In 2017, researchers based in Philadelphia announced that they had successfully gestated premature goat fetuses at the developmental stage equivalent to approximately 23 weeks in a human fetus for four weeks using a technology designed to imitate “the environment of the womb.” The researchers have since replicated their study, and another team has completed promising animal trials using a similar model. With this work, along with efforts across the U.S., Australia, Japan, and The Netherlands, an artificial womb prototype is anticipated to be ready for human trials within approximately five years-time. The technology promises to act not simply as emergency life support upon birth, but as a means of allowing the neonate to continue developing as though it had not yet been born.

The priority of such research is to improve poor health outcomes for extremely premature babies, and it is understandable that the key focus of scientists doing this work would be on the already challenging problem of simply creating a successful prototype. But despite the stated intentions of researchers, these developments have been met with speculation from all sides of the political spectrum as to the other possible uses of this technology. 

On one end of the political spectrum, conservative commentators have been quick to suggest artificial wombs might bring about the end of abortion by allowing unwanted fetuses to be removed and grow inside the technology rather than being terminated. On the other end, those who support the cause of reproductive freedom have found emancipatory possibilities in a form of automated gestation that might one day, in some form, allow pregnant people to “pause, share, transfer, redistribute, and walk away from pregnancies.” Amidst these emerging debates over what artificial wombs may mean politically, ethically, and legally, little discussion has focused on the technology as a material object—how its impact may be entangled with its design. 

In the 1970s, feminist writer Shulamith Firestone speculated that artificial womb technology could present an opportunity to alleviate women from the weight of the work of gestation and allow for a radical redistribution of care labor. She cautioned, however, that this could only be possible under the right circumstances.“[I]n the hands of our current society and under the direction of current scientists (few of whom are female or even feminist),” she wrote, “any attempted use of technology to ‘free’ anybody is suspect.”

In whose hands, then, and in what form, could ectogenesis (external gestation) be “free[ing]”? Could artificial wombs become something other than expensive neonatal care available only to a select few? 

The technology currently in development is not what Firestone had envisioned. Built for limited use in the most well-equipped of neonatal wards, these artificial wombs have “nothing whatsoever to do with reproductive justice struggle.” Access to safe, sufficient, and culturally appropriate healthcare for pregnant people and neonates remains deeply stratified globally. Within wealthy nations like the U.S. and England, rates of maternal and neonatal mortality and morbidity are significantly higher for black women than for white women. A technology that is likely to be highly costly, introduced without accompanying social change, and available only to some is unlikely to be adaptable or accessible to the communities that might benefit from them the most.

“What might artificial wombs mean and do if they were developed by feminist researchers with the goals of affordability, sustainability, and adaptability to multiple environments in mind?”

While partial artificial wombs are in development, and full ectogenesis remains inherently speculative, there is space to imagine what artificial wombs might mean for the gendered reproductive body, for care labor, and for reproductive rights. Such questions are entangled with the context of the technology’s availability and development. 

What might artificial wombs mean and do if they were developed by feminist researchers with the goals of affordability, sustainability, and adaptability to multiple environments in mind? Today, reproductive care outside the context of a hospital—for instance, with the support of trained midwives or nonclinical advocates such as doulas—can offer “a model that normalizes pregnancy and birth and focuses on the physical, social, and psychological needs of the [pregnant person].” How might an artificial womb be different if its use by midwives, or even doulas, is taken into consideration? And if we look to a future with ectogenesis, how might automated gestation be altered if access, adaptability, and community-based practices were prioritized at each stage of the technology’s development?

Of course, safety is a vital concern; rightly, this will likely be the first concern raised in response to the idea of using artificial wombs outside a hospital setting. To be very clear, I am not advocating for experimental practices that could endanger pregnant people and neonates. Instead, this is a project of speculation: could, or would, artificial wombs be different depending on the practices that guide how they are used? Thinking through the many possible ways of mobilizing artificial wombs now can reorient research in different directions in the future. 

This is where speculative design might offer a glimpse of another possible future. The Máxima Medical Centre, where scientific research toward a functional artificial womb is ongoing, invited Hendrik-Jan Grievink of the Next Nature Network and Lisa Mandemaker, a social designer based in Amsterdam, to construct a speculative artificial womb for an exhibition during the 2018 Dutch Design Week. The outcome was a super-sized bouquet of large red balloons, each yearning upward from thin stems while rooted and floating. Even though the request for the design came from the group that will lead medical research toward an artificial womb, the design is not a working prototype, but a prompt for reflection, discussion, and debate. 

In an interview with Lady Science, Mandemaker explains that she wanted to invoke a futuristic botanical garden with the image of a pumpkin patch. An ethos of visceral, imperfect, organic intimacy, of familiarity and whimsy, informs the design at every level. While each sphere had initially been printed with a repeating formulaic pattern, Mandemaker felt that this was too prescriptive. Instead, she made prints at her kitchen table with plastic sandwich bags filled with liquid, jam, and sparkling water. These were flattened on a scanner, with each of the bags wrinkling and compressing in its own peculiar way. The final prints reflect a series of unique images. At first, they came out too blue (too cold). The first red was too much like blood. The softened shade of red of the final design was chosen to communicate warmth—something alive but not, and perhaps trying too hard to replicate a human. 

Mandemaker notes that she made a deliberate decision to exclude certain elements, such as transparency and sound permeability, to leave flexibility for people to imagine the possible relational features of the technology in different ways. Mandemaker remembers that members of the public who came to view the artificial womb struggled to imagine it outside the context of a hospital. Picturing this technology operated by neonatologists in a specialist ward is the most immediate way for many people to fathom it working safely, and indeed, this is likely to be true for the foreseeable future. But the speculative artificial womb design, unlike the image of a lamb in a bag, invites contemplation of the “what ifs” of ectogenesis—what if it were possible in one’s own garden, in one’s own community, and carefully, gently, on one’s own terms. 

“But the speculative artificial womb design, unlike the image of a lamb in a bag, invites contemplation of the ‘what ifs’ of ectogenesis—what if it were possible in one’s own garden, in one’s own community, and carefully, gently, on one’s own terms.”

Scholar Michelle Murphy argues that precisely the features that make some reproductive technologies viable as tools of feminist self-help and collective care (being homemade and easy-to-use) can be what may make these same technologies easy for states to co-opt. This is particularly true where these tools are developed in the absence of antiracist and anticolonial praxis. Murphy notes the necessity of thinking with and through these kinds of contradictions, a process that will also be necessary in considerations of the possible forms artificial wombs and ectogenesis might take.

The solutions to the vast global inequalities in health outcomes for pregnant people and neonates; to the racialized inequalities in these outcomes; and to the way in which many social burdens of care continue to heavily fall on women do not lie with developing an adaptable artificial womb. But people have always found practices of care within oppressive systems and ways of engaging technologies in ways that reject, undermine, and circumvent the status quo even while working toward systemic change. The process of speculating now, while artificial wombs are in development, is a means of reaching toward other ways of imagining a future with this technology. 

We might ask how centering accessibility, cost, sustainability, and adaptability could orient artificial wombs toward these causes. And then we might explore, more speculatively, how ectogenesis might be altered if it could be performed by an individual in a place of their choosing rather than being mediated in a medical setting. Of course, it is true for the moment that specialist mediation is necessary. But the challenge here is in thinking about whether that mediation must always be necessary and what kinds of questions we need to ask now in order for other uses to be possible in the future. 

Further Reading

Giulia Cavaliere, “Gestation, Equality, and Freedom: Ectogenesis as a Political Perspective.” Journal of Medical Ethics 46, no. 2 (2020): 76-82. 

Loretta J. Ross, Lynn Roberts, Erika Derkas, Whitney Peoples, and Pamela Bridgewater Toure, eds. Radical Reproductive Justice: Foundations, Theory, Practice, Critique (The Feminist Press, 2017). 

Image credit: Pumpkins by Brande Jackson, 2010 (Flickr | CC BY-NC-ND 2.0)