Parents of premature babies might have a new hope coming their way. Scientists have created an artificial womb that would allow babies born early to keep growing - outside their mothers' bodies. However, the new research is raising some serious ethical questions as to how the device could be used . . . and potentially misused.
What is an artificial womb?
The research, conducted at the Children's Hospital of Philadelphia and published in Nature Communications, looked at how to create an environment in which a baby born prematurely could survive. Scientists created a "biobag," complete with amniotic fluid and a technical umbilical cord to supply oxygen, letting the heart pump blood on its own. The study used eight lambs; five were about the same age as a 23-week-old premature baby, and three were older. The lambs were placed in the device for four weeks. Scientists observed the animals' wool, lungs, and brains grow. The lambs even opened their eyes.
The biobag scientists used was temperature-controlled and filled with an electrolyte solution to make up the amniotic fluid. Scientists hope to change the amniotic fluid to something closer to an actual womb as research continues.
Why is this research groundbreaking?
The artificial womb could help premature babies around the world, allowing them to develop lungs and other body parts outside of the mother's body. According to a press release from the Children's Hospital of Philadelphia team that engineered the artificial womb, "about 30,000" premature babies are born each year at 26 weeks old or younger. When a baby is born that young, it only has a 30 to 50 percent chance of survival. The artificial womb could increase those chances. "Our system could prevent the severe morbidity suffered by extremely premature infants by potentially offering a medical technology that does not currently exist," said Dr. Alan W. Flake, a fetal surgeon and director of the Center For Fetal Research in the Center For Fetal Diagnosis and Treatment at the hospital. "If we can develop an extra-uterine system to support growth and organ maturation for only a few weeks, we can dramatically improve outcomes for extremely premature babies."
Why are some people uneasy?
While the reaction to the artificial womb was widely positive, given its potential to save the lives of babies, people are rightly concerned that it brings up an array of ethical questions. Flake addressed some of these in a conference call. For example, Flake doesn't want anyone to believe that this device could actually mimic the creation of life. "There are likely developmental requirements that we cannot replicate earlier in gestation, so we could create developmental abnormalities," he said, according to MIT Technology Review. "We have no interest in creating more survivors with impaired quality of life. That is what we are trying to prevent."
Others, like Dena Davis, a bioethicist at Lehigh University, are concerned that such a device could stress a baby out more. "If it's a difference between a baby dying rather peacefully and a baby dying under conditions of great stress and discomfort then, no, I don't think it's better," said Davis to NPR. Another bioethicist, Scott Gelfand, also has worries that states or employers could use the device in dubious ways. For example, he shared with NPR that states could possibly require women who are getting abortions to put their fetuses in these devices instead, or an employer could use this device to pressure women into skipping maternity leave.
Previous studies and research on artificial wombs brought up other issues. A womb is more than just an environment for a baby; it lets the baby and mother develop a connection. "The maternal voice is heard very well, which probably sensitizes the baby to the sounds of their own language. Amniotic fluid develops the odor of certain foods that women eat, and so there's a notion that cultural likes and dislikes are transmitted to the fetus via the amniotic fluid," said Janet DiPietro, associate dean for research at the Johns Hopkins Bloomberg School of Public Health, to The Atlantic. "So the maternal context provides an environment that goes far beyond the direct circulatory-system connection."
The next steps for the research team include continuing to work on the biobag and make it smaller so a human baby could fit in it. "This system is potentially far superior to what hospitals can currently do for a 23-week-old baby born at the cusp of viability," said Flake. "This could establish a new standard of care for this subset of extremely premature infants."