombs mean for reproductive rights - including abortion, equality and the role of women in society? The moral, ethical, legal and societal consequences are profound and we are unprepared for them.

What happens when women, like men, can be parents without bearing children?  Does one form of gestation become a status symbol? Another a stigma? Who decides which gestation environment is healthier or more economical? You? Your gamete-partner? Your priest? Your employer? Your insurance company? If we think we have a complicated debate now, just wait. The current War on Women pales in comparison to the potential impact that ectogenesis, a technology in which a human fetus gestates completely out of a mother’s body, will have. It is, in its ultimate manifestation, qualitatively different from birth control or other assisted reproductive technologies. This change has the power to alter, in unprecedented ways, the interests, rights and responsibilities of women, men and the state.

J.B.S. Haldane, a British scientist, who predicted that by 2074 live human births would make up less than 30 percent of all births, first coined the term ectogenesis in 1924. His prediction was ambitious, but not unrealistic.  Despite the sci-fi horrors evoked by “artificial wombs,” this isn’t the stuff of dark dystopias. It is a partially realized, life-saving technology. Since the 1920s, researchers have seen the development of artificial wombs as a final goal of assisted reproductive technologies. Research focuses variously on helping premature babies to survive to finding substitutes for women’s bodies as baby machines. In the past 30 years, our reproductive technologies have achieved what would have previously been considered miraculous. Artificial wombs, a form of life support, are the logical conclusion of those efforts.

Current Research

There are two commonly cited endeavors in progess. Focusing on finding ways to save premature babies, Japanese professor Dr. Yoshinori Kuwabara of Juntendo University, has successfully gestated goat embryos in a machine that holds amniotic fluid in tanks.  On the other end of the process focusing on helping women unable to conceive and gestate babies, is Dr. Helen Hung-Ching Liu, Director of the Reproductive Endocrine Laboratory at the Center for Reproductive Medicine and Infertility at Cornell University.  Quietly, in 2003, she and her team succeeded in growing a mouse embryo, almost to full term, by adding engineered endometrium tissue to a bio-engineered, extra-uterine “scaffold.” More recently, she grew a human embryo, for ten days in an artificial womb. Her work is limited by legislation that imposes a 14-day limit on research project of this nature.  As complicated as it is, her goal is a functioning external womb.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Predictions for the full realization of what scholars Scott Gelfand and John Shook call “immaculate gestation”* range from 10 to 60 years.  However, it is already partially possible and entirely within the spectrum of acceptable practices.  Even if it takes scientists several decades, medical advancements are steadily narrowing the gap between in vitro conception and fetal viability outside of the womb.  When the gap closes then babies, navel-less, will no longer have to be “born” through women.

Is that an advantageous human adaptation?

Medical Benefits

The medical benefits seem clearest – the technology will help infertile couples, enable premature babies to survive, create an alternative to surrogacy when needed, and help women unable to carry their own babies. Ectogenesis can provide safe, healthy gestational environments – free from drugs and alcohol. It will give gay couples new fertility options.  Other benefits posited by advocates of the technology range from better-adjusted children, freed from mothers who are overly invested in them, to, although morally repugnant, the steady supply of “spare parts” that could be harvested from “bottled” embryos.

Societal Consequences

The moral, ethical, legal and societal consequences are profound and we are unprepared for them.  Definitions and distinctions, the meanings of words like “life,” “human,” “embryo,” “natural,” and even “mother,” that we’ve historically relied on to make ethical decisions, are dissolving faster than we are adapting. What happens when both men and women contribute equally – by providing only gametes – to reproduction? Do women have to carry human babies? What if they don’t want to? Who decides? What does it mean to sever human “birth” from the human body? This connection, between women and babies, is one of the sole sources of power that women have in some societies.

Abortion, Reproductive Rights and Equality

In immediate terms, the foundations on which a woman’s rights to choose are predicated in Roe v. Wade, namely the issue of fetal viability and the right to privacy (the right not to be pregnant), will be rendered virtually meaningless.  First, once a fetus can be safely and entirely gestated outside of a biological womb, it can be removed from its mother.  Second, ectogenesis means that viability starts with conception.  Both consequences radically alter the terms of the pro-choice debate as it is currently framed and understood.  The tension inherent in the current debate, between the rights of the woman and the state’s interest in the fetus, disappears when the woman and the fetus can be safely and immediately made independent of one another.  The reproductive choices of men and women become equal and women lose the primacy now conferred on them as a result of gestation. States could require women to have their fetuses extracted as an alternative to abortion, with serious long-term negative impacts.  Reproductive rights and social justice issues will take on an even more surreal dimension.

Feminists, not surprisingly, have extensively considered what ectogenesis could mean for women’s rights, the structure of the family, class, and society.  Right wing anti-choice activists, although perhaps initially delighted to have an alternative to abortion, will have to contend with a radical redefinition of “motherhood” and the hierarchical and gendered societal relationships for which it is an antecedent.  There is no guarantee that these changes will be good for women who currently already struggle to defend reproductive freedoms. Feminist critique ranges from one extreme to the other in terms of whether ectogenesis will liberate or further oppress women.

In her seminal work, The Dialectic of Sex, written in 1970, Shulamith Firestone argued that inequality between genders, and women’s virtual imprisonment in the home, was the direct result of biological reproductive differences and women’s correlating investments in mothering.  For her, ectogenesis, accompanied by revolutionary social changes, was the way to free women from the tyranny of their own biology put in the employ of patriarchal structures, including the traditional family.  She noted that, so far, these technical and social changes have been impeded by medicine’s domination by men, who have no vested interest in upsetting the traditional status quo. 

This same status quo has demonstrated the extent to which it is willing to view mothers as flesh and blood mother machines**.  Ann Oakley’s book The Captured Womb: A History of the Medical Care of Pregnant Women illustrates how ectogenesis would be part of a long-standing process by which virtually all male and often misogynistic medical cultures have taken control of birth and women’s wombs in the name of science.  In this framework, ectogenesis will potentially exaggerate preexisting inequities and biases.  In this equation women aren’t liberated, they are further subjugated and alienated from their own bodies and abilities.  This Handmaiden’s Tale scenario is fairly believable if you pay any attention to, for example, Rick Santorum’s antediluvian reproductive rights agenda and the number of people willing to vote for him.  

Prominent feminists and activists, including Andrea Dworkin and Janice Raymond, have concluded that not only will women be further marginalized and oppressed by this eventuality, but they will become obsolete.

Fertility, and the ability to be the species’ reproductive engine, are virtually the only resources that women collectively control, they argue. And, although women do have other “value” in a patriarchal society–child rearing, for example–gestation remains, worldwide, the most important.  Even in the most female-denigrating cultures women are prized, if only, for their childbearing. If you take that away, then what? This technology becomes another form of violence. 

Other feminist analyses takes into account the class and race implications of the enthusiastic adoption of assisted reproductive technologies by the wealthy. Some, eco-feminists, relate the eventuality to correlating a general campaign against nature. Ectogenesis also opens up the real possibility of men becoming mothers and primary care takers.***

Who controls ectogenesis and how it is utilized is the key to whether or not it is a tool of liberation or oppression for women. Men rule, literally, and until we have more gender balanced representative leadership in all sectors of society, that has predictable consequences. Women are outnumbered as researchers and scientists in the field of reproductive technology, as opinion-shaping media commentators and pundits, as clerical and religious leaders, and as governmental policy makers and regulators.  In this context, as with the current contraception/Catholic church debacle, is highly unlikely that woman-centered reproductive agendas, especially those that take into account the needs and health of poor women and women of color, will result.  

Bioethics and Regulation

Scientists are the first to admit the complexity of gestation.  They don’t understand the subtle interactions – everything from the nature of the mother-child bond to the necessary and ideal balance of temperature, sounds, fluids and hormones – between women’s bodies and the bodies and development of fetuses.  As with all new technologies, particularly biotechnological ones like in vitro and cloning, bioethicists are thinking about the social, legal and ethical implications. But, compared to other developed countries, the United States  has very little regulation regarding assisted reproductive technology.   And, although lots of people in Congress are eager to wax on about the moral status of embryos and the definition of personhood there are currently virtually no federal or state regulations regarding the impact of how we use gametes, embryos, artificial wombs and engineered birth to define those terms. A quick search of the Presidential Council on Bioethics’ website for “artificial womb,” “ectogenesis,” “gestation,” yielded only one result on the not-specific-to-reproduction moral science of limiting human subject research.  A 2004 Presidential Commission on Regulation of New Biotechnologies was concerned with commercialization of ova and sperm donations, insurance coverage, truth in advertising and patent issues.  The NIH is primarily in the business of monitoring stem cell research. The FDA with regulating substances used in IVF.

Any integrated, comprehensive pragmatic and/or philosophical approaches are political nightmares in this country. However, not any longer in others. Britain, for example, established a Human Fertilization and Embryology Authority (HFEA) in 1990. HFEA has authority, independent from the health and research facilities and the government, to regulate assisted reproductions services and products. 

Decisions about reproductive technologies are more often then not made by doctors and individuals in the absence of a social justice framework. Progressive people, interested in equality and social justice, need to prepare for how rapidly evolving technology will shift reproductive rights and responsibilities. The real dystopian future is one where we look back with nostalgia at the brief period during which Roe vs. Wade had its fragile relevance and impact as a high point in women’s reproductive freedom. It may sound alarmist, but really, we have time to consider the ethical, moral, societal ramifications of this technology and frame the arguments of the future before others do it for us. We have some time, but, not much.

 

Sources and Additional Reading

* Scott Gelfand and Shook, John R., eds., Ectogeneis: Artificial Womb Technology and The Future of Human Reproduction, Editions Rodopi, B.V., 2006

** Gena Corea, The Mother Machine: Reproductive Technologies From Artificial Insemination To Artificial Wombs, Harper Collins, 1985

***Maureen Sander-Staudt, Of Machine Born?, Ectogeneis: Artificial Womb Technology and The Future of Human Reproduction,Editions Rodopi, B.V., 2006

Richard T. Hull, Ethical Issues in the New Reproductive Technologies, Prometheus Books, 2007

Christopher Kaczor, The Ethics of Abortion: Women’s Rights, Human Life, and the Question of Justice, Routledge, 2011

Jessica Pierce and Georgle Randels, Contemporary Bioethics: A Reader with Cases, Oxford University Press, 2010

J.B.S. Haldane, Daedalus Revisited, Oxford University Press, 1995

Shulamith Firestone, The Dialectic of Sex, 1970

Ann Oakley, The Captured Womb: A History of the Medical Care of Pregnant Women, Blackwell Publishers, 1985 

News Politics

Democratic Party Platform: Repeal Bans on Federal Funding for Abortion Care

Ally Boguhn

When asked this month about the platform’s opposition to Hyde, Hillary Clinton’s running mate Sen. Tim Kaine (D-VA) said that he had not “been informed of that” change to the platform though he has “traditionally been a supporter of the Hyde Amendment.”

Democrats voted on their party platform Monday, codifying for the first time the party’s stated commitment to repealing restrictions on federal funding for abortion care.

The platform includes a call to repeal the Hyde Amendment, an appropriations ban on federal funding for abortion reimplemented on a yearly basis. The amendment disproportionately affects people of color and those with low incomes.

“We believe unequivocally, like the majority of Americans, that every woman should have access to quality reproductive health care services, including safe and legal abortion—regardless of where she lives, how much money she makes, or how she is insured,” states the Democratic Party platform. “We will continue to oppose—and seek to overturn—federal and state laws and policies that impede a woman’s access to abortion, including by repealing the Hyde Amendment.”

The platform also calls for an end to the Helms Amendment, which ensures that “no foreign assistance funds may be used to pay for the performance of abortion as a method of family planning.”

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Though Helms allows funding for abortion care in cases of rape, incest, and life endangerment, the Obama administration has failed to enforce those guarantees.

Despite the platform’s opposition to the restrictions on abortion care funding, it makes no mention of how the anti-choice measures would be rolled back.

Both presumptive Democratic nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) have promised to address Hyde and Helms if elected. Clinton has said she would “fix the Helms Amendment.”

Speaking at the Iowa Brown and Black Presidential Forum in January, Clinton said that the Hyde Amendment “is just hard to justify because … certainly the full range of reproductive health rights that women should have includes access to safe and legal abortion.” In 2008, Clinton’s campaign told Rewire that she “does not support the Hyde amendment.”

When asked this month about the platform’s opposition to Hyde, Clinton’s running mate Sen. Tim Kaine (D-VA) said in an interview with the Weekly Standard that he had not “been informed of that” change to the platform though he has “traditionally been a supporter of the Hyde amendment.”

“The Hyde amendment and Helms amendment have prevented countless low-income women from being able to make their own decisions about health, family, and future,” NARAL President Ilyse Hogue said in a statement, addressing an early draft of the platform. “These amendments have ensured that a woman’s right to a safe and legal abortion is a right that’s easier to access if you have the resources to afford it. That’s wrong and stands directly in contrast with the Democratic Party’s principles, and we applaud the Party for reaffirming this in the platform.”

Analysis Human Rights

El Salvador Bill Would Put Those Found Guilty of Abortion Behind Bars for 30 to 50 Years

Kathy Bougher

Under El Salvador’s current law, when women are accused of abortion, prosecutors can—but do not always—increase the charges to aggravated homicide, thereby increasing their prison sentence. This new bill, advocates say, would heighten the likelihood that those charged with abortion will spend decades behind bars.

Abortion has been illegal under all circumstances in El Salvador since 1997, with a penalty of two to eight years in prison. Now, the right-wing ARENA Party has introduced a bill that would increase that penalty to a prison sentence of 30 to 50 years—the same as aggravated homicide.

The bill also lengthens the prison time for physicians who perform abortions to 30 to 50 years and establishes jail terms—of one to three years and six months to two years, respectively—for persons who sell or publicize abortion-causing substances.

The bill’s major sponsor, Rep. Ricardo Andrés Velásquez Parker, explained in a television interview on July 11 that this was simply an administrative matter and “shouldn’t need any further discussion.”

Since the Salvadoran Constitution recognizes “the human being from the moment of conception,” he said, it “is necessary to align the Criminal Code with this principle, and substitute the current penalty for abortion, which is two to eight years in prison, with that of aggravated homicide.”

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

The bill has yet to be discussed in the Salvadoran legislature; if it were to pass, it would still have to go to the president for his signature. It could also be referred to committee, and potentially left to die.

Under El Salvador’s current law, when women are accused of abortion, prosecutors can—but do not always—increase the charges to aggravated homicide, thereby increasing their prison sentence. This new bill, advocates say, would worsen the criminalization of women, continue to take away options, and heighten the likelihood that those charged with abortion will spend decades behind bars.

In recent years, local feminist groups have drawn attention to “Las 17 and More,” a group of Salvadoran women who have been incarcerated with prison terms of up to 40 years after obstetrical emergencies. In 2014, the Agrupación Ciudadana por la Despenalización del Aborto (Citizen Group for the Decriminalization of Abortion) submitted requests for pardons for 17 of the women. Each case wound its way through the legislature and other branches of government; in the end, only one woman received a pardon. Earlier this year, however, a May 2016 court decision overturned the conviction of another one of the women, Maria Teresa Rivera, vacating her 40-year sentence.

Velásquez Parker noted in his July 11 interview that he had not reviewed any of those cases. To do so was not “within his purview” and those cases have been “subjective and philosophical,” he claimed. “I am dealing with Salvadoran constitutional law.”

During a protest outside of the legislature last Thursday, Morena Herrera, president of the Agrupación, addressed Velásquez Parker directly, saying that his bill demonstrated an ignorance of the realities faced by women and girls in El Salvador and demanding its revocation.

“How is it possible that you do not know that last week the United Nations presented a report that shows that in our country a girl or an adolescent gives birth every 20 minutes? You should be obligated to know this. You get paid to know about this,” Herrera told him. Herrera was referring to the United Nations Population Fund and the Salvadoran Ministry of Health’s report, “Map of Pregnancies Among Girls and Adolescents in El Salvador 2015,” which also revealed that 30 percent of all births in the country were by girls ages 10 to 19.

“You say that you know nothing about women unjustly incarcerated, yet we presented to this legislature a group of requests for pardons. With what you earn, you as legislators were obligated to read and know about those,” Herrera continued, speaking about Las 17. “We are not going to discuss this proposal that you have. It is undiscussable. We demand that the ARENA party withdraw this proposed legislation.”

As part of its campaign of resistance to the proposed law, the Agrupación produced and distributed numerous videos with messages such as “They Don’t Represent Me,” which shows the names and faces of the 21 legislators who signed on to the ARENA proposal. Another video, subtitled in English, asks, “30 to 50 Years in Prison?

International groups have also joined in resisting the bill. In a pronouncement shared with legislators, the Agrupación, and the public, the Latin American and Caribbean Committee for the Defense of the Rights of Women (CLADEM) reminded the Salvadoran government of it international commitments and obligations:

[The] United Nations has recognized on repeated occasions that the total criminalization of abortion is a form of torture, that abortion is a human right when carried out with certain assumptions, and it also recommends completely decriminalizing abortion in our region.

The United Nations Committee on Economic, Social, and Cultural Rights reiterated to the Salvadoran government its concern about the persistence of the total prohibition on abortion … [and] expressly requested that it revise its legislation.

The Committee established in March 2016 that the criminalization of abortion and any obstacles to access to abortion are discriminatory and constitute violations of women’s right to health. Given that El Salvador has ratified [the International Covenant on Economic, Social and Cultural Rights], the country has an obligation to comply with its provisions.

Amnesty International, meanwhile, described the proposal as “scandalous.” Erika Guevara-Rosas, Amnesty International’s Americas director, emphasized in a statement on the organization’s website, “Parliamentarians in El Salvador are playing a very dangerous game with the lives of millions of women. Banning life-saving abortions in all circumstances is atrocious but seeking to raise jail terms for women who seek an abortion or those who provide support is simply despicable.”

“Instead of continuing to criminalize women, authorities in El Salvador must repeal the outdated anti-abortion law once and for all,” Guevara-Rosas continued.

In the United States, Rep. Norma J. Torres (D-CA) and Rep. Debbie Wasserman Schultz (D-FL) issued a press release on July 19 condemning the proposal in El Salvador. Rep. Torres wrote, “It is terrifying to consider that, if this law passed, a Salvadoran woman who has a miscarriage could go to prison for decades or a woman who is raped and decides to undergo an abortion could be jailed for longer than the man who raped her.”

ARENA’s bill follows a campaign from May orchestrated by the right-wing Fundación Sí a la Vida (Right to Life Foundation) of El Salvador, “El Derecho a la Vida No Se Debate,” or “The Right to Life Is Not Up for Debate,” featuring misleading photos of fetuses and promoting adoption as an alternative to abortion.

The Agrupacion countered with a series of ads and vignettes that have also been applied to the fight against the bill, “The Health and Life of Women Are Well Worth a Debate.”

bien vale un debate-la salud de las mujeres

Mariana Moisa, media coordinator for the Agrupación, told Rewire that the widespread reaction to Velásquez Parker’s proposal indicates some shift in public perception around reproductive rights in the country.

“The public image around abortion is changing. These kinds of ideas and proposals don’t go through the system as easily as they once did. It used to be that a person in power made a couple of phone calls and poof—it was taken care of. Now, people see that Velásquez Parker’s insistence that his proposal doesn’t need any debate is undemocratic. People know that women are in prison because of these laws, and the public is asking more questions,” Moisa said.

At this point, it’s not certain whether ARENA, in coalition with other parties, has the votes to pass the bill, but it is clearly within the realm of possibility. As Sara Garcia, coordinator of the Agrupación, told Rewire, “We know this misogynist proposal has generated serious anger and indignation, and we are working with other groups to pressure the legislature. More and more groups are participating with declarations, images, and videos and a clear call to withdraw the proposal. Stopping this proposed law is what is most important at this point. Then we also have to expose what happens in El Salvador with the criminalization of women.”

Even though there has been extensive exposure of what activists see as the grave problems with such a law, Garcia said, “The risk is still very real that it could pass.”