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The sci-fi idea that we'll soon be growing babies in artificial wombs has 3 major problems
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Imagine a future in which babies are born not from women, but from machines that replicate the uterus and sustain a growing fetus for nine months.
The idea that an external, artificial womb could do away with pregnancy as we know it is a staple of science fiction, and discussion of its social implications could leave people wondering if this strange new world is going to be reality not too far in the future.
Despite all the talk, the medical technology to shift the function of pregnancy from women to machines is not really imminent. Katherine Don at The Atlantic recently laid out the significant technical problems any attempt to develop an artificial uterus would face.
1. We actually don't know that much about the placenta.
The idea of the artificial womb would be less far-fetched if we knew more about the organ we were trying to replicate.
That organ is the placenta, which mediates the exchange of oxygen and nutrients from the mother with carbon dioxide and other waste from the fetus.
The problem is, the placenta is "the least understood human organ," according to Alan Guttmacher, director of of the National Institute of Child Health and Human Development. That's a significant barrier to re-creating one capable of sustaining a human embryo to term in the lab.
2. A mother is more than a uterus.
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What we are learning about pregnancy underscores how much a woman's behavior while pregnant affects the fetus.
A mother's sleep cycle, posture, voice, and diet all affect the fetus, Janet DiPietro, associate dean for research at the Johns Hopkins Fetal-Development Project, told Don. "The maternal context provides an environment that goes far beyond the direct circulatory-system connection," she said.
In other words, even if we did get the placenta down, there's more to being a pregnant mother than the physical exchange of nutrients and waste that happens in the womb. What a woman does with the rest of her body matters too, and humans are complex enough machines that just simulating the uterus might not cut it. (That's one reason uterus transplants — rather than external wombs — have already had some success.)
3. No one is actually working on this anymore.
Hope for a human artificial womb relies heavily on research by Dr. Helen Liu, today the director of the Reproductive Endocrinology Laboratory at Weill Cornell Medical College.
Liu has managed to get cells from the endometrium, the uterine wall, to grow outside the body on a scaffolding shaped like a uterus. She got a human embryo to implant on this recreated uterine wall successfully in 2001, and it survived for 10 days until Liu ended the experiment, according to Don. (The US government didn't allow research on human embryos beyond 14 days after conception.)
Liu continued her work in mice, and in 2003 she produced one baby mouse that gestated full-term in an external uterus, though that mouse was born deformed. At that point, Liu thought some gestation time inside a living animal would work better than complete external gestation, Don writes. Liu tried implanting mouse embryos that had started growing in the external uterus into the abdomen of a mouse, and the results were indeed better — the babies were smaller than normal, but not deformed. This sounds pretty promising, but Liu stopped her research there. All the attention from medical ethicists, activists, and the media put her off of the whole project.
"It turned out to have all of these social implications, and I didn't want to deal with it," Liu told Don.
With Liu directing her attention elsewhere and no record of other scientists picking up where she left off, progress on achieving complete external gestation is stalled until further notice. Even Liu, when she stopped her project, was already moving toward partial gestation inside of an animal, rather than a fully external "pregnancy."
Those anticipating the artificial womb also cite advances in treating extremely premature babies. In a few cases, children born at only 22 weeks have survived without many health problems, when treated aggressively. Premature babies are effectively kept in artificial wombs until they're really ready to enter the outside world, but it would be a major leap in medical technology to move gestation outside the human womb completely from conception to birth — especially since no one right now is even trying to figure out how to do so.
While it may be worth thinking about the impact artificial wombs could have on our society one day, urgent discussion of this alternate future is premature. There's no need to get too excited or freaked out about the idea anytime soon.
For now, growing a human baby in an external device remains solidly in the realm of science fiction.
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