The picture doesn’t quite register the first time you see it. Inside what appears to be a clear plastic shopping bag floats a pink lamb fetus with its eyes closed. tubes that enter its umbilical cord. Somewhere off-frame, a monitor is blinking. The Philadelphia researchers who captured that image in 2017 referred to it as a “biobag,” a term engineers use when they are unsure whether they want the public to feel reassured or uneasy. It’s difficult to ignore the fact that they selected a word more akin to packaging than medicine.
The artificial womb ceased to be a thought experiment after that lamb and the seven others were kept alive inside biobags for almost a month. Some bioethicists believe that the field has crossed a boundary that has not yet been established. The term “artificial womb” was never used in the initial statements made by the Alan Flake-led Children’s Hospital of Philadelphia team. Their preference was “extra-uterine support.” However, the media did what they always do, and in a matter of days, headlines about babies grown on shelves surpassed scientific findings.
The real goal is more limited, at least for the time being. The smallest preterm babies, those born at twenty-two or twenty-three weeks, have lungs that are more like wet paper than actual lungs, and doctors want to save them. At that age, the survival rate is approximately seven tenths of one percent. Those who do survive frequently have lifelong health issues. The incubators used today are not significantly better than those used twenty years ago, and neonatal intensive care has reached a plateau. Researchers describe a barrier that they are unable to overcome.
Thus, the biobag and EVE, a comparable Australian system, try something different. The technology treats an underdeveloped baby like a fetus that just so happens to be outside the body, rather than like a sick newborn. The umbilical cord facilitates the exchange of oxygen. The fluid is similar to amniotic fluid. The delicate lungs are not being inflated by a ventilator, breathing, or feeding tube. The idea is almost philosophical: keep gestating the baby instead of trying to save it.
Legal scholar Elizabeth Chloe Romanis, who has written more than most on the subject, contends that although these animals are no longer fetuses, they are also not infants. She suggested a new term, gestateling, which sounds a little clinical, like it was created during a committee meeting. It does, however, depict something authentic. The language that is currently in use isn’t quite appropriate, and language is important in the legal and medical fields. Eventually, parents will be asked to sign consent forms that they can hardly comprehend.
The moral dilemmas grow rapidly. The obvious concern is complete ectogenesis, which is the process of creating a human entirely outside of a body from conception. While this is still technically impossible, it no longer seems ridiculous to talk about. Feminists are divided. For some, this means being freed from a biological burden that has been carried unevenly throughout the species’ history. Others envision a more sinister future in which the womb is portrayed as ineffective hardware and pregnancy is pathologized. There are objections from the Catholic medical community as well. Advocates for disability rights have their own.
The trials come next. Someone must decide that the risks are acceptable before the first human baby is placed in a biobag. Whose infant? In what situations? In that case, parents are already experiencing grief. Although the FDA has not indicated how it will handle approval, investors appear to think the technology will be available within ten years.
As you watch this play out, you’ll notice how quietly everything is moving. No hearings in Congress. No glitzy launch parties. In a Pennsylvania hospital basement, it’s just lambs, then maybe something else, while everyone else is debating chatbots.
