How Artificial Wombs Could Transform the Abortion Debate

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D.A. Kirk

Outer space enthusiast. Japanese history junkie. I write about politics, culture, and mental illness. Disagreement is a precursor to progress.

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39 Responses

  1. Avatar pillsy says:

    As artificial wombs are an entirely hypothetical technology, it’s difficult to say for sure what they would look like, and what drawbacks they might have, but one thing I’m confident about is that they won’t be cheap. Certainly not at first (revolutionary technologies rarely are), and very possibly not ever.

    So we, as a society, will be confronted with the question of who’s going to pay to bring those fetuses to term in the fancy new gizmo? It doesn’t sound like the sort of thing many insurance companies would be falling all over themselves to reimburse, and I’m not sure a hypothetical Medicare for All program would be any different.

    If artificial gestation costs $100 000, which is, you know, in line with what a lot of health care interventions cost, we’re looking at $100 billion/year, which is a ton of money even when we’re talking about health care costs in the US or the federal budget. Way more than you can just sort of hand wave away.

    Maybe the woman seeking to terminate her pregnancy will be responsible. But if we’re saying a woman has to scrape together a huge amount of money to be able to end a pregnancy, well, that poses some serious questions about her bodily autonomy, doesn’t it?

    Anyway, somebody will have to pay for it. Maybe various pro-life groups can do it through charitable giving, but that’s a lot of charity.

    So I definitely think this technology would change the nature of the debate, but I’m not sure how it would do so. Things can look awfully different when people are given the opportunity to decide how important something is to them when it comes with a price tag attached. It can be more clarifying than hypotheticals about violinists, or exhortations to empathize with people who come from vastly different life circumstances, or just about anything else.

    It’s one thing when it’s somebody else’s body on the line, and another thing when it’s your pocketbook.Report

    • Avatar Oscar Gordon in reply to pillsy says:

      I could certainly see it benefiting infertility/adoption. Currently, if a couple is not a good candidate for IVF, and they really want an infant, they have to do infant adoption, which means going overseas, or ‘contracting’ with a pregnant woman here in the hopes that when she delivers, she will honor the ‘contract’ and surrender custody. I use the scare quotes because there isn’t any real enforceable contract. It’s a gamble. I know of no state that won’t let the mother keep the baby and tell the parents they are effectively SOL.

      However, finding a pregnant woman early on and spending $100K to get the embryo or fetus transferred to an artificial uterus could shift how the law treats such contracts. If the mother doesn’t carry to term, defending her interest in the child is a much tougher lift. At the very least, I could see the law defending the contract to the tune of reimbursement to the couple who paid out 6 figures.Report

    • Avatar Chris in reply to pillsy says:

      It’s telling, in many ways, that anti-choicers see such a hypothetical technology as an alternative route to limiting women’s reproductive freedom rather than adding another reproductive choice.Report

    • Avatar D.A. Kirk in reply to pillsy says:

      Cost is a big issue, for sure. I was more focused on the personhood angle than the cost angle mostly because, as you sort of implied, the cost is going to depend a lot on what kind of system is in place when artificial wombs become a reality. If we still have a heavily privatized health care system, most folks won’t be able to afford these wombs. Not at first, at least. But what if it’s a single-payer system similar to the NHS, or a hybrid system like Singapore’s?

      “Things can look awfully different when people are given the opportunity to decide how important something is to them when it comes with a price tag attached.”

      I agree 100%.Report

      • Avatar pillsy in reply to D.A. Kirk says:

        The cost doesn’t go away with a single payer system, or with one of the hybrids. Those systems tend to be run by people who are preoccupied with keeping costs down, much more so than in our system. That’s a big part of the reason they’re cheaper than ours.

        And really, every dollar that goes into those artificial wombs (and gestating the fetuses in them) is a dollar that won’t go somewhere else. There may be a few people who think spending hundreds of billions of dollars is an “easy way out”, but I doubt it will be enough to actually push the spending through (one way or another).Report

  2. Avatar Road Scholar says:

    I read a sci-fi story awhile back that, as a background story element, had people using cows and sheep as natural “artificial” wombs. Which sounds squicky but from what little I know about that sort of thing might actually be workable. Probably have to modify the animal’s immune system or something idk. Anyway, part of that scenario was that perfectly reliable contraception was administered the way we do childhood vaccines.

    What will (eventually) really change, virtually eliminate actually, the abortion debate is when conception, pregnancy, and parenthood flip from an “opt out” to “opt in” proposition, where there simply is no such thing as an unintended pregnancy. Alsotoo, no genetic accidents unless you intentionally choose to spin that wheel.

    Brave New World meets Gattica…Report

  3. Avatar Jaybird says:

    Imagine how much economic growth we’d finally be able to experience if we could remove the inconveniences of pregnancy from women and allow them to fully enter the workforce without any risk of pregnancy whatsoever!

    With the addition of sexbots, we could also eliminate the inefficiencies of relationships.Report

  4. Avatar Chip Daniels says:

    “Would the pro-life community be prepared to do its part to satisfy the ensuing demand for more resources? Would they agree to pony up the taxes needed to house, feed, and educate all those kids?”

    Question asked, and answered.Report

  5. Avatar bookdragon says:

    “Would the pro-life community be prepared to do its part to satisfy the ensuing demand for more resources? Would they agree to pony up the taxes needed to house, feed, and educate all those kids?”

    Given evidence so far, I’d bet on ‘No’ since the majority of people identifying as ‘pro-life’ seem to be perfectly content to support politicians, parties, and policies that let children starve or die of preventable conditions once they are out of the womb. If you vote for people who vote to eliminate CHIP and do nothing to protest that or pressure them to change their vote, I don’t hold out much hope for you caring about any child who comes out of an artificial womb and has no parents waiting for them.

    For that matter, this article talks about artificial wombs as though they’re free. Consider the cost of a couple weeks in NICU. Now imagine months. Realistically, bringing a fetus to term in an artificial womb with all the attendant monitoring and support required from medical professionals is bound to be a fairly expensive option even if it ever becomes well established enough to no longer count as experimental (by insurance standards). Are ‘pro-life’ people really committed enough to pony up the money to make artificial wombs an available option for women who would otherwise choose abortion?

    If not, who picks up the tab? If a woman becomes pregnant and cannot or does not want to carry it to term, would the anti-abortion movement push to pass laws that would force her to pay for gestating the fetus in an artificial womb? Given that the majority of women who seek abortions are poor, how would that work?Report

    • Avatar D.A. Kirk in reply to bookdragon says:

      “If you vote for people who vote to eliminate CHIP and do nothing to protest that or pressure them to change their vote, I don’t hold out much hope for you caring about any child who comes out of an artificial womb and has no parents waiting for them.”

      Fair point, but I’m not sure I agree. I mean, let’s be honest; a lot of people don’t pay that much attention to how their elected reps vote. They just show up to the polls and vote for the letter, not the name. I imagine some portion of those people are principled and sincere, though perhaps a little lazy. In any case, I suspect that a fair number of them would be willing to help out financially. The bigger question is whether or not they could afford to help out. Red America isn’t exactly swimming in gold and treasure.

      “For that matter, this article talks about artificial wombs as though they’re free.”

      I addressed this above, but just to reiterate, I did that for two reasons. First, I was hoping to drive the conversation in the direction of the personhood debate, which I just happen to find more intriguing. Secondly, the financial side of things will depend a lot on what kind of health care system we have in place when artificial wombs become a reality. And since I have no idea what system that will be, I tried not to delve too deeply into the subject.Report

      • Avatar bookdragon in reply to D.A. Kirk says:

        “Fair point, but I’m not sure I agree. I mean, let’s be honest; a lot of people don’t pay that much attention to how their elected reps vote.”

        While that may be true for a lot of people, I think it’s a cop out wrt folks who identify as ‘pro-life’. They have become an important voting block within the GOP because they have become single issue voters wrt abortion. If they aren’t willing to use that political power to oppose things harmful or even directly threatening to the lives of people outside the womb, they should stop talking about personhood and human dignity and the sanctity of life, because it just underlines the hypocrisy.

        Now I admit I don’t find the personhood debate all that intriguing, mostly because the way I have always heard it brought up is in the context of fetal heartbeat laws or rules in force at Catholic hospitals, which ignore or dismiss the idea that women of child-bearing age are also persons with a right to life. In the majority of the cases where a woman in an emergency room is denied a therapeutic abortion because the fetus still has a heart beat it’s unlikely that a successful transfer to an artificial womb could be made. I don’t know what the transfer procedure would entail, but it’s possible that in such a situation requiring it would eliminate any chance the mother had to survive.

        I do think the technology is valuable for infertile couples or for women who want children but have health issues that would prevent carrying a pregnancy to term.Report

  6. Avatar Blomster says:

    As expensive as these artifical wombs would be – surely it still pales against the cost and effort required to raise the child? Who would be responsible for the raising of the child? Even if the artifical womb technology and all the attending monitoring and support is free, that’s only the start of the 20 year commitment now that you have a live little human kicking around. Or is the assumption that there would be willing adoptive parents for all of these babies?Report

    • Avatar D.A. Kirk in reply to Blomster says:

      “Or is the assumption that there would be willing adoptive parents for all of these babies?”

      I definitely don’t make that assumption. Your questions are exactly the types of questions that the pro-life side in particular will have to wrestle with when artificial wombs become a reality.Report

  7. Avatar Silver Wolf says:

    Just to muddy the amniotic fluids.

    Some people are arguing in bad faith, using this as a means to force their views on others and inject themselves in other peoples’ private lives, rail against change that they are not comfortable with, or to control women. They, like their anti-contraception brethren, are not interested in finding a viable solution to the question that does not let them dictate restrictions to others.

    As the technology develops, expect ever greater pushback from moralists decrying the unnatural, abdominal, and inhuman use of technology to facilitate childbirth that just happens to also make women’s lives easier.Report

    • Avatar pillsy in reply to Silver Wolf says:

      As the technology develops, expect ever greater pushback from moralists decrying the unnatural, abdominal, and inhuman use of technology to facilitate childbirth that just happens to also make women’s lives easier.

      Awesome typo.Report

    • Avatar D.A. Kirk in reply to Silver Wolf says:

      You think the pro-life crowd will actually object to the use of artificial wombs? Interesting. I’ve always figured that they wouldn’t hesitate to seize on an opportunity to do away with abortion entirely, and I can’t think of any potential innovations or technologies that would present that opportunity other than artificial wombs. I suppose they might feel a little uncomfortable by the “unnatural” aspect of it, but I’d be genuinely surprised if that was enough to discourage them from using the technology as the launching point for a campaign to abolish abortion.Report

      • Avatar Marchmaine in reply to D.A. Kirk says:

        There are things for which artificial wombs ought to be objected to (let’s say breeding state owned soldiers or workers) and things for which there would be no objection… medical treatment for at risk mothers or babies. Additionally, if the option is voluntary termination or a medical solution via an artificial womb, it would satisfy all of the moral considerations for extraordinary care (as far as Catholic medical ethics are concerned); and, given that the outcome would be a full and healthy life, it has few (perhaps none) of the confounders for applying extraordinary care to end-of-life situations.

        Assuming that the hypothetical technology of artificial wombs doesn’t have a moral “gotcha” in terms of how it works I would expect that it would be a licit life-saving measure. There’s nothing particularly “luddite” about the pro-life movement when it comes to pre-natal or post-natal technology. More than a few close acquaintances of mine are Pro-Life OBGYN Doctors.

        There are, of course, second and third order consequences of this (or any) new technology; it is mostly in those areas where policies, law and morality would scramble.Report

      • Avatar Silver Wolf in reply to D.A. Kirk says:

        Not the “real” pro-lifers. I am talking about the people who are using the movement as an excuse. If you want to promote childbirth then this device is a godsend. If, however, one wants to control other peoples’ lives, this will provide choices that are unacceptable.Report

  8. Avatar LeeEsq says:

    Who is going to raise the babies that were placed in artificial wombs rather than aborted if neither the natural mother or father wants to raise them? It doesn’t strike me as plausible that we will find willing, able, competent, and loving adults for all of them to be adopted. Reviving the institution of the orphanage and have a state or private charity take charge of their upbringing also seems like a really bad idea.Report

  9. Avatar North says:

    It’s a fine and thoughtful article but one that, I suspect, has a simple and cynical answer. The advent of artificial wombs would have very little impact on the abortion debate such as it is because the question of artificial wombs would not directly involve controlling women’s decisions and women’s bodies.
    This is observable in the very real, existent and widespread technology of in vitro fertilization. IVF, by the pro-life movements’ own criteria, creates a huge number of tiny human lives; implants a tiny minority and summarily discards the rest. You’ll occasionally find pro-lifers making half-hearted swipes at IVF practices but there is no passion there and certainly no significant political movement or activist action against it.
    Couple this observation with the very trenchant comments above about the cost of artificial wombs (we’re in sci-fi la la land when these things are more cost effective than the mark I model) and I think the shallow answer presents itself pretty succinctly; artificial wombs would not heavily impact the abortion debate directly.
    The non-shallow answer is even simpler. A world where our science understood the nuance and intricacies of gestation sufficiently to simulate it in an artificial womb would also be a world where abortion itself would likely be incredibly easy and non-invasive to obtain. Without abortion clinics as a nexus of protest pro-lifers would mostly end up stuck with limited targets. Couple this with the political reality that 2/3rds of the population is actually pro-choice (but a significant fraction of that group likes to pretend to be pro-life so long as there is no realistic prospect that THEIR access to abortions is infringed) and the conclusion is pretty clear. The abortion debate will continue to roll along.Report

    • Avatar D.A. Kirk in reply to North says:

      “This is observable in the very real, existent and widespread technology of in vitro fertilization. IVF, by the pro-life movements’ own criteria, creates a huge number of tiny human lives; implants a tiny minority and summarily discards the rest. You’ll occasionally find pro-lifers making half-hearted swipes at IVF practices but there is no passion there and certainly no significant political movement or activist action against it.”

      I was waiting for someone to bring this up, and it is an excellent point, to be sure. I’m skeptical though that the pro-life movement’s apparent disinterest in IVF says as much as you suggest it does. In my experience, a lot of pro-life people, especially the younger ones, don’t actually know how IVF works. And the fact that IVF results in discarded embryos as opposed to discarded fetuses does make a difference for at least some of the pro-lifers who understand how the process works. The hardcore fundamentalists oppose all of it, but I suspect that a decent portion of the pro-life movement takes a more nuanced approach, or is at least more open to a compromise, even if they won’t admit it openly. And my hunch is that it’s actually those moderate pro-lifers who would be the most vocal proponents of some sort of abortion ban after artificial wombs hit the market. The wombs would resolve a major conflict that has always hung over the heads of the moderates: the conflict between their respect for women’s bodily autonomy and their belief in the dignity of all human life. With artificial wombs serving as an alternative option for women who wish to terminate their pregnancy, the moderate pro-lifers will finally be able to say that they are both anti-abortion *and* pro-bodily-autonomy without having to grapple with the contradiction that those two statements currently present. Again, though, that’s just my hunch.Report

      • Avatar North in reply to D.A. Kirk says:

        Well the passion is what drives votes and the narrative. I have a suspicion that IVF is more analogous than you think but then again we’re both speculating on the future.

        I would emphasize, also, that practical considerations also matter in this area. A society technically capable of building and deploying masses of artificial wombs will probably have an “abortion pill” technology that induces the body to re-absorb or miscarry unwanted pregnancies with little to no major discomfort or danger. While artificial wombs might replace later term abortions (the vast minority of abortions that exist) the governments ability to identify and interdict early pregnancies from being so easily aborted would probably be quite limited. Likewise contraception would probably become so effective and easy in that era that abortion will also be extremely rare. If we can duplicate gestation technologically then our understanding of those processes will, necessarily, be pretty comprehensive and those other applications are comparatively simple compared to bringing a fetus to term.Report

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