The biobag is not an “artificial womb”

An image of a lamb within a "biobag"; a bag filled with fluid which supports extremely premature infants.

Artificial wombs and the immense impact they would have on society have been a fascination of mine since childhood. This fascination led to a lot of reading and understanding why it would be an incredibly complicated process to support an embryo outside of a uterine environment. I did research to try to understand the hurdles that would be involved, so that in my upcoming science-fiction novel I could offer at least an educated guess as to how this technology would develop. And that’s why I was quite shocked and confused when, two days ago, a friend sent me a video of a “real working artificial womb.”

“Bullshit” was my instant and uncharitable response. Then I watched the video and was very impressed with the engineering involved, but troubled at the fact that it was being framed as something it wasn’t. The biobag is amazing. It also isn’t an artificial womb.

But the headlines say something different.

Hope for preemies as artificial womb helps tiny lambs grow
Artificial Womb Works for Lambs, Study Shows
Scientists create ‘artificial womb’ that could save premature babies’ lives

I watched friends on Facebook have meltdowns in terror over the ethical problems in this (there aren’t actually many) and worry over how this strips away familial bonds (it doesn’t). Comments on these articles were worse. After using those incredibly sensationalized headlines that failed to remotely explain what was actually happening, most responsible articles did then go on to explain some of the science and admit that the biobag is essentially a glorified incubator and not a womb at all, but the initial video I saw didn’t and less responsible news sources didn’t. And now there are confused, worried people out there, worrying about something that isn’t worth worrying about.

Interestingly enough, the people reacting with concern seem to be better informed about what the word womb means than the journalists or editors involved in covering this story. Womb is another word for uterus, an internal organ that is still very much in need of a living being to support it. In humans, the uterus normally thickens its lining during each menstrual cycle, in preparation in case an egg gets fertilized. If a blastocyst successfully implants in the thickened uterine lining, congratulations! A pregnancy has been achieved. If this does not occur, then in most cases the lining is sloughed off: this is menstruation. Supporting a growing embryo (and later in its development, a fetus) is physically taxing, but millions of years of placental mammalian evolution means that this harrowing task doesn’t normally kill the pregnant person. Hooray for not dying! But childbearing still has dangers, physical and societal costs, and, yes, maternal mortality unfortunately still happens. It’s also a time of intense bonding for a lot of families, with incredible hormonal changes for pregnant and birthing people. For many people, childbirth has important spiritual and cultural aspects. Anything that might drastically alter how pregnancy and birth happen is going to work up a lot of strong emotions. To wrongfully imply that pregnancy is no longer a requirement for human reproduction is, in essence, clickbait.

The fetal side of the placenta is formed from the same fertilized egg as the embryo. When the fertilized egg implants in the uterine wall, it’s the fetal placenta that develops to support the new growing life as a conduit between parent and offspring. An artificial womb that could support life from fertilization to birth would have to support the fetal placenta. There would have to be a living structure–sometimes called the maternal placenta or the decidua basalis–for the fetal placenta to implant into. That’s how an embryo starts.

But the biobag has no living structures to it. It’s a bag. There’s not even a pump (because the pressure would be too much for an undeveloped heart), with the lamb’s heart moving fluids through the umbilical arteries. This is a big, fancy, awesome incubator for premature infants. If it turns out to be safe and can be used on humans, it would be an incredible new medical technique for helping premature infants like my nephew who was born too early last summer. It would not (and physically could not!) be used with embryos. Viable preterm infants, such as those born at 23 gestational weeks, are the target patients for this. This is not about reproduction, but better protecting already existing tiny lives. Undeveloped hearts, lungs, brains, and other organs would be given a chance in a hospitable environment, drastically reducing the suffering and long-term health consequences that many born preterm face.

Despite those involved in the study stressing that use of this wouldn’t lead to babies floating in bags on the walls and would simply be set up very much like current incubators in use, bad science reporting keeps describing stuff that sounds like vat babies from space. It’s not. It’s less of a breakthrough than that, and also something that is very exciting that may save a lot of people a whole lot of suffering.

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