Would you use an artificial womb?
"Artificial wombs..." "Being tested on lambs..." "The future of pregnancy" "Straight out of science fiction..." "I think I was really overwhelmed..." "The birth of human life!" "So, I'm about to go into surgery..."
"I'm not so sure I'm excited for labor..." "AHHH--" Ohhhhkay. This isn’t a normal explainer video… But I don’t actually know that at the beginning.
It all started a few months ago with a Twitter fight about artificial wombs. Basically, Elon Musk tweeted something about population collapse, and then … this investor mentioned artificial wombs… and then someone else asked "why would we want those?” and then the founder of Ethereum said “because pregnancy is a burden on women”… and then all hell broke loose. Some people LOVED this idea, others HATED it. I was skeptical, but I wanted to understand. So I did what I do, I started making an explainer video! [SIGH] But I was about to get a big perspective shift.
And for you to really understand what that was, we have to go back… “The scariest thing that she said was that I might lose my ovary.” This is me finding out - in the middle of making a video about artificial wombs - that I needed to have surgery in order to preserve my ability to have kids. Suddenly the thing I was researching and my actual life collided. "Are you ready?" "Yes" And after all of it, I came to a conclusion that I didn’t expect: I’d totally use an artificial womb.
[Heartbeat] Whaaat! I’m having my mind blown. This is Dr. Jacob Hanna. And THIS is his artificial womb… for mice. “So I definitely see the heartbeat...
Where do I see the head and the legs?” Dr Hanna: "The head is on the other side. So if you look at..." This moment is wild. Dr Hanna and his team have done something that NO ONE has done before… “Until our study, you can grow mouse embryos until what's called the blastocyst outside the uterus.” Nothing new, we’ve been growing human embryos to this early stage since the 1970’s. It’s the basis of IVF, where doctors remove eggs from a person’s ovary, fertilize them with sperm in a lab, and then place the embryo back into the uterus. But Dr. Hanna’s team was focusing on the NEXT phase, when nearly all organs are formed.
What they wanted to know was: Is it possible to do THAT outside of a uterus? “It was always thought that the uterus is absolutely essential to induce the shape and the correct formation of these organs…” But they proved, for the first time, that YES, this critical part of mammal development can happen in an artificial environment. This is a major leap. But this headline is a bit of a leap too… We’re nowhere CLOSE to artificial wombs for humans. For one thing, Dr. Hanna’s study covers just one small part of what needs to happen
to get from embryo to baby. There are other studies - you might’ve heard about this famous one with a lamb. The video is kind of terrifying. “They took it about two-thirds of the pregnancy and grew it a month outside. This is long after the organs were formed, but it is interesting.”
The quest for artificial wombs doesn’t look like one big new technology that changes everything. It looks like the slow movement of science. A few weeks here, a new study there… and we’re only beginning to put the pieces together. I doubt we’ll see anything like this in our lifetimes. And lots of people are juuuuust fine with that… "It's very easy to be led off track by the slightly Matrix nature of this technology..." "Lots of concern for the idea of science being so involved in reproduction..."
"If technology replaces traditional childbirth and reproduction, then who controls its use?" So I’ve been deep in this debate, and it really boils down to whether or not you think this (if we could do it) does more harm or more good. On the side of “more harm," you might think… This is a big distraction. There’s way more important stuff we should be investing in RIGHT NOW to make life easier for parents - parental leave, affordable childcare - and in the US at least, we don’t. Or you might think artificial wombs could be used for terrible things, like to control how people have kids or to breed babies.
"This means you could manufacture children in factories..." Or you might think pregnancy is important and special. We could never replicate that connection with technology, and we shouldn’t try. "If you are frightened of an artificial womb replacing you... we got some competition now!" "There's going to be a dispute about natural birth versus artificial birth..."
Or, on the “more good” side, you might think: Pregnancy is a risk. Childbirth kills 800+ women around the world EVERY DAY. Or, you might think pregnancy holds women back. There’s evidence to suggest the wage gap is mostly a motherhood penalty, and though policy changes could also help change that, technology could help too. Or you might say, bearing children is painful. On surveys, roughly 30% - 45% of women say giving birth was traumatic.
"An artificial womb is like a dream come true. It's almost like magic." "This will change the lives of many people." I feel pretty conflicted.
On the one hand, I think it’s pretty cool that my body could CARRY ANOTHER HUMAN BEING (Probably, I haven't tried). And on the other hand... I think I want biological kids, but… I’m not sure I want to be pregnant. "Push!" "PUSH!" "Keep pushing!" "AHHHHHHHHHHHH!!!!!" I do feel like if men had to, you know, risk their lives and miss months of work and just have more discomfort and do this whole pregnancy thing then we might have more artificial womb research... I don't know. But all of that aside, here what I think most people are missing: This whole debate is framed as “artificial wombs versus pregnancy" when 1) even the most extreme version of this is just as an option and 2) it turns out that artificial womb research is crucial in the near term to SUPPORT pregnancy.
There are three big reasons we need artificial womb research long before the whole "artificial womb” thing: One: We can help more premature babies survive. In my lifetime, look at this, we have taken enormous strides here. To do that, we’re constantly developing new tools and technologies to help moms and babies, like new kinds of incubators and “liquid ventilation.” "If they get born prematurely you could put them into the artificial womb..." "giving extremely premature babies an opportunity to develop their lungs..."
"they could breath the fluid, just like in a mom's..." "could save the lives of premature babies." No matter what you call them, all these technologies are part of the puzzle that's going to help us let babies grow and survive outside of a uterus.
Two: Growing organs for organ transplants. I don’t mean the kind of “Never Let Me Go” style, where you're growing full humans I mean just growing independent organs. Right now, there are 106,285 people on the waiting list for organ transplants just in the US That number has gone up since I last checked it And 17 people die every day waiting for a transplant. But depending on the organ, anywhere from 5-40% will actually reject their transplants. This is the problem that Dr Hanna is actually motivated to solve.
“Let's say I'm a patient that I have a liver disease. One day the dream is that I will give a drop of blood and then make some kind of structure that has liver cells and transplant it back. No need to find donors.
The DNA is completely identical, so rejection cannot happen. So this is the holy grail. This is the idea, this is the motivation...” His research is teaching us about organ development, to get closer to that holy grail save more people’s lives. And three: We still have a lot to learn about human development. It’s hard to study humans, or any mammal, in utero. Yes, we have ultrasounds, and we also have procedures that are invasive and only give us snapshots… but none of this is anything like just being able to watch an embryo develop.
Hold on, let me find some of these pictures... These are zebra fish embryos, which are used in TONS of scientific research for some simple reason: We can look at them! “Because the embryo grows outside the uterus, it just grows in the water.” Now we can do this, for some parts of some mammals' development. That’s huge.
“The uterus for us is a black box. This is very limiting, 'cause we don't know what's happening. We would like to look at the same embryo over time And now that we can do this in you know, just in front of our eyes, outside the uterus, this is possible.” All of this is possible. It doesn’t really matter if we get to “artificial wombs” for humans - Yeahhhhh.
I changed my mind about that. Here’s where things got complicated for me. My mom: "Well maybe some slightly wrong information..." "go over all the points that you've gone over with me..." "I think you really should talk to her longer and again and..."
"it's not surprising, Cleo, this is why..." "I think I was just..." "You heard this scary news, and it was like oh my god!" The scariest thing that she said was that I might lose my ovary. My mom: “This is going to be okay, even if you have surgery." Yeah.
“Did you need me to say that? I will say it again." I... Thanks, Mom. I did need to hear that. Thank you. I did not really want to be on camera right now... So I went to the doctor today.
I had about a month ago... I had a very severe pain in what, like, I would call my stomach, but a little bit lower, like my uterus. It was very very severe, like I was lying on the floor for half an hour The next day I got in to see a doctor and they took a transvaginal ultrasound.
It's not the cute kind where you're about to have a baby and you like have the gel and you put it on your stomach. They stick something up into you. And then they look around.
And what they saw was that on my left ovary, I had a bunch of cysts. Usually these things go away. So they said come back in a month to six weeks.
So I went to this doctor today, and she found that I still have a bunch of cysts on the left side. Right side looking great. Good job, this guy over here. This... gal, they're probably gals… This one's doing great.
This one, not so great. What she thinks is happening when I'm having that pain is that because my left ovary is a little bit heavier because of these cysts, it's twisting slightly She was very worried that if it twisted too much unexpectedly, that I could stop the blood flow to my ovary and I could lose my left ovary. And so she recommended that I have surgery, sooner rather than later. God, I hope this works out.
Um, you're just watching me cope, basically. You're watching me have a health problem and then try and make an explainer. All right. I will report back later.
So, it’s later. And I’m having surgery tomorrow. I got the pictures from my doctor, if you wanna see them... but you can actually see there are two different kinds of cysts That cyst is 5 centimeters in diameter… which is… it’s 6.3 inches in circumference. I was imagining these things WAY smaller! Actually, hold on a sec...
I just wanna know what I'm talking about here... This is 5.5 inches. What the [BLEEEP]?? I have one cyst that's slightly larger than this, and one cyst that's slightly smaller...
both on the same side on my ovary, here. I don't have room for this!! So tomorrow, they're gonna remove these and that's gonna stop my ovary from twisting. They’re going to go in laparoscopically which means they're gonna go in through my belly button and three incisions that they're gonna make...
They seem large to me but they're small for surgery, they're gonna be about 2 inches I’m gonna have some scars from this. And in order to see what they’re doing, they’re going to blow me up like a balloon. (Don’t google this. You don't need to see this.) Then they're gonna remove the cysts and when they're done they're gonna deflate me. I'm not looking forward to this.
But I also don’t want to lose my ovary. So. I’m about to go through something pretty painful in order to preserve for my ability to bear biological kids. Women go through this all the time. Right now as I’m recording this, someone is making a much harder decision about their health in order to preserve their ability to have kids. And, I gotta say having even just this happen to me puts into perspective any technology that could help. Here we go.
So I’m about to go into surgery… I've never had general anesthesia before so I'm feeling kind of nervous but I know what's gonna happen and it's gonna be fine. "Are you ready?" "Yes." Look at all my gadgets! Everything's fine, it went really well! Hi. So it's two weeks after surgery and I’m ok! I'm definitely feeling sore I am walking like an old person still but I feel pretty good. I mean, modern medicine is amazing. I’m also really lucky.
I needed this surgery, for my health and for my future ability to have kids. [SIGH] I also learned a lot. I didn’t really understand how scary it would be to be told that your chance of getting pregnant was at risk.
I think I probably said I didn’t even know if I want to… “I’m not sure that I want to be pregnant…” Now I know that I want the option. I caught a glimpse of how devastating it would be to be told that you can’t. And people go through that all the time. Also… I just went through a not-so-insignificant surgery… and a not totally insignificant amount of pain...
for the potential privilege... for a lot more pain later!! Like... !!! Pregnancy is incredibly hard. And we humans have it particularly bad. We walk on two legs, so we have narrow hips.
We have large brains, so we have huge heads. For us, giving birth is a painful, medically complicated process. "Labor is nothing like you've ever experienced!" "My labor at the end of the day was 43 hours long" "So I had stitches going out from here this way..." "My stomach is still, the skin is still stretched out it looks like crepe paper" "From the moment I set foot in the hospital it was my worst fear come true." "My hair loss! Oh my goodness! I'm surprised I'm not bald yet..." And because I know this, you have to also: 2-8% of women tear from one hole to the other.
What the *BLEEP*! If you get pregnant yourself, if you adopt, if you use surrogacy... it doesn't matter, SOMEBODY has to go through pregnancy in order for a new kid to exist. That can be beautiful.
And it can be brutal. I’m in awe of people who have had kids. We talk about this as though it’s normal but… it’s superhuman! I don’t think it should have to be.
I know that I want the option, but I think that’s what it should be, an option. The idea that the only thing between us and a dystopian baby-breeding future is the physical discomfort of millions of women a year… Like... really?? There's isn't any other way we could, you know, NOT DO THAT in other ways, or stop it from happening? Really?? Again, if this were men... ??? !!
We use technology to reduce risk and pain all the time. We set impossible goals. I mean, we sent humans to the MOON. Where is the moonshot to make it easier to have kids? I’ve come to think we need one… Yes, for all the benefits the research can provide in the near term… AND for a vision of a future where our kids, or maybe their kids, might have more options, and less risk, and less pain. We’ve been here before. IVF was extremely controversial.
The Vatican called it immoral. Some in the US government tried to constrain it to “lawfully married couples.” A member of the British Parliament said it opened up “Hitlerian” possibilities. But when I was doing this research, I found - hold on - I found this quote from a doctor at the time that really clarified things for me: He said: “There is an obligation to relieve suffering when the means to do so are available, or in the absence of the means, to search for the means.” I think we should do that.
I think we should search, and keep searching.