How Artificial Wombs Could Transform the Abortion Debate
At what stage of its existence does a human life become a human being? Since personhood isn’t a scientific concept, science has little to say about this topic. Science has, however, provided us with important information about the physical qualities and capabilities of the unborn at their various stages of development, information that has served to both clarify and complicate the issue of personhood. We know, for example, that the unborn are indeed human. We know, too, that they are individual entities with their own unique DNA. Thirdly, we know that they are alive. If they weren’t, they would cease developing in the womb, resulting in a miscarriage or stillbirth. So when we talk about the unborn, we are indeed talking about individual human lives. And to many pro-life activists, that means we are talking about people.
Confronting the question of personhood is an intriguing philosophical endeavor. But from a policy standpoint, it is, for the time being, an irrelevant question. That’s because forty-six years ago today, the Supreme Court legalized abortion nationwide with its opinion in the landmark case of Roe v. Wade. In that opinion, the majority concluded that a woman’s right to an abortion was covered by the privacy rights enshrined in the Fourteenth Amendment of the U.S. Constitution.
The odds that Roe will ever be overturned are exceedingly slim. It has already survived one major legal challenge in the 1992 case of Planned Parenthood v. Casey, and there’s no indication that the current court, despite its conservative majority, is any rush to rock the abortion boat. It’s been less than a year since Brett Kavanaugh was confirmed to the Court, and he has already sided once with patients of Planned Parenthood in Kansas and Louisiana. He was joined in that case by Chief Justice John Roberts. Roberts, like Kavanaugh, was also once considered a serious threat to abortion rights. That of course was before he voted to uphold Obamacare. Since then, he has not been as reliably conservative as Republicans had once predicted. It is very far from certain that either he or Kavanaugh would vote to overturn Roe. And it’s even less likely that they would both vote that way. So for now, the right to an abortion appears to be secure.
There is, however, a very impressive technological innovation that could intensify the abortion debate to a degree not seen since Roe: the artificial womb. While it may sound like the stuff of science fiction, researchers at Children’s Hospital of Philadelphia have already used the technology to facilitate the development of fetal lambs for a period of four weeks. The technology holds tremendous promise for future generations of premature babies who might otherwise experience a wide array of lifelong health problems.
While the researchers at CHOP have insisted that they aren’t interested in using the technology for any purpose other than to address the complications resulting from premature births, it’s naïve to think that this is where the story ends. Artificial wombs could be of tremendous value to infertile couples. They would give doctors easy access to the fetus so that they could act quickly to resolve any potential issues that arise during gestation. Perhaps most significantly, they would also give women the opportunity to bypass the burdens and dangers associated with pregnancy altogether.
However, they would also give the pro-life community a powerful new argument: if it’s possible to terminate a pregnancy without terminating the life of the unborn, abortion should be abolished once and for all.
That assertion may resonate quite strongly with many Americans who are on the fence about abortion. But will it result in any substantial changes to federal law? Probably not. Even if it one day becomes just as safe to transfer an embryo or fetus from a woman’s uterus to an artificial womb as it is to have an abortion, the right to choose between the two procedures rests in the hands of the patient. Only under very specific and rare circumstances can a doctor perform a procedure on a patient without that patient’s consent.
It’s less clear—to me, at least—how the medical community might respond to the advent of an artificial womb. If it becomes possible to safely terminate a pregnancy without also terminating the life inside the womb, would a doctor’s decision to continue performing abortions constitute a breach of medical ethics? Could it be argued that when presented with two viable procedures for safely terminating a pregnancy, doctors would have a moral duty to refrain from performing the one that unnecessarily ends a human life? I suspect there will be some disagreement among medical professions on those questions, but I digress.
Regardless of how that particular debate plays out, common sense says that the prospect of becoming a mother without having to endure an actual pregnancy will be too good for many women to pass up, and that the use of artificial wombs will consequently become widespread. Common sense also tells us that some of those women—and some of their partners and spouses, as well—will have second thoughts about becoming parents before their babies have fully developed.
Enter the issue of personhood and the passionate responses it provokes.
What happens when the soon-to-be parent(s) of an unborn human gestating inside one of these artificial wombs suddenly decides that they don’t want children? What will be the fate of their still-developing offspring? This is where the situation gets messy. If that embryo or fetus is indeed a person, then clearly it must be allowed to gestate to term and be given a chance at life. If it is not, then, presumably, the would-be parent(s) would be at liberty to abort it.
The debate over personhood isn’t new, but it hasn’t registered much of an impact on modern-day conversations about abortion. One of the reasons for this is because of a very powerful argument put forth by philosopher Judith Thompson in A Defense of Abortion. Thompson’s position is that even if the unborn are indeed people, that does not mean abortion is morally impermissible. She illustrates her argument with an interesting theoretical scenario involving a violinist who suffers from a fatal illness. You wake up one morning and discover that in order to save the violinist’s life, a group of musicians have kidnapped you and joined the violinist’s circulatory system to yours. Now the two of you are connected, and you must remain connected for the next nine months. If you decide to unhook yourself from the violinist before those nine months are up, he will die. Thompson argues that while it would be very kind of you to voluntary remain connected to the violinist, you are not morally obligated to do so. His right to life does not trump your right to decide what to do with your own body.
Thompson’s argument is as compelling today as it was when she first published it in 1971. However, it obviously doesn’t apply to artificial wombs. In fact, when artificial wombs do hit the market, the “my body, my choice” mantra of the pro-choice movement will be rendered meaningless except in cases involving women who choose to have children the old-fashioned way. When that day arrives, the focus will shift squarely to the question of whether an unborn human life residing inside an artificial womb has the right to live, the answer to which would seem to depend on whether that unborn human life should be considered a person in the eyes of the law.
In that scenario, pro-life activists may have a slight advantage. In Roe v. Wade, the Supreme Court did not confer personhood on the unborn. However, it did give the government the power to regulate abortions involving viable fetuses. A fetus becomes “viable” once it’s able to survive outside a woman’s womb. It therefore stands to reason that, under Roe, the government might have the power to criminalize abortions carried out on any embryo or fetus gestating inside of an artificial womb.
A potential counterargument against such a law is that only the parent(s) should have the right to decide the fate of their unborn child. But that argument could prove to be extremely problematic, as it implies that it should be both legally and morally permissible for the parent(s) to essentially claim ownership of another human life. Ironically, such an argument could run afoul of the very same constitutional amendment that has preserved the right to an abortion for the last forty-six years. One way to avoid that scenario would be to try and convince the American people that the unborn are not actual people—at least, not until a certain stage of development. If the public agrees, then embryos and fetuses that have yet to reach the agreed-upon stage at which personhood is formally recognized would not be protected by the Constitution, including those sustained by artificial wombs.
Pro-life activists might find this all very encouraging. They may believe this is a debate they can win. But they, too, have serious considerations and difficult questions to ponder. If they one day succeed in lobbying for a ban on abortions for embryos and fetuses that reside in artificial wombs, there’s bound to be an increase in the number of parentless children in this country. And if that increase is substantial, it could overwhelm the social programs and charitable organizations designed to assist those children. 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?
Abortion is an issue that many Americans feel very passionately about, so much so that fourteen years after the Roe decision, Supreme Court Justice Harry Blackmun, author of the Court’s opinion, was still receiving hate mail. However, it’s not the front-page topic that it used to be. It didn’t even rank as one of the top ten issues that voters had in mind when they cast their ballots in the 2016 presidential election. When artificial wombs become a reality, though, Americans will suddenly find themselves in the position of having to tackle one of the most complicated questions humanity has ever encountered: what, exactly, does it mean to be human? The debate over that question isn’t going to be pretty, but it should certainly be interesting. I, for one, just hope we’re up for the challenge.
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
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
Artificial wombs would no doubt be an immensely valuable technology which would help thousands and thousands of people who want a child but can’t carry a pregnancy to term for one reason or another.
An expensive, possibly scarce technology that those people will be struggling to get access to and pay for.Report
So, not so different from IVF today*.
*For what we spent on IVF for my son, we could have paid for 4 year tuition at a top state school. They had financing packages available. There was an urge to go that route, so I could use the threat of having the bank repo him when he wouldn’t eat his carrots.Report
I had no idea that IVF was that expensive. That’s an incredible price tag!Report
$10K – $15K per attempt, depending on what drugs are needed, etc.Report
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
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
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
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
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
I can’t tell if you’re being ironic, but this is a common view among radical feminists. The idea is ultimately taking the burden –physical, financial, career, etc. — of child-bearing from women entirely. (I happen to share this view.)Report
For a while, it’ll probably be the domain of the richest folks but like a lot of medical tech, it’ll eventually become viable for the upper middle classes too.
So how do we deal with the poor still having these burdens?
I suggest birth control in the water supply.Report
We’d never do that. The poor are needed to do all the work.Report
Just the adult ones!Report
I don’t think you know how adults are made. 😉Report
You import them from other countries.Report
I have an idea! I call it “socialism!”Report
This will also cut down on the surplus population.Report
Which would have the added bonus of reducing rush hour traffic.Report
I imagine that *some* religious charities (the ones who are genuinely willing to walk the walk) would be willing to intervene in cases where the woman in question has narrowed the choices down either having a child via an artificial embryo or having an abortion.
Your idea would make a good plan B though! 😉Report
“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
“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
“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
“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
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
“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
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
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
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
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
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
Newborns are the easiest to find adoptive homes for. Older kids and those with disabilities are much harder to find homes for. Fresh out of the womb babes would move off the shelf.Report
I suppose so but I’m doubtful for the numbers we might be talking about.Report
I think you’re both right. Newborns would get adopted fairly quickly, but I think it’s right to assume that we might need some more group homes and foster care providers to help fill the void.Report
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
“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
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
I am tempted to agree with North here. Specifically, if one argues that it’s immoral to force anyone to ever let anyone use their body and/or to undergo any kind of surgery regardless of anything, then I really don’t see artificial wombs actually changing the abortion debate that much–at least in regards to early-term fetuses. After all–and please correct me if I’m wrong here–I would think that pro-choicers would object to forcing pregnant women to undergo even minimally invasive fetal extraction surgery if these women can end their pregnancies in an even less invasive way by simply taking an abortion pill. If pro-choicers oppose forcing people to undergo surgeries–including minimally invasive surgeries–in any other context, I don’t see why exactly they would be in favor of this in regards to this specific issue if there is a safer and/or less invasive alternative available for pregnant women (such as, again, the abortion pill).Report