Exhibition ‘Chronic Health: If not us then who?’ by Waag  is licensed under CC BY-NC-SA 2.0

Artificial Wombs and the Politics of Disability Futures

Amelia DeFalco and Luna Dolezal

In April 2017 researchers at the Children’s Hospital of Philadelphia (CHOP) published a report detailing the creation of an extra-uterine device, or ‘Biobag,’ which successfully gestated a lamb for 4 weeks. CHOP’s goal is to develop the Biobag for human use, artificially extending gestation in cases of extreme prematurity in human babies. A similar ‘extracorporeal system’ is being developed for human use by researchers at Eindhoven University, with project leaders predicting a working prototype by 2024. Like the CHOP project, the Eindhoven project is aimed at creating artificial wombs for the treatment of extremely premature babies, who have high death and disability rates. One of the largest studies that has examined disability rates among premature babies, has shown that about half of extremely premature babies have some form of neurological or developmental disability, with severe forms of disability present in 23% of babies that are born at 22-25 weeks of gestation. Technologies like the Biobag that aim to successfully extend gestation outside of the womb are indeed technologies that indirectly seek to prevent disability in later life.

Perhaps unsurprisingly, reporting of the CHOP and Eindhoven extra-uterine systems frequently involves speculation that it is only a matter of time before full ectogenesis–reproduction and gestation, from conception to birth, outside the human body–becomes a reality. Science and speculative fiction are often invoked in these discussions, particularly dystopian narratives like Aldous Huxley’s A Brave New World, that imagine human ectogenesis as part of a larger project of fascistic bioengineering to create ‘perfect’ human subjects. This is an imaginary that is invoked repeatedly in science and speculative fiction, where in the recent film I Am Mother a robot undertakes a eugenics-inspired project to produce a near-perfect child through ectogenesis and a highly regimented upbringing.

Debates surrounding ectogenetic technologies often echo the concerns that arise in these dystopian fantasies. Feminist critics have been particularly vocal in these debates, questioning whether such technologies herald the liberation of women from biologically-determined motherhood, with the potential to dismantle hetero-patriarchal gender roles, or a dystopian age of patriarchal reproductive control, through technologies that have been designed not with the interests of women (or children) as their primary concern. However, there has been less attention to the way these technologies manifest what Alison Kafer in her book Feminist, Crip, Queer calls the “curative imaginary,” which she defines as “an understanding of disability that not only expects and assumes intervention but also cannot imagine or comprehend anything other than intervention” (27).

While the aim of preventing premature infant death and unnecessary disability may be unimpeachable and unquestionably worthwhile in its pursuit, it is worth considering the traces of ableism within the stated motivations of artificial womb developers. As Kafer explains, “Futurity has often been framed in curative terms, a time frame that casts disabled people (as) out of time, or as obstacles to the arc of progress” (28). It is perhaps no surprise then that these technologies of the future are framed as dispellers of disability. As Jenny Kleeman writes, “Women at risk of going into very early labour could have their babies transferred into an artificial womb. It sounds extreme, but if it could mean a healthy future instead of illness and disability, who could deny it to them?” (emphasis added).

If we turn to disability studies, we can see that the aim of eliminating illness and disability is not as unproblematic as Kleeman presents it. Kafer’s reflections on disability futures show that the curative aims of artificial womb technologies are bound up with political questions about which lives are worth living, and which lives are valued within society. As if writing in response to Kleeman, Kafer explains, “The presence  of disability . . . signals something . . . a future that bears too many traces of the ills of the present to be desirable. In this framework, a future with disability is a future no one wants, and the figure of the disabled person, especially the disabled fetus or child, becomes the symbol of this undesired future” (2-3). Following Kafer’s lead, we ask what are the implicit politics of technologies like the Biobag and the interventions they propose? To what degree do artificial wombs manifest an individualized, mechanistic, biomedical vision of the human that perpetuates the individualization and depoliticization of disability? What assumptions about gestation, maternity and fetal health underlie the development of artificial wombs? Which lives are ectogenetic technologies most likely to improve and/or extend? Which lives might be excluded from ectogenetic assistance?

Like many technologies promising the creation of healthier, less disabled, more caring futures, the discourse around artificial wombs relies on the transparency of key terms — health, disability, care — that are in fact highly contentious, and ethically and politically fraught. Not only do the potential outcomes of ectogenetic intervention require interrogation, but so too do the motivations and assumptions driving such technological development demand informed, sustained examination.

Further Reading:

Aristarkova, Irina. Hospitality of the Matrix: Philosophy, Biomedicine and Culture. Columbia University Press, 2012.

Bhatia, Neera and Evie Kendal. “We may one day grow babies outside the womb, but there are many things to consider first.” The Conversation. 10 November 2019.

Kafer, Alison (2013) Queer Feminist Crip. Bloomington: Indiana University Press.

Kleeman, Jenny (2020) Sex Robots and Vegan Meat: Adventures at the Frontier of Birth, Food, Sex, and Death. London: Picador.

Lewis, Sophie. Do Electric Sheep Dream of Water Babies? Logic.

Smajdor, Anna (2007) “ The moral imperative for ectogenesis.” Cambridge quarterly of healthcare ethics.