Ectogenesis - gestation using an artificial womb - is fast approaching reality. Even without legislation, this innovation has the potential to cause harm.
ONE DAY human wombs may no longer be needed to bear children. In 2016, a research team in Cambridge, England, grew human embryos in ectogenesis—the process of human or animal pregnancy in an artificial environment—for up to 13 days after fertilization. Another breakthrough came the next year, when researchers at the Children's Hospital of Philadelphia announced that they had developed a basic artificial womb called the Biobag. The Biobag maintained fetal lambs, equivalent in size and development to a human fetus at approximately 22 weeks of gestation, until full term. Then, in August 2022, researchers at the Weizmann Institute of Science in Israel created the world's first synthetic embryos from mouse stem cells. In the same month, scientists at the University of Cambridge used stem cells to create a synthetic embryo with a brain and a beating heart.
Ectogenesis has the potential to transform reproductive work and reduce the risks associated with reproduction. It could allow people with wombs to reproduce as easily as cisgender men: without risk to their physical health, their economic security, or their bodily autonomy. By removing natural pregnancy from the childbearing process, ectogenesis could offer an equal starting point for people of all genders and sexes, especially queer people who wish to have children without having to rely on the morally ambiguous option of surrogacy.
If made available for safe and efficient ectogenesis—as opposed to privatization, which risks further entrenching social and economic inequalities—the technology could result in a more prosperous and equal society. However, the development of ectogenesis could also wreak havoc on the hard-fought right of women and people with a uterus to access safe and legal abortion, and could significantly weaken abortion policy around the world.
CONTEMPORARY PHILOSOPHICAL LITERATURE and legislation on abortion revolve around three debates: the moral status of the fetus, the bodily autonomy of women, and the viability of the fetus. Ectogenesis means that fetuses at all stages will be viable, so the development of technology will affect all three of these debates.
Anti-abortion advocates tend to argue that a fetus is human at conception and that killing an innocent person through abortion is immoral. Pro-choice advocates of abortion rights, meanwhile, emphasize bodily autonomy, drawing on arguments such as those made by philosopher Judith Thomson in her highly influential 1971 essay A Defense of Abortion. Thomson argues that even though a fetus is a person at the moment of conception, a woman's bodily autonomy—her right to decide what can happen in and to her body—means that it is morally acceptable to remove the fetus from her body. The subsequent death of the fetus is an inevitable consequence of the termination of the pregnancy rather than the woman's intention. This means that abortion is an act of self-defense on the part of the woman rather than intentional killing.
Meanwhile, in an attempt to strike a balance between women's bodily autonomy and the moral status of the fetus, abortion legislation in many countries uses fetal "viability"—the ability of the fetus to survive outside the womb, including with the aid of medical devices—as a yardstick to determine the moral acceptability of abortion. Under the law in many places where abortion is permitted, the fetus's right to life overrides the woman's bodily autonomy the moment the fetus becomes viable. Abortion law in the UK, for example, only allows abortion before 24 weeks of fetal development, which is the earliest developmental stage from which a fetus can survive with the help of medical devices.
Successful ectogenesis would ensure fetal viability at a very early stage, perhaps even from conception. If ectogenesis—even partial ectogenesis—is available, it would be possible to transfer an unwanted fetus into an artificial womb to continue developing without impairing the woman's bodily autonomy, depending on how the fetus is removed. Women would thus be able to terminate their pregnancies without resorting to traditional abortion. Given this option, if a woman chooses a traditional abortion regardless, the abortion will look more like intentional homicide.
Consequently, if abortion jurisprudence continues to use fetal viability as its central criterion for whether abortion should be permitted, abortion in the era of ectogenesis risks being less morally and socially acceptable than it is today.
There is a real risk that future legislation, especially in conservative communities, states, and countries, will outlaw abortion entirely once ectogenesis becomes available. Although ectogenesis would allow pregnancy to be avoided without terminating the life of the fetus, such an outcome is not necessarily positive from a feminist perspective. The reality is that some women who choose to have an abortion do so not only to end the pregnancy—to preserve their bodily autonomy—but also to avoid becoming a biological mother. Ectogenesis would still make her a biological mother against her will, and its use as an alternative to traditional abortion could therefore violate her reproductive autonomy.
Another possible scenario is one where a woman wants to have an abortion, but her partner wishes her not to. In the absence of the bodily autonomy argument, the viability of the fetus and the presumed right to development, combined with the wishes of the partner, could lead to a situation that forces women to transfer the fetus to an artificial womb.
As ectogenesis continues to develop, activists and lawmakers will need to address the question: At what point is it justifiable for a woman to choose a traditional abortion when there is another option that guarantees both the termination of the pregnancy and the continued chance of the fetus to live? At what point should women's desires not to become biological mothers override the alleged right of the fetus to exist?
In examining this question, it is useful to consider why some women might resist becoming biological mothers, even though they would not have to bear the burden of raising a child who could be adopted after being transferred and fully developed in an artificial womb. Social attitudes and pressures related to biological parenthood would likely cause some hesitation. Even if the legal system has absolved the biological mother of legal obligations to her biological child, she may still feel a sense of obligation to the child or guilt toward herself for not embodying the self-sacrificing qualities that are often idealized and associated with motherhood. Living with these emotions could cause psychological harm to the biological mother, and she could also be at risk of experiencing the associated social stigma.
Admittedly, the question still remains whether the desire to avoid possible social stigma or psychological suffering is sufficient to override the fetus' alleged right to life. We believe that this question is highly debatable depending on both the extent of social stigma and the developmental stage of the fetus. Still, if social pressures and stigma are enough to make a woman who uses ectogenesis suffer, such a woman's desire not to become a mother deserves to be respected, especially in the early stages of fetal development.
Legislation on ectogenesis will also need to take bodily autonomy into account by ensuring that women have the right to decide what operations are performed on their bodies. Although it is not clear what form the procedure of transferring the fetus into the artificial womb will take, it will almost certainly be invasive, probably similar to a C-section, at least in later-stage pregnancies. Women should have the right to refuse ectogenetic surgery based on bodily autonomy; otherwise, as the Canadian philosopher Christine Overall pointed out, the process of forced transfer would be similar to the deliberate theft of human organs, which is deeply unethical.
Ectogenesis complicates the ethics of abortion, and forcing women to undergo ectogenetic surgery interferes with both their reproductive autonomy and their bodily freedom. Allowing early abortion in a world where ectogenesis exists could be a good compromise that reduces complications and ensures women's rights. However, to ensure women's reproductive rights, abortion must remain an available option, even after ectogenesis becomes a reality.
Future legislation will need to ensure that ectogenesis is a choice rather than a new form of coercion. The right to abortion will need to be centered in law around the value of reproductive autonomy and the right not to become a biological parent against one's will, as opposed to fetal viability. As this legal debate gains the attention of politicians, legislators, community leaders and the general public, it will become more apparent than ever how much people and companies respect women's right to choose.
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