Artificial Wombs: Exploring the Story of an Emerging Health Technology

By Robert Bernstein

Our last Humanist Society talk was a bit unusual for me to write up. You may understand why when you read on. The title was: Artificial Wombs: Exploring the Story of an Emerging Health Technology. The speaker was Srishti Hukku.

Humanist Society President Judy Flattery introduced this talk on Artificial Wombs by noting these relevant Affirmations of Humanism:

We are committed to the application of reason and science to the understanding of the universe and to the solving of human problems.
We believe that scientific discovery and technology can contribute to the betterment of human life.
We respect the right to privacy. Mature adults should be allowed to fulfill their aspirations, to express their sexual preferences, to exercise reproductive freedom, to have access to comprehensive and informed health-care, and to die with dignity.

Judy then introduced the speaker Srishti Hukku. She is a Kashmiri Canadian who loves exploring ethical, existential, emotional and equity issues. She’s a humanist chaplain.

She serves her community at the University of Ottawa. Srishti is a lifetime member of Humanist Canada, a supporter of the American Humanist Association, Humanist UK, Humanist Australia and Humanist International. She’s also a humanist officiant, providing a range of ceremonies from child adult namings to weddings and celebration of life services.

Srishti is passionate about creating spaces that maximize human potential by leveraging a trauma informed, anti-oppressive healing centered lens.

She’s especially moved by sound public policy. And 2SLG BTQIA+ issues. (Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning, Intersex, Asexual.) Including sexual romantic and reproductive rights and justice. As the first racialized and youngest accredited humanist chaplain in Canada, Srishti is also passionate about immigration, integration challenges, diversity, including disability and neurodiversity. And social determinants of health. She holds a master’s degree in public administration from Queens University.

And is completing a joint PhD in population health and medical anthropology from Macquarie University and the University of Ottawa.

Srishti began her talk by thanking her research supervisors Dr Angel Foster and Dr Lisa Wynn. And her parents who created an environment where she can live “courageously”.

She showed photos of her family to show that Humanists come in all shapes and sizes. Seven generations of Kashmiri residents in her case. She noted that Kashmir is the most militarized zone in the world. Leading to intergenerational trauma. Including losing their mother tongue.

She speaks English and Hindi and her family is Hindu and Christian.

Srishti grew up in San Jose, CA. She showed a photo of herself in fifth grade in a NASA uniform. She became a tech enthusiast and attributes that in part to being in the Silicon Valley.

She was born in India but traveled and lived in many countries. She is a non-conformist on many fronts and has never been pregnant or married.

She thinks community is important and tries to support people in the “Four E’s”: Existential, ethical, emotional, and equity based issues.

Artificial Wombs (AWs) are her real passion. How they relate to health, ethical, legal and social issues. Including the meaning of kinship.

Srishti told us that the magic happens when we step outside of our comfort zone. To gauge our level of engagement, she began by asking us these questions:

Are you ready to step outside of your comfort zone?
Do you like to challenge the status quo?
Do you ever get lost in thought about making the world a better place?

She went on to a “Values Clarification” exercise to help us understand and reflect on why we believe what we believe with regard to the sexual and reproductive health spectrum. She asked us to take notes of our reasons for our answers. She asked us to answer yes or no to the following statements:

Sexual education should only be taught in private households.
Penis and vagina sex is the purest way to conceive.
Contraception undermines family values and the fabric of society.
Natural pregnancy is better than having interventions like a cesarean, also known as a C section.
Pain and childbirth reflects the selfless nature of women.
Surrogacy is exploitative.
Abortion is only acceptable in a rare circumstances.
Adoption is a moral act.
Every child should have two parents.
Using assisted reproduction is playing God.

We then took ten minutes to discuss our answers.

Dave Flattery noted in response to the first question that we don’t say that math should only be taught at home. Parents are not experts.

I noted that “purest” is a religious term. I noted that assisted reproduction is no different from other health care. Except that it has evolutionary consequences. Notably, we are allowing genes to be passed along that will require assisted reproduction in the future.

Srishti asked me if I was suggesting that other health interventions did not have evolutionary health consequences. I responded that in fact many health interventions do have those consequences.

Our newest Humanist Society Board member Gary Noreen ran with the idea of innovative new forms of reproduction as a feature, rather than just as a remedy for problems with conventional methods.

Notably, he believes in genetic engineering. For “intelligent design by humans”. He also noted that his niece doesn’t want to have babies because she has watched too many shows about what can go wrong.

Judy Flattery disagreed with all of the statements and focused on the realities of childbirth from her own experience. She was glad to have an epidural to take away the pain. In contrast to her mother who gave birth in a Catholic hospital. Where they said it is good to suffer in childbirth.

With regard to the two parents question, she said it is better to have one good parent than to have one good and one bad parent.

Wayne answered from the perspective of an engineer: We have only limited understanding of how wombs work. Not sure we can duplicate all of what is going on. He suggested that AI might help.

Ted claimed that statistics support the benefits of having two parents. Srishti in response indicated that it would be interesting to look at the detailed data (with which she was unfamiliar) to see if childhood outcomes are impacted by other factors (e.g., poverty, the devaluation of motherhood, etc.) rather than the number of parents. She said it would be interesting to look further at the data to determine whether a causal link could be identified.

Srishti said that the statement made the assumption that community-based child rearing was not possible or successful, which made it problematic. She also mentioned that sexuality has evolved to include consensual non-monogamy and that may have an impact on the number of parents that is deemed appropriate or desirable. Maybe a whole community is best.

Srishti then offered a list of Reproductive History Milestones on two slides.

Listeners commented on how long these conversations have been going on and how much rights vary on the whims of the different times.

Gary Noreen noted that deformed babies were killed after birth in ancient Rome.

Judy Flattery noted “Stand Your Ground” laws in places like Florida, which allow you to kill someone for invading your space. Isn’t abortion just killing an intruder in your space?

It was now about 3:55PM and the title topic of Artificial Wombs (AWs) was finally raised. Our Humanist talks are usually about an hour, with another 15-20 minutes of discussion. I wondered what would happen next.

Srishti asked the audience what they think of when they hear of an Artificial Womb. I said I think of “Brave New World”.

Gary Noreen said he thinks of the engineering excitement.

Dave Flattery said he thinks of The Matrix people growing in pods. Also, artificial hearts. Not as good as the real thing, but good to have in an emergency.

Romie said she worries about “militarization”.

Evolutionary biologist JBS Haldane published the book “Daealus or Science and the Future” in 1924. It was first a 1923 speech to the Heretics Society. He predicted a future where: “As we know ectogenesis is now universal, and in this country less than 30 per cent of children are now born of woman.”

He predicted that the first ectogenic child would be born in 1951. In fact, no ectogenic child has yet been born. An AW would have to replicate a uterus and placenta.

How is ectogenesis different from an incubator? It would facilitate external gestation (outside the human body) from Day Zero. Sex and reproduction would become separate.

In 2017 Alan Flake and his team published a paper about growing a lamb in a “biobag”. It worked for eight preterm lambs that were extracted at 105-120 days. Equivalent to a 22-24 week human fetus.

But it is partial ectogenesis. The earliest premature human fetus that has survived was at 21 weeks.

Srishti is still working on her dissertation and can’t share all details. She would like to come back when it is done with updated information.

She offered some common fears:

Health concerns:
How will fetal lifespan and health compare to traditional?
What about maternal bonding?
Lactation?
Will lower quality embryos be allowed to survive?

Social concerns:

Will people be pressured to do AW by employers?
Denial of health insurance?
Devalue women or motherhood?
Will there be discrimination?
Will men use it to control women?

Legal concerns:

Will AW limit access to abortion?
Will women who seek an abortion be forced to have their fetus extracted and raised in an AW?
What about parental benefits and leave?
Who will make pregnancy decisions?
What happens if an AW business shuts down?

Ethical concerns:

Equity issues
Moral status of embryo and fetus
Will governments use AWs to create armies or slave labor?
Environmental impacts?

But there is a long list of possible benefits, too.

Health:

Help with infertility
Tokophobia – Fear of childbirth
PTSD
Postpartum depression
Maternal mortality
Drug use or cancer
Fetal surgeries
Gender affirmation
Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome happens in about 1 in 5,000 women. They have no uterus

Social:

Individual autonomy
Family planning options increased
Combat gender norms
Choice for 2SLGBTQIA+
Pay equity
Career flexibility
Reducing domestic violence

Ethical:

Alternative to surrogacy
Potential alternative to abortion

To close the presentation, Srishti asked which society you would prefer from a Humanist standpoint:

Society A in which part of the population bears all of the risks and burdens of gestation and childbirth
Or Society B in which ectogenesis is available and widely used

The rest of the meeting was open to discussion.

I asked about the issue of a state creating soldiers or armies. Srishti wondered whether we could ask ourselves instead why the state would want to take on the burden of child rearing for 10-20 years for when you could be part of an army or slave labor.

Srishti suggested that the other thing that we may want to think about is how much of war is person to person combat versus other types of technologies that do things from a distance. Perhaps the needs of warfare, however undesirable, may shift to look entirely different.

Gary Noreen expressed the view that there is no reason for more than one sex. We could at least engineer men to be less aggressive. In the long run we may become more centered on community than on family.

Srishti noted that infertility is rising, with no known reason.
She noted that half of pregnancies end in a loss now, too. Perhaps evolution is already happening to adapt to our current situation.

Elon Musk and some academics have suggested that perhaps in a colony on another planet it makes sense to use AWs.

She suggests that we don’t need two gametes to reproduce. Parthenogenesis occurs in some other vertebrates and may make sense for humans, too.

Pat Ward said that she has a bias. Women make babies. This technology is all being done by guys and she doesn’t trust them. She also declared regarding abortion that “It is not living until it comes out.”

Srishti said that there are women involved in this work. And that there are not just men and women. Trans people want to reproduce, too.

The discussion finished up at 4:50PM. It is not clear that these questions have any immediate practical urgency. But the discussions were helpful to exploring what we value as Humanists.

Srishti also offered some supplementary pointers. Starting with Self Care support:
888-493-0092 All Options Talkline
888-717-5010 Faith Aloud

She also invited people to check out her web site:
https://www.srishtihukku.ca/

For more information about upcoming events with the Humanist Society of Santa Barbara or to become a member, please go to https://www.sbhumanists.org/