It seems as though extra-corporeal gestation (or ectogestation) no longer exists only in the realm of science fiction. As the technology becomes more advanced, the possibility that the future of human reproduction will take place in an artificially created environment becomes ever more likely. To get a head start on some of the theoretical difficulties and questions that ectogestation may give rise to, in April 2024, we organised a two-day interdisciplinary conference, with funding from the Future of Human Reproduction programme at Lancaster University. We invited speakers from different backgrounds to create opportunities for detailed discussion about a number of important implications of ectogestation. The starting point for our conference was the metaphysics of pregnancy: this is an area of Philosophy concerned with understanding the connection between gestational agents and foetuses. We wanted to consider the impact that our metaphysical understanding of gestation has for the way we understand reproductive technologies of the future. Such theoretical commitments can influence ethical assessments, and so we also looked at the normative implications of this technology, as well as what artificial gestation environments might eventually look like.

What is the Metaphysics of Pregnancy

One of the main motivations behind the conference was to consider how metaphysical discussions of pregnancy impact other philosophical conversations. We were especially interested in reproductive technologies, particularly ectogestation, with a focus on the normative and ethical implications of such technologies, as well as how they impact our own conceptions of pregnancy and gestation too. So, what does the metaphysics literature say about pregnancy, and why is this important?

There are two main framings of the way in which pregnant people and foetuses are related to each other: the container model and the parthood model . The first of these states that the pregnant person and foetus are metaphysically separate entities; that the foetus merely grows within the body of the pregnant person, but that there is no further connection than this – the foetus is, as it were, a ‘bun in an oven’. The parthood model of pregnancy, on the other hand, states that the foetus is a part of the pregnant person, rather than merely contained within. They are connected through the umbilical cord and placenta, which creates a topological connection (or a shared internal boundary) between them – in the same way that your organs are connected to the interior of your body.

So why is this important, and what does it have to do with ectogestation? The metaphysical model of pregnancy that we choose can influence our thoughts and perceptions about gestation generally and, by extension, reproductive technologies including abortion, surrogacy, and, of course, ectogestation. For instance, since ectogestation relies on the gestation of the foetus outside of the womb, it appears that this technology builds on the container model of pregnancy. There seems to be the assumption that gestation can occur entirely externally, and that a separation of gestational carrier and foetus may not be detrimental to the overall continued development of the foetus. On the other hand, a supporter of the parthood view would perhaps hesitate when it comes to suggesting that gestational processes can be completed outside of the womb in this way. For, on this view, external gestation would disrupt the physiological closeness of pregnancy which the parthood model places so much emphasis on. It is, of course, important to note that at the moment, only partial ectogestation is a scientific possibility, and it is not clear whether full ectogestation, where the entire process of gestation from fertilisation to birth takes place externally, is or will ever be, a scientific reality. Having a comprehensive metaphysical understanding of pregnancy is crucial to evaluating the future of human reproductive technology.

What are the Metaphysical Implications of Extra-Corporeal Gestation?

Our conference also aimed to assess what the implications of the metaphysics of extra-corporeal gestation are. It was important for us that discussion of the normative implications of extra-corporeal gestation form a strong basis in our conference, as these implications will obviously have an impact on the future practicalities and the ethics of using extra-corporeal gestation, particularly if full ectogestation becomes a reality. My own talk focussed on how the metaphysics of pregnancy especially impacts certain normative assumptions we may hold about gestation and gestative technologies: for instance, that the assumptions that we may make about gestation and the future uses of extra-corporeal gestation are entrenched in certain metaphysical preconceptions.

The way that we talk about full ectogestation as a possible future reproductive technology seems to imply that we think that the pregnant person’s role in gestation can be replicated (or taken over) by a machine, and furthermore that this separation may have minimal to no impact on the human gestator/gestated. Of course, this technology is still in the very early stages of development. Indeed, as Suki Finn and Sasha Isaac note in their paper Evaluating Ectogenesis via the Metaphysics of Pregnancy (2021), the fact that full ectogenesis may never actually be a reality, precisely because there exists a connection between gestator and gestated that cannot be replicated externally. Considerations such as these are extremely important when assessing the future of human reproduction, as they may seriously change the way we view pregnancy and what it means to be gestated and have knock on effects on legislation which governs the use of reproductive technologies.

Our Conference

Our conference was structured into five 90-minute sessions, including a commentary, which allowed for detailed discussion of these areas of interest. The commentaries from Teresa Baron, Katherine Furman, Mary Donnelly, Claire Pierson, and Thomas Schramme helped to provide further depth to these conversations as they provided different perspectives and aided discussions with the audience.

Our goal was for the conference to reflect a wide range of disciplines, particularly in terms of the different impacts of ectogestation, and to widen the discussion of what we consider the most significant aspects of this conversation. It was therefore important for us to invite speakers from a wide range of different disciplinary backgrounds. The sessions considered the implications of this technology from different angles including bioethical, legal and political. This allowed for in-depth discussion of how ectogestation is predicted to change certain discourses, such as outlining the importance of maintaining realistic expectations when discussing ectogestation, as well as clarifying conceptual distinctions to elucidate legal positions. It was also illuminating to see how assumptions about gestation and birth in these areas of philosophy are influenced by metaphysical commitments, something which was noted by the speakers and featured prominently in discussion.

The first day began with a talk by Megan Rawson: Normative Implications of the Metaphysics of Extra-Corporeal Gestation which acted as an introduction to ectogestation, the metaphysics of pregnancy, and the metaphysical implications of such a technology. Following this, Seppe Segers (Ghent University) delivered a talk entitled: Current Debates in the Ethics of Ectogestation: Mortality, Morbidity and Speculation, which provided great insight into speculative / realistic implications of ectogestation, how we decide what the realistic implications are, and how this steers our view on moral relevance. That afternoon, we considered the link between science fiction literature and ectogenesis. The University of Liverpool is home to Europe’s largest collection of Science Fiction material: The Olaf Stapledon Collections - Special Collections and Archives. Since the history of understanding and picturing ectogenesis is so heavily intertwined with science fiction and speculative fiction, we felt it would be a great opportunity to include a tour of the collection with the help of Tom Dillon, the University of Liverpool’s science fiction curator, and Anna McFarlane (University of Leeds) who works closely in considering the crossovers between science fiction literature and medical humanities including reproductive technologies. They gave us a wonderful tour of the collection, showcasing several of the works archived there, and talked us through the importance of each in shaping our perceptions of extra-corporeal gestation. Anna even encouraged us to have a go at writing our own speculative fiction!

The second day of the conference included talks by Elizabeth Chloe Romanis (Durham University) on Gestation, Pregnancy and Birth, and Victoria Adkins (University of Greenwich) on Partial Ectogestation and Unexpected Contributions to the Existing Medicalisation of Pregnancy and Childbirth. These talksexplored the legal and political dimensions of what the use of ectogestation technology means, and how discussions on the metaphysics of pregnancy influences legal and political discussions of reproductive technologies like ectogestation. Our final talk of the conference ‘Designing Ectogenesis’ came from Andrew Darby (Lancaster University) . He explored what ectogestation might look like in the future, and what it looks like as of now. This was particularly interesting following the discussions we had had about the influence science fiction has had on these type of perceptions. Andrew helpfully walked us through this topic, providing a detailed understanding of current technologies used for partial ectogestation, including incubators for extremely premature infants, and biobags, and how these technologies may be used to continuously push the boundaries of viability. Andrew’s talk provided an insightful look into how these types of technology are currently used and how they are likely to be used (and designed) in the future and ended the conference in a thought-provoking way.

Goals and Outcomes of Our Conference

The conference was a great success; the presentations were detailed and provided nuanced discussion of a complex and, at times, difficult topic. We felt as though a wide range of disciplines and ideas had been represented, and that, by the end of the conference, the future of understanding ectogestation from a metaphysical perspective was certainly clearer. We created a space of interdisciplinary community for scholars working on the philosophical, legal, and social questions raised by ectogenesis to consider a familiar topic from new perspectives, and we are now working towards publishing a co-authored monograph with the aim of sharing the findings of our conference with an even wider audience.

The Future of Reproductive Technology

Radical changes to the way we understand reproduction and gestation may be less distant than they seem. It is our belief that ironing out conceptual difficulties and clarifying concepts relevant to ectogestation is the first step towards realising its full potential. To do this, we must have a clear grasp on the metaphysics of pregnancy, particularly what it means to be pregnant, what it means to give birth, and how important the gestator-gestated relation is. The ethical, legal and political aspects of ectogestation are heavily linked with these metaphysical questions and must be considered carefully as ectogestative technologies become more technologically advanced, and before human reproduction changes forever.

Related Blogs

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  What’s Literature Got to Do with It? How Literature Shapes Our View of Reproductive Technology

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  In Vitro Gametogenesis (IVG) – What Issues Does It Raise? Video recording and transcript

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  Science Fiction and the Futures of Human Reproduction

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