At the end of September, advisors US Food and Drug Administration (FDA) met to discuss the possibility of greenlighting human clinical trials of an artificial womb. These devices have been studied for many years to help premature babies complete their development more safely. Their first major milestone came in 2017 when they managed to preserve the fetuses of lambs born very prematurely for four weeks. This was even discussed in the chapter Gray’s Anatomy.
Since then, more and more successes have been achieved, but never with humans. So far, the use of artificial uterus V premature babies. And in fact, even if the FDA grants approval, there are still many steps to be taken before it becomes a reality.
However, the simple fact that they were considering this option triggered an intense debate between defenders and detractors this type of device. It is true that it can bring many benefits on a medical level. But there is also talk of ethical issues that could arise in the future when artificial wombs become common practice in hospitals. Everything, both good and bad, will be taken into account by FDA experts. And whatever your decision, you should continue to think about it in the future so that weigh both extremes on a scale and decide which one weighs more. Of course, saving the lives of babies born prematurely seems like a compelling reason.
A child is not the same as a fetus…
An artificial womb, also known as an extrauterine environment for neonatal development (EXTEND), is designed to do exactly what its longer name suggests: to promote development outside the womb of babies born very prematurely.
Children born up to 37 weeks. This is something very common. Indeed, it is believed that approximately 10% babies They are born this way. According to the World Health Organization, in 2020 alone 13.4 million premature babies World.
But not everyone is born around week 37. TO up to 28 weeks They are considered extremely premature. Of these, it is believed that with the help of incubators it is possible to keep born babies alive. from 24 and 25 weeks. However, in these extreme cases there are usually consequences such as respiratory, neurological or digestive problems. They are also more prone to serious infections and mortality increases greatly.
…and they shouldn’t be treated the same
Despite all this, alternatives to incubators have been explored, such as the possibility artificial uterus. The big difference between these devices and an incubator is that while newborns are treated like babies in incubators, they continue to be like fetuses in an artificial womb.
The big differences between a fetus in its later stages of development and a child are, first of all, that the fetus as such does not breathe. They actually oxygenate your blood. through the placenta. They also don’t have the same cardiovascular system. As Elseline Kingma and Suki Finn explain in a 2020 bioethics study, “the fetal heart functions as one bomb, and not twins, as in newborns.” In addition, “the fetal cardiovascular system, compared to newborns, has multiple bypasses, different blood flow rates and blood pressure in different parts of the system.”
In this way, the artificial uterus supports the premature newborn in the same way as the fetus. in the womb. And for this there are several considerations taken into account.
This is how an artificial uterus works
In an artificial womb, a premature baby, or lamb, is kept in liquid mediumwith some catheters attached to the navelimitating an umbilical cord, and external membrane oxygenator. In this way, they are supplied with all the necessary nutrients and gas exchange improves in the same way as in the uterus.
As for the selected liquid, it has the same properties as amniotic fluid in which the fetus develops normally. Thanks to all this, it was possible to keep lambs equivalent to human fetuses for four weeks. 24-25 weeks of pregnancy. At the moment there appears to be no intention or possibility of doing so before then. However, bioethicists are already considering all possibilities.
Benefits for which EXTEND technology was conceived
The use of an artificial uterus is a form of complete ectogenesis. Any form of embryonic or intrauterine development is known as ectogenesis. outside the uterine environment. In vitro fertilization can be considered partial, after which the embryo is kept in the laboratory for several days before being transferred to the uterus. There are even those who view neonatal incubation this way because these are not babies born at 40 weeks.
But complete ectogenesis is more radical. These are fetuses that develop outside the uterus, but under conditions almost identical to those that could arise naturally in it.
This can be very useful on two levels. On the one hand, giving birth outside the womb will allow for a better diagnosis or even easier intervention if necessary. But above all, from everything we have seen so far, it is beneficial for premature babies. As explained Hypertext Ruben Rodriguez RodriguezThe doctor, who specializes in obstetrics and gynecology at the University Hospital of Mother and Child of the Canary Islands, believes that an artificial uterus “will help prolong the gestation period so that the fetus has more time to develop before birth.” As a result, “we will have fewer deaths and fewer newborns with fewer short- and long-term complications“
What are the disadvantages of an artificial uterus?
Opponents of the artificial uterus criticize it mainly on two levels. On the one hand, they believe that this could be used to limit women’s freedom to have abortions. At first glance this may seem strange. But it makes sense if we base it on so-called visual bioethics. In 2008, Professor of Ethics Paul Lauritzen coined the term to refer to how what we see influences what we consider moral and what is not.
This especially affects reproduction. In fact, this is what many religious and conservative groups use to prevent some women from having abortions. They make them see ultrasound images of their fetuses so they can imagine them as “living people” and they feel guilty during termination of pregnancy.
In an artificial womb, this effect would be even more intense. The fetus will be clearly visible, and it will be much easier for the pregnant woman to see in him a person so alive and independent that he is able to remain outside her uterus.
Right now it’s This is something impossible. However, it is necessary to take this into account for a future in which what seems like science fiction to us today may become something very everyday.
It is not easy to preserve the fruit for 9 months.
Many opponents of the artificial uterus also argue that little by little it will be possible shorten a week of pregnancy which they are used. There is even talk of preserving for 9 months to the fetus and that the pregnancy was completely external.
However, at this point it is science fiction. “Given current knowledge, it is unlikely that an artificial uterus will be able to support the entire period of pregnancy,” Rodriguez says. “It’s because need to simulate a very specific environment and it is difficult to recreate.”
In addition, the gynecologist notes that the use of these devices will be very expensive, since specialized centers and specialists will be required at the initial stage. “It won’t be easy to spread this around the world, given the need highly qualified personnel and very complex centers until, in the second stage, costs are reduced and the training of professionals becomes universal.”
This is not about playing God, but that won’t do any good either.
Let’s say the artificial womb can be used for 9 months. Many will consider this to be playing God. But leaving aside religious implications, from a medical point of view, this will also not be beneficial. This can be harmful for both the baby and the mother.
“For the baby, pregnancies that occur outside the womb carry a greater risk of infection. Likewise, lack of maternal stimulation may have an impact on his development in the long term. On the maternal side, in addition to the consequences of premature birth, one can mainly identify psychological problems such as stress, anxiety or depression due to separation from the child. However, additional research will be required to further evaluate these shortcomings.”
Raúl Rodríguez Rodríguez, gynecologist at the Mother and Child Hospital of the Canary Islands.
After all, pregnancy is perhaps the strongest bond that exists between two people. Breaking these connections from the very beginning can cause many problems. Their early separation for the benefit of both parties is, without a doubt, one of those benefits to humanity for which science should work.
Source: Hiper Textual
