I have definitely felt like an ectogenetic gestator. I have had to lie back while a 20cm needle was plunged into my belly so doctors could extract my son’s DNA because something on a scan made them think he might have Down’s syndrome. (He didn’t, but then I got appendicitis.) I have had to stop myself from gagging while forcing down a cloying glucose concoction because a late scan of my daughter showed I might have gestational diabetes. (I didn’t.) I have had to lie with my legs clamped apart while a surgeon stitched up my cervix because a scan showed I was at risk of going into another early labour. Being pregnant is a remarkable experience, and I loved carrying my first child, but I have never felt more like a thing, being acted upon purely because my very dedicated doctors knew too much about what might be going on inside me.

Smajdor was “not very surprised” when she saw CHOP’s lambs. “Those people were clever in their – ” she chooses the word carefully – “marketing. And, of course, being unwilling to talk about ectogenesis is part of the PR approach.” Instead of pouring resources into saving premature babies, she says we should be growing them in artificial wombs from the start, “because it’s a trauma for the foetus, being removed from the uterus, even if it then goes into a Biobag and survives”.

Smajdor uses provocative ideas to raise difficult questions. It works: she has made me think about how messed up our notions of what “normal” childbirth, pregnancy and motherhood are.

If perfect ectogenesis could ever exist, there is a long list of women who would want to use it: women with epilepsy, bipolar disorder or cancer, for whom pregnancy would mean risking either their own or their foetuses’ lives by stopping or starting medication; women who have had their wombs removed for medical reasons. Ectogenesis will also help women in circumstances much less likely to attract public sympathy: social surrogacy clients and older women, whose male equivalents have babies without a thought. You could conceive an embryo while you’re young and grow it in a bag after you retire.

But perhaps the people most likely to be emancipated by this technology are those not born female: single men, gay men and trans women desperate for their own biological children. I ask Smajdor about the benefits of ectogenesis for them.

“I don’t support anyone’s right to have a child. I support people’s right not to have their body interfered with.” Then she leaves the world of philosophical logic for a moment. “Assuming we could get perfect ectogenesis, it seems like a thing we should do, in a fully just society. The problem is that our societies are not fully just. In a society that believes natural reproduction is the most amazing part of a woman’s life, ectogenesis is going to be very problematic, and more likely to be used in ways that are detrimental to women. ”

“What kind of ways?”

“When we talk about rescuing very premature babies, there’s a risk of a desire to rescue babies because their mother is not fit to carry the foetus,” Smajdor says. Across the world, inappropriate behaviour during pregnancy is increasingly viewed as child abuse. Since the 50s, dozens of US states have prosecuted women for using drugs while pregnant. If you can save a baby from the dangers of premature birth, would you not be prepared to save it from a reckless mother?

It’s easy to imagine a future where the kind of “help” already offered by employers in Silicon Valley and beyond, enabling staff to freeze their eggs so they can focus on their careers, might include the option to grow their babies in an artificial womb. Using a real womb, inside the body, could ultimately become a sign of poverty, of chaotic lives, of unplanned pregnancy, or of being a borderline-dangerous “freebirther”, choosing to have a baby without any medical input.

The greatest existential threat faced by unborn babies today doesn’t come from women “unfit” to be pregnant, but from unwilling mothers. Once a woman’s body is no longer the incubator, abortion can be both pro-choice and pro-life. In the ectogenetic future, foetuses aborted by mothers who didn’t want them to exist could be “rescued” and adopted. In that world, some women might seek out backstreet abortions that would end their babies’ lives, rather than legal ones that would allow them to live. It’s a horrifying thought. But it could happen if the foetus’s right to life trumps that of a woman to refuse to become a mother.

Artificial wombs will be an incredibly powerful new technology. How that power will manifest itself depends on who is demanding, making, controlling and paying for the technology. Once IVF became mainstream, research into treating fertility problems such as blocked fallopian tubes all but stopped. Why bother, if the problem can be circumvented by assisted reproduction? The same could happen with research that makes it easier and safer for women to have babies without being sliced, probed and torn. What’s the point, if the solution is already there?

Women gain so much more than we lose by bearing children: the creative power of being a mother, the right to choose whether to become a parent at all. Can the freedom to have babies without being pregnant be worth sacrificing any of this?

Full ectogenesis will not exist for decades, but artificial wombs are coming. We need to ensure that, when they do arrive, it’s in a society that values women for more than just their reproductive capacity, and that they are put to use for the benefit of people who can’t be pregnant for biological rather than social reasons. We do still have time. But the race to innovate means maybe not enough.

“This certainly is a project that would have sounded more like science fiction,” Emily Partridge says at the end of the CHOP video. “But over three years of doggedly pursuing it, it has become very real.”

This is an edited extract from Sex Robots & Vegan Meat: Adventures At The Frontier Of Birth, Food, Sex & Death, by Jenny Kleeman, published on 9 July by Picador at £16. 99. To order a copy for £14.61, go to guardianbookshop.com.

Little Nastya was born on Epiphany Eve. While the baby is sleeping, Evgenia's mother tells what a miracle the birth of her third child was for her.

“It was hard, hard and scary. You think in your head that the case is really unique, they barely survived, ”says Evgenia Baturina.

Evgenia did not know that she was pregnant. When she felt severe pain in her stomach, she went to the antenatal clinic at the place of residence, in Boguchar. The doctor diagnosed pregnancy, and, to the surprise of the future mother, the 34th week. The woman was admitted to the hospital, but the pain began to intensify. Doctors also could not determine the position of the fetus. And they decided to urgently hospitalize the pregnant woman in a perinatal center in Voronezh.

“She was transferred to us with a different diagnosis and impaired blood flow in the fetus. We didn't prepare at all. We found out that she had such a pregnancy during the abdominal excision, ”said Galina Nikonova, head of the obstetric remote center of the Voronezh Regional Hospital.

What the doctors saw during the operation was shocking. The almost fully formed fetus was not inside the uterus, but outside. The placenta attached to the appendages without damaging the vital organs. All this time the child developed normally. The emergency operation lasted an hour and a half - not much for such a difficult case, and the doctors performed it flawlessly.

The baby does not yet know how unique she is. But now she is already being cared for in the usual way, like all the other babies in the perinatal center.

Two kilograms one hundred grams - the baby was born at the 38th week of pregnancy. Five days of resuscitation monitoring with light respiratory support, then another week in the therapy department, and it became clear to the doctors that the child could be transferred to the ward with the mother. Today, their health is no longer a matter of concern to doctors.

“Statistically, 50% of these children are definitely born with some kind of anomaly. The fact that an almost full-term baby was born here, without any violations, this will probably be an isolated case in world practice, ”said Tatyana Gushchina, head of the obstetric department of the perinatal center in Voronezh.

There are only 17 such cases in the world when healthy babies were born. After all, an ectopic pregnancy is dangerous for both the mother and the child.

“Fertilization does not take place in the uterus. It takes place in the fallopian tube. For some reason, the fertilized egg fell out of the tube and stayed where it was not supposed to live, ”says Galina Nikonova, head of the obstetric remote center of the Voronezh Regional Hospital.

“A unique rare case. A fetal egg can attach to the liver, spleen, ovaries, intestines, and peritoneum. And, of course, delivery is very dangerous, because it threatens with great blood loss, ”says the head of the Institute of Obstetrics. Kulakova Roman Shmakov.

As a result of the operation, the doctors were able to save not only the life and health of the child, but also the reproductive functions of the mother. Now they are being prepared for release. At home in Boguchar, little Nastya is waiting for a large family: Evgenia has a son, an adult daughter, and even a grandson has already appeared.

"Real miracle". A resident of Voronezh was able to bear a child outside the uterus | HEALTH: Medicine | HEALTH

02/06/2020 00:09

Faina Mania

Approximate reading time: 7 minutes

13435

A 38-year-old woman was unaware of her situation for a long time / Faina Mania / AiF

Voronezh doctors performed a unique operation - a child born outside the uterus was born in the perinatal center of VOKB No. 1. A 38-year-old resident of Boguchar, Voronezh Region, Evgeniya Baturina , unaware of anything, carried the baby in the abdominal cavity. At the same time, the girl, who was named Anastasia, was born completely healthy. This case is considered unique even by world standards.

AiF-Voronezh talked to the happy mother and the doctors.

"One in a Million"

According to the world statistics, the development of a child in the abdominal cavity occurs in approximately 0.4% of cases of ectopic pregnancy. In this case, the outcome is almost always unfavorable - the fetus does not survive under these conditions. Such a pregnancy is extremely dangerous for a woman. Maternal mortality reaches 20%.

Interestingly, for a long time Evgenia had no idea about her situation. As soon as she felt pain in her stomach, she went to the doctor at the Boguchar district hospital. Evgenia Baturina found out about her pregnancy at the 34th week. At the same time, ultrasound did not show that this was a very difficult case.

“When a woman sees a doctor at a short term, of course, first of all, it is checked whether this is a uterine pregnancy or not. In this case, the woman applied for a long time. Uzist saw a large fruit. I think he could not even imagine that a child could reach such a size while outside the womb. So it is impossible to blame the doctors of ultrasound diagnostics for not making a diagnosis right away. After all, they faced a one-in-a-million case. Yes, it was a fetus that was essentially "nowhere", just in the stomach. And if they found out about this at a short time, then, of course, they would not continue the pregnancy. Nature is such that pregnancy cannot develop outside the uterus. The fact that in this case the child grew up to 36 weeks and was born alive and healthy is a real miracle,” says head of the remote obstetric advisory center VOKB No. 1 Galina Nikonova .

The fact that the pregnancy was ectopic was already known on the operating table during the caesarean section. The woman was transported to Voronezh from the district hospital for a completely different reason.

“She was admitted to the Voronezh perinatal center at the 36th week of pregnancy. The fetus was in a transverse position, the woman complained of pain. Soon it became known about intra-abdominal bleeding. It was impossible to leave her in the district hospital. It was decided to urgently transport the patient, notes obstetrician-gynecologist of the perinatal center VOKB No. 1 Tatyana Gushchina . - What kind of diagnoses we did not put on her in absentia - starting with placental abruption and ending with uterine rupture. But that we are talking about an ectopic pregnancy, we could not even think. The patient arrived in Voronezh in a condition close to critical. And only when we started the operation, it became clear what we were dealing with. The situation was out of the ordinary. It was necessary to act quickly. A team of qualified doctors was urgently assembled. In total, 11 people participated in the operation, which lasted an hour and a half. A great role in the fact that the operation was successful was played by the coordinated work of all the staff of the perinatal center. As a result, late in the evening on January 17, a healthy girl Anastasia was born without any deviations, weighing 2150 grams and 46 centimeters tall. Mom is fine too. In addition, the woman also has a fertile function.

“There are only 17 such cases worldwide”

According to the doctors, the woman was really lucky. If, for example, the placenta was attached to the vessels of the intestine, the result would not be so joyful. In this case, several meters of the intestine would have to be resected (removed - ed.), and the mother would have remained disabled. There was a high probability of a fatal outcome for both - both the mother and the baby.

“For the first time in 44 years of work, I have encountered for the first time a healthy child born in such a situation. When it turned out what we were dealing with, I confess, I was scared, - says Galina Nikonova. – In this situation, another logical question arises. How could a woman, being at such an impressive time, not notice her position? Despite being pregnant, she was menstruating. And all because the uterus was not involved in the process. Perhaps the placenta gave some kind of failure, but they were insignificant.

The resident of Boguchar herself, for whom this child was the third, admits that she did not have any special feelings. She continued to work until the moment when she first went to the doctor. And on the 34th week, I had to urgently go on maternity leave.

“I didn't feel sick, I didn't feel bad. I myself am not very thin, so the increase in the abdomen was not evident. Only when everything inside began to hurt, I went to the hospital, - Evgenia Baturina admits. - When I found out about the pregnancy, of course, I was shocked. Couldn't believe it. Moreover, I was pregnant twice before - I have 19-year-old daughter and six-year-old son - but the sensations were completely different. I worked until the last - a confectioner in a local restaurant. On December 19, she was registered for pregnancy, and almost a month later Anastasia was born. I found out exactly what kind of pregnancy I had only after the operation. So I didn't get scared. But I still can't believe it. Doctors repeat: "This is a real miracle." And indeed, some kind of miracle. Many thanks to the doctors for saving me and my daughter. In Boguchar, probably, they would not have been able to save. Now I can say for sure that I will not give birth again.

The mother says that she and her daughter are now feeling well and are preparing for discharge. The baby is gradually gaining weight - in two and a half weeks she recovered by 300 grams. Now Evgenia is striving to return as soon as possible to her native Boguchar, where her husband, children and grandson are waiting for her.

“What is unique about this case? There are several components. Firstly, we encountered an ectopic pregnancy, which has grown to such a period. Secondly, despite the fact that the child was in abnormal conditions, his development was fully consistent with the period. Thirdly, the obstetric service worked in such a way that it was able to take the situation into its own hands at the last critical moment and prevent massive bleeding and death of the mother and child. Fourthly, the child was born healthy, emphasizes chief freelance neonatologist of the Department of Health of the Voronezh Region Lyudmila Ippolitova . – Yes, in our practice there were cases of ectopic pregnancy, but they all ended in the death of the fetus. According to open sources, over the past 150 years there have been only 17 such cases in the world with a successful delivery. And now we have witnessed another miracle.”

See also:

• "We had little chance." Moms - about the fight for the health of premature babies →
• "Protection function is activated". Why pregnancy changes a woman →
• In Voronezh, a baby born outside the uterus was born →

Voronezh birth of a child

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