J.Y. Lee, Andrea Bidoli, & Ezio Di Nucci (all @University of Copenhagen), "Does ectogestation have oppressive potential?"

Forthcoming, Journal of Social Philosophy

By J.Y. Lee, Andrea Bidoli, and Ezio Di Nucci

Was Shulamith Firestone right when she wrote that pregnancy is barbaric in her 1970 book “The Dialectic of Sex: The Case for Feminist Revolution”? If so, what should we do about it? The prospect of artificial reproduction – including artificial gestation – is perhaps one way to free women from what Firestone called the ‘tyranny of reproduction.’ Firestone believed that artificial reproduction will be necessary for us to critically re-examine and overcome the ‘ancient’ value of motherhood, especially in its painfully embodied forms.

Artificial amnion and placenta technology (AAPT), more commonly known as artificial “womb” technology, will soon be a reality. In alignment with Firestone’s observation that, at least in our pronatalist social world, artificial placenta research is “excused on the grounds that it might save babies born prematurely,” AAPT is regarded as a potentially superior replacement of the neonatal incubator for the support of very premature infants. Such usage would constitute partial ectogestation: the removal of a fetus from a human body for re-placement in an extracorporeal uterine environment for completion of the gestational term.

Philosophers and bioethicists, however, have also pondered whether we could potentially be headed towards full ectogestation – the hypothetical scenario in which the entirety of conception, as well as the gestational period, would be carried out fully outside of the human body. If we could someday have full ectogestation via AAPT (and the help of other techniques, like in vitro fertilization), what would this mean for aspiring parents? Would full ectogestation be able to deliver Firestone’s feminist utopia – a world in which women are ‘free’ from pregnancies and oppressive reproductive norms? 

As alluring as it may be to consider full ectogestation as a way for women to be liberated from the burdens, risks, and stigmas of pregnancy and childbirth, our own argument is that the path to achieving these emancipatory potentials is likely to involve challenges and growing pains. Building upon the insights of contemporary feminist bioethicists, who have worried that such technologies might be accessed and distributed unequally, or perhaps reinforce harmful pronatalist norms, our research focuses on the potential risk that full ectogestation might exacerbate, rather than resolve, gendered oppression.

To be clear, we retain the hope that ectogestation might still pave the way for the emancipation of women and other potentially pregnant persons. But we worry that without careful consideration of social issues related to reproduction and gestation, the path to Firestone’s feminist utopia is far from straightforward. In our article, we firstly reflected on the potentially negative implications that the advent of ectogestation might have for our overall valuing and understanding of female reproductive embodiment. As it stands, our social world values pregnancies and pregnant people in selective and ambivalent ways: childbirth itself is celebrated, yet visible signs that a pregnancy took place are expected to be erased as soon as possible thereafter, and phenomena like postpartum depression alongside other issues related to gestation and childbirth are unfortunately shrouded in secrecy and shame. Without concurrent efforts to fully recognize and destigmatize these various processes involved in embodied reproduction, the opportunity to disembody gestation would not necessarily help. For example, the latter might contribute to intensifying certain neoliberal narratives which place expectations on able-bodied parents untouched by pregnancy to work and balance domestic life in ever more stringent ways.

The next worry we discussed in our article regards the unresolved threat of unwarranted scrutiny when it comes to gestational methods. Pregnant women especially face all manner of judgment and unsolicited counsel with regards to what they should do with their bodies during pregnancy and how best to take care of their unborn children. We believe that, with ectogestation in the picture, such invasive judgment might extend to child-bearing and child-birthing methods. For example, ectogestation might be treated as an inferior method to ‘natural’ child-bearing, thereby stigmatising those who do want to use the technology; on the other hand, ectogestation might come to be preferred to natural child-bearing, precisely because the artificial uterine environment could be controlled or surveilled to a greater extent than a human body ever could. Either way, we anticipate that ectogestation alone will not itself help adjudicate or bring clarity to these value conflicts. To prevent a potentially emancipatory technology from being co-opted by various sides as a proxy for pre-existing prejudice about what constitutes ‘good’ or ‘bad’ gestation, it is crucial that we highlight and combat these social concerns.

Overall, we want to ensure that speculations about future tech solutions like ectogestation – however promising it may seem – do not hijack a necessary reckoning with the continued social oppression of pregnant women. To this end, we hope that our article helps to temper some of the over-excitement for artificial amnion and placenta technology in a critical and socially sensitive way, with due regard for feminist concerns.