In Aldous Huxley's Brave New World (1932), ectogenesis—growing embryos in artificial environments—thrives at the Central London Hatchery and Conditioning Centre. Here, ‘standardised’ individuals are grown in bottles on a conveyor belt ‘travelling at the rate of thirty-three and a third centimetres an hour.’ Later we learn that ‘The [ectogenesis] discoveries of Pfitzner and Kawaguchi were at last made use of,’ beginning ‘intensive propaganda against viviparous reproduction’.
For some, the recent news (Roberts, 2017) that Partridge et al (2017) had kept premature lambs alive in a ‘plastic bag’ womb invited the inference that human ectogenesis may soon be realising the grim portent evoked in Huxley's fiction. As Partridge et al (2017: 11) state: ‘[O]ur system offers an intriguing experimental model for addressing fundamental questions regarding the role of the mother and placenta in fetal development.’
With uterine transplantation already a fact of reproductive life—and with its own ethical concerns (Winter, 2014)—there are questions as to whether human ectogenesis might further challenge what has hitherto been considered the inviolable bond between mother and baby. It is possible, but as Murphy (2017: 273) suggests, for women with uterine incapacity who do not wish to consider surrogacy, ectogenesis might be an attractive option that also avoids the hazards of uterine transplantation: ‘In fact, in the name of protecting women […] from the harms of pregnancy and in the name of securing for women social opportunities equal to those of men, some commentators have called for making research into the development of [human ectogenesis] a high priority.’
On the other hand, Johnstone (2010) argues that ectogenesis could adversely affect women's reproductive rights and health, hypothesising, for instance, that in a coercive society, women considered by governmental authorities to be ‘unfit’ to continue to term with a pregnancy could be served with a ‘coercive treatment order’, and their embryos incubated in artificial uteri until they become viable. Johnstone (2010) also warns that ectogenesis may harbour unforeseen outcomes in terms of physical and emotional health for infants born by this technique.
Another aspect of human ectogenesis, were it to become a reality, might be a reshaping of the ethical landscape in relation to abortion. Singer and Wells (2006: 11) distinguish between the freedom to assert one's own reproductive autonomy and the freedom to bring about the death of a being that is capable of life outside of one's body. These two dimensions are at present inextricably entwined, provoking a conflict between freedom of choice and the embryo's alleged right to life: ‘When ectogenesis becomes possible, these two issues will break apart, and women will choose to terminate their pregnancies without thereby choosing the inevitable death of the fetuses they are carrying. Pro-choice feminists and pro-fetus right-to-lifers can then embrace in happy harmony.’
This is one point of view, albeit a rather simplistic one, which anticipates with evident eagerness such a harmonious resolution of the fiercely contested abortion issue. And somewhat further down the line looms the gender debate and the role of reproductive rights for those who have undergone sex reassignment surgery from, say, male to female and who wish to assert what they consider to be a right to have a biological child. It may well be that technological advances—including synthetic gametes, uterine transplantation and ectogenesis—make the realisation of such ambitions scientifically feasible, but would that make them morally right? Is the intimate and unique bond that develops between a child in the womb and its mother about to be challenged by those questioning traditional assumptions about gender identity and the biological roles of male and female bodies in relation to conception and birth?
It appears that the speed of current scientific and technological progress is such that the ethical framework from which we view the technological landscape is in constant need of adjustment. In this respect, and in the context of ectogenesis, midwives will have a significant role to play in shaping the debate.