Throughout human history, every single one of us has been born from a person. But that is about to change. It is claimed we are within ten years of developing an artificial womb, raising the possibility that having children could take place without pregnancy or childbirth. In this interview, Claire Horn discusses the pressing legal, social, and ethical questions that arise from this radical innovation, and offers a compelling blueprint for the way forward.
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A natural parallel to this upcoming technology is the birth control pill, which some credit as catalysing huge shifts such as the sexual revolution, the transformation of the traditional family and workplace, and paving the way for gay rights. What changes do you think the artificial womb might catalyse in our society?

While writing Eve I thought about the parallels between the artificial womb as promissory technology (a technology that is in development but doesn't exist yet), and other technologies of reproduction that were once promissory, such as the contraceptive pill, IVF and medication abortion. What they all have in common is that, when they were in development, they were heralded as big game changers for family making and women’s autonomy. But in actual fact, many of those technologies were absorbed into the existing legal framework and regulatory system, rather than revolutionising them. That doesn't mean that they didn't catalyse social change, but there was a kind of limitation around what was possible because it was within this existing, imperfect, social context. And that's the argument that I make in Eve: ectogenesis (the development of a foetus outside the uterus) certainly has the potential to change crucial facets of family, reproduction, and what it means to be a person. But we need to look at the social context that curbs the possibilities that are inherent with this technology. Having said that, I do think it is important to imagine: what if there was a world in which, for instance, the aims of reproductive justice have been realised? What if from that place we could imagine how this technology could be used in interesting, compelling ways?

This tension between hope and concern is really prominent in Eve. In your book, you pose the question “why is it so much easier for people to imagine a world where artificial wombs lead to dystopian authoritarianism than a feminist utopia for communal childrearing?” In the media, we see time and time again the headline ‘Brave New World’ when discussing artificial wombs. What about contemporary society makes us so inclined to evoke dystopia?

The context from which people are speculating is really important here. When we look historically and even in the present, there are some unjust, horrific ways in which new reproductive technologies have been used. For women, particularly black and indigenous women, new reproductive technologies have often been used to cause harm. And so appreciating this historical precedent means it is entirely reasonable to discuss the problematic and dangerous ways that artificial womb technology could be used.

On the other hand, however, I think there is a lot of anxiety among those who benefit from a patriarchal society. In bioethical literature, you do often get these articles, mostly from men, proposing that artificial wombs would mean the end of abortion. Even as they're saying those kinds of things, they're also filled with anxiety about the possibility that there could be liberatory uses of this technology. They’re worried that some women might actually want to circumvent pregnancy, and simply say that they would rather use an artificial womb. And I think some of this continual evoking of Aldous Huxley’s world, over and above radical feminist ideas, is also to do with this kind of patriarchal grasp on gendered bodies and quelling voices who might preface the potential dangers of this technology, but also dare to dream how it could be something different.

On the topic of abortion, which you dedicate an entire chapter of your book to, what would the implications of this technology be for this area of reproductive rights? What do these bioethicists mean when they say the artificial womb could ‘solve’ abortion?

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Many of these commentators are approaching abortion as a moral issue that requires a solution. I fundamentally differ from this view because I don't think that abortion is a moral problem.

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In the first instance, many of these commentators are approaching abortion as a moral issue that requires a solution. I fundamentally differ from this view because I don't think that abortion is a moral problem. I think it is a form of health care and a human right. So there's a fundamental divergence there. But as it stands, the moral argument for abortion is that for someone to remain pregnant against their will is egregious and it undermines their bodily autonomy. And so we allow for the termination of foetuses, which they frame as a moral ill, because the enforcing of pregnancy would be a more significant moral ill. From this, they propose that an artificial womb could resolve the debate between pro-choice and anti-abortion because it will allow the foetus to be gestated externally, and therefore to survive without impeding the pregnant person's bodily autonomy.

This premise, whilst concerning for people who don’t want to be forced to bring their genetic offspring into the world, is surely also hugely impractical - buying into this ‘solution’ only throws up more issues, such as who are the legal parents of the resulting child and who is responsible for its care, so it quickly becomes unviable. Yet this technology would still fundamentally undermine most abortion policy, which rests on foetal viability. In the UK, abortion is only allowed before 24 weeks because that's when a foetus can survive outside the womb. But in theory, successful ectogenesis would mean that the foetus could survive from a very early stage, maybe even from conception. Contrary to the proposed ‘solution’ to abortion using artificial wombs, this technology might force the legislation itself to change - legislators might have to acknowledge the pregnant person’s rights, as opposed to weighing this moral dilemma, as you say.

I think you're totally bang on; while some bioethicists conclude that the artificial womb will challenge abortion legislation such that abortion is no longer permitted, from my perspective the conclusion they're actually pointing to is that abortion legislation is outdated and insufficient to protect people. So I think that what this technology and this discourse really brings to light is that these kinds of laws are just not fit for purpose anymore.

This technology has far-reaching implications beyond reproductive rights; how might the artificial womb impact the gender pay gap and women's economic standing?

I think what we're talking about is a problem of social policies. In the vast majority of cases, the person who isn’t gestating, and especially fathers, tend not to get time off work, creating a real imbalance. That is very gender biased, and in Eve I do discuss the ‘motherhood penalty’ for women in the workplace. And there are still so many issues around insufficient leave, both for the person that is gestating and for any other partners that are involved. And there is currently an implicit expectation that if you are a mother, you will shift into this space where your role is to, by default, care for your children. To give an example from my own life, there is currently a massive childcare crisis where I live in Canada, to the extent that my family is on waitlists for about ten daycares in the city and there are no day-care spaces. And the default implication is that there is a mother at home who is going to take on that labour. And similar crises are occurring all over the world; these are massive failures of social policy. All to say that an artificial womb, unfortunately, would not pose a solution to those problems of social policy. Having said that, again, I think it's important to leave space for imagining - what if we were to address these social problems? Could we then have a situation where the technology could be used in ways that diversified what was possible within a family? So, for example, could artificial wombs enable a baby to be gestated by a family on the whole, or by a community or several friends? I think it's interesting to still imagine that possibility.

This notion of technology ‘leapfrogging’ political reform comes up a lot in Eve; you yourself clearly come down on one side of the argument, but some radical feminists differ, arguing that we can’t expect these reforms to happen because of the societal structures, namely capitalism, that we exist in. For these thinkers, the artificial womb is a possible radical intervention necessary to force change in society. What’s your perspective on this revolutionary thinking?

I wouldn't put myself in the category of someone that is necessarily idealistic or optimistic about political reform. I talk a lot in Eve about social problems and the insufficiency of the status quo. And yet I wouldn't say that I necessarily believe that the way to address those problems are changes to law or policy. If anything, for instance, in the area of abortion, what we actually need is less law. There does not need to be a law on abortion.

Shulamith Firestone, a feminist and Marxist, was one of the most radical and prominent thinkers on the topic of the artificial womb; in her 1970 The Dialectic of Sex, she argued that the “tyranny of reproduction” was the root of women’s oppression and that eradicating pregnancy was necessary for emancipation. But she also does caution that, in the contemporary context that she's writing from in the seventies, it isn't feasible to imagine an artificial womb that's actually liberatory because of the condition of science at the time being incredibly patriarchal and misogynistic. I think she is calling for a revolution before technology can do these incredible things.

Having said that, I'm still really interested in the ways that even as technologies are co-opted into existing frameworks, there are also always these other paths that they take. So we're seeing this with medication abortion and the way that it is shared around among activists. And you also see it with technologies of fertility. So for instance, in the US, there are some activist groups where you have people that work in health care settings, midwives and nurses and folks that work in fertility clinics who are then taking those technologies to their communities to experiment with how to safely use them outside of those settings. So there are often simultaneous uses of new technology.

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it will benefit every single person of every gender if we stop perceiving pregnancy as something that is solely the property of women.

There has been some discussion on the implications this technology has for the meaning of womanhood, and for the sex/gender debate more broadly. Australian sociologist Robyn Rowland argued that artificial wombs would spell the end of women's innate power: “if that last power is taken and controlled by men, what role is envisaged for women in the new world? Will women become obsolete?” What’s your take on this opinion?

I think that commentators that write from that viewpoint are so invested in the idea of this ‘fundamental truth’ that there are only two sexes and only two genders, and as a result, they’re concerned that these new technologies will shatter those binaries. And I think that it's an argument that falls apart at its face because it's not true that there are only two sexes and two genders, and it's been the case for a long time that trans people, non-binary people and genderqueer people can also become pregnant. And then this idea of motherhood as an essential power is super reductive. There is a huge range of experiences of motherhood and pregnancy. There are families where the primary caregiver is not a person who gestated the child, and there are so many different relationships of mothering that have nothing to do with gestation and birth. So I think that it kind of falls apart in that sense. And it also just really undermines the many experiences of people for whom pregnancy or motherhood is not empowering. Rowland's arguments are of a particular time. And I think we need to move on from them.

What do you think of Rowland's argument that a monopoly on pregnancy gives women a “bargaining chip” under patriarchy?

Within many contemporary societies, pregnant people are subject to intense cultural scrutiny, and so actually I would argue that it's quite the opposite. Often a person's autonomy is incredibly subject to being undermined when they are pregnant. That's not to say that pregnancy can't be an empowering experience. I think there always needs to be room for that, but it's certainly not a universal truth that it grants people power, or translates into real social capital. I strongly believe that it will benefit every single person of every gender if we stop perceiving pregnancy as something that is solely the property of women.

Your personal experience of pregnancy is woven throughout your book. As you said, a lot of the discourse around the artificial womb is often very detached from the real experiences and views of people who would have use of this technology, and how it might affect their experiences of childbearing and childrearing. If you had access to an artificial womb, which carried the same risks as biologically gestating a child, do you think that would have changed your experience of pregnancy?

Yeah, probably. And I liked being pregnant for the most part. But certainly, as a cis heterosexual woman, when my partner and I decided that we wanted to have a baby, there was no question that the way that we would try to do that is for me to become pregnant. Again, if we are imagining from an uncomplicated setting in which none of the issues that I lay out in the book exist, and it is just a decision of whether you want to be pregnant or whether you want to use an artificial womb, it would be a different kind of conversation, where the intensity of the experience of gestating is very explicit. Do you want to take on all of these drastic physical and psychological changes? For better or for worse? Or do you want to try using this technology?

The element of risk is interesting as well, because there is this tendency, certainly in the bioethical literature, to create this false dichotomy of human pregnancy as inherently risky and then artificial gestation as this safe alternative, when in fact, neither of those things would be without risk. It's just that the risks would be different.

In Eve, you say that “scientific progress frequently outpaces our regulatory systems and even our imaginations.” You make the urgent case for social reforms in the book. But, as we’ve seen in the case of CRISPR, science will march on, reforms or not - do you think we can ever truly be ready for innovation like this?

I don't think we can ever be fully prepared because you can have the best-laid plans, in terms of having a public engagement and sort of sitting down and thinking out the problems that are to come and how we would address them. But for one thing, there will never be collective agreement on these issues, so there's the question of who gets to decide what those kinds of reforms look like. And then also there are independent and unpredictable agencies at play here. So for instance, in 2021, Elon Musk and a cluster of other tech billionaires had this very casual discussion online on how they should fund ‘synthetic wombs’ to make pregnancy easier for women and to address problems of declining fertility. And so this shows that you could have the best intentions of having a coherent approach to governing these technologies, but then you have a Musk that decides to fund a private tech firm that has other plans. And so we're also dealing with a situation where globally there are really different laws and policies in place around what constitutes an ethical approach to the development and use of these kinds of technologies.
Once the ball has gotten rolling in terms of technological development, I don't think you can just put a lid on it; we're living in a world where if it doesn't happen in one context, it will likely happen in another. We can be better and worse prepared, but that preparation can only be partial.

The transcript of this interview has been edited for length and brevity.