One of the abortion threads got me wondering this. 1.) How feasible is it to transplant a fetus? At any stage of the pregnancy.
2.) How far are we from being able to do this? In the future will someone wanting an abortion be given the opportunity to instead have the fetus transplanted to a female who can’t get pregnant (but can carry a baby to term)?
3.) If this were possible, how often would this be done? Because it might be that if we are at this stage, medically speaking, there would be far better options for a couple having trouble conceiving a child of their own. (ie. It might be easier and cheaper to use another method where at least one of the couple is the biological parent, making this option far less desirable.)
4.) Will this have any effect on abortion statistics or on the debate?
Of course, doing so permanently sterilizes the donor; so as applied to the issue of abortion you’d be replacing a minor procedure with no long term effects with a major surgery that permanently sterilizes the woman.
I’m sure there would be quite a few prolifers who would do it to save the fetus even if they could have a baby themselves. It would probably get to be a status thing in those circles to some extent.
Apparently the results aren’t very good, and it doesn’t seem like this has been done with a fetus inside.
Additional issue I’d like to see discussed: Is there a certain time during the pregnancy when this would be most viable (I mean, in the first trimester.) My knowledge of the whole process is fuzzy, but might it be easier VERY early on, before it make the trip from the fallopian tubes and implants in the uterus? If so, could the pregnancy even be detected this early?
To put it another way, would you call “BS!” if you saw this scene in a sci-fi movie:
“So you think you’re pregnant? How long since you had sex? 3 days? OK, let’s check. [uses either a wand or a CAT scan looking device]. Yep, you’re pregnant. Do you want to donate it or abort it? Because we have a list of couples. Donate? OK, nurse, get her prepped, we only have about 12 hours. Secretary, start at the top of the list of couples. Tell them they have to be here in 2 hours. We have to fish this out of you before it implants. After that, it’s too risky.”
Just being able to remove and implant is not going to have a major effect. It will be useful in the fertility field. It will almost definitely cut down a percentage of abortions performed for medical reasons on women who wish to have a child, at least those who can afford or otherwise have access to a surrogate. Not everyone will have such access.
The real game changer in the debate will be the artificial uterus. If a woman can undergo a procedure that is equivalent in cost and intrusion to an abortion that ends with the fetus surviving, than many of the pro-choice arguments will be undercut.
I expect that the “pro-lifers” will try to ban any such technology, since it would reduce the suffering of women (women in general, not just the ones who want abortions). Not that most of them will admit that that is their motivation; I can just see, say, the Catholic Church going on about it being “unnatural” and interfering with “God’s will”. These are the same sort of people who opposed the application of painkillers during childbirth because the purpose of the pain of childbirth is to punish women for Eve’s sin.
And at any rate it’s highly unlikely that any such thing would be “equivalent in cost and intrusion” to abortion. And that’s not even counting the cost of raising the resulting child; not that I expect the anti-abortionists to take any other attitude than"let it starve" to such children.
I am not going to try and respond to your first paragraph because, frankly, I don’t care to.
But for your second part, of course it will not be equivalent in cost, at least not at first. But if each “uterine replicator” (to use a term common in SF) is reusable, the price should come down to something that is easily covered by insurance. As for the intrusion, I would expect, just like abortion, it would be mild at first and get worse the further into the pregnancy you go. It could obviously never get as simple as chemically induced abortion, but it could be made safer.
As for taking into account the cost of raising the child, that gets into entirely different justifications than the ones that this would affect directly. Interestingly enough, it could lead to sexual equality on the decision of choice. Right now because the pregnancy can only take place in her body a women gets a post sex choice that a man does not. If her choice of what to do with her body has no effect on whether on not there is a baby nine months after conception, then either can choose to keep the resulting child and expect the other to be required to provide support.
Before anyone jumps on me, this is just speculation on my part. My personal preference in regards to abortion would be not to have it illegal, but rather unnecessary. A combination of universally available, fool proof birth control that requires a conscious choice by both parties for conception to be possible and genetic scanning technology in addition to technology under discussion is what I think that would take.
I would totally buy this. It’s barely half a step to the left from what they do now for the most advanced infertility treatments. There, ova are harvested after release, fertilized in a test tube (more or less) and then the resulting blastocyst is put into someone’s uterus - could be the woman who produced the ova, could be another woman - to (hopefully) implant. The only difference in your scenario is that you’re allowing it to fertilize inside the body.
Once implantation has occurred, though, things get a lot more complicated very quickly. I think the biggest issue is probably vascular. Removing an intact placenta leads to a whole lot of bleeding from a whole lot of points, and the embryo can’t really tolerate a big loss in blood volume. But let’s say we can clamp off what we need to clamp off, either mechanically or chemically. The placenta would probably need to be hooked up to a uterus which has the major vessels already formed, or the developing embryo will be starved of nutrients pretty quickly. So that would mean either enducing a placenta to form without a pregnancy in the surrogate so she had the blood vessels in place, or..
As you can see, what we’re really looking to do is transplant the PLACENTA. And that’s pretty hard. But what if we literally only transplanted the fetus? Could we find a surrogate, say, who had a nonviable pregnancy of her own? Could we remove her nonviable fetus at the umbilical cord and attach the donated fetus’ cord to her cord? That’s actually fairly plausible. We’d have to match immune systems and gestational age, we’d probably have to figure out how to fine tune the maternal and fetal hormones (which we don’t entirely understand yet), and we’d only be able to use surrogates who for whatever reason were terminating their own fetus, so it probably wouldn’t be a very widespread practice. But it’s theoretically not much more difficult than transplanting a liver.
Matching for transplant gets more complicated. Much of the placenta is fetal in origin. Might (probably?) would need to transplant the fetus and placenta together.
Matching two parties for a transplant is difficult. Matching 3 or 4 much more so.
Legally it would be interesting. Most people vaguely understand the trimester ruling in Roe, basically that abortions during the first and second trimesters are generally constitutionally protected (or at least you can’t outright ban them–many States have made life extremely hard on providers of abortions in their State such that some States have virtually no abortion providers.) A lot of people are unaware that the trimester system in Roe was actually overturned in Planned Parenthood v. Casey. Whereas Roe said that only at the third trimester when a fetus could generally be viable was it permissible to ban abortions outright (because of the State’s interests in the fetus) with exceptions for medical necessity; Casey’s plurality opinion held that viability (whatever that might be at the current state of medical technology) was when the State could step in and prohibit abortion due to its interests in protecting the life of the fetus.
I don’t believe (someone would have to fact check) any States have really adopted the “moving viability” line for basically two reasons. One is that it’d always be scientifically and medically contentious and the trimester system is simpler to regulate. Two is that Casey still allows post-viability abortions for health of the mother, and health of the mother can be interpreted so broadly that the viability argument doesn’t really matter as you can functionally almost always justify any post-viability abortion as “medically necessary” under current precedent.
But all that being said, if viability were to become a bigger feature in the law, and “health of the mother” exceptions were not so broad (and in some cases they have been pared down recently) then the existence of some way to remove a fetus at any stage of pregnancy and preserve its life would technically allow for a State to pass a law, that at least under current precedent, could constitutionally ban all abortions post-viability (and if viability was possible from the moment of conception that would essentially ban all abortions.)
Illinois uses viability, rather than trimesters or weeks. An MD must certify the nonviability of the fetus before an abortion can be performed. If the fetus is viable, an MD must certify that abortion is necessary to preserve the life or health of the mother, must use a form of abortion which, in his medical opinion, gives the best chance of preserving the life of the fetus, and a second doctor must be in the room at the time of the abortion.
Yes, that allows some wiggle room re: “health” of the mother. And yet somehow, we manage.
Not all pro-lifers are religous fanatics out to punish women; in fact most aren’t. Yes, those tend to be the loudest and most obnoxious, but they’re in the minority. The costs of raising the resulting child aren’t really relavent to the disscussion since those also apply with adoption; something the pro-life camp strongly advocates. And there’s no shortage of couples wanting to adopt infants. You do have a point about the costs of performing the actual procedure and servicing the artificial wombs. That would almost certainly cost alot more than a simple abortions, and probally more than the medical costs associated with a normal pregnancy.
Who pays for that? Would be it like adoption is now where the adoption agency factors it into the fees the adopting couple pays? Will the government pay for it? Or will private charities? I guessing a combination of all 3.
Thing is, an artificial womb/artificial uterus/uterine replicator/call it X is a better incubator. We already have the technology to have micropreemies survive; in much of the world, survival of a child born at 7 months has gone from “unlikely” to “routine although still complex” thanks to incubators.
As the technology gets better, cheaper, more reliable (and perhaps takes that jump from dry to wet), will there be a point where “delivering/extracting the fetus early and incubating” becomes a feasible choice? Will there be one where a natural pregnancy carried to term is seen as backwards and old-fashioned? The point where “deliver/extract early and put up for adoption” becomes an option would be midway between those two, I guess. [related but still a hijack]There are already instances where in-vitro fertilization in order to perform genetic selection is perceived as advantageous (there are no fertility problems, but there is a reason to select for or against certain traits), will it ever become the default?[/hijack]
There is a shortage of couples - not right now. But the number of abortions performed every year is not quite as large as the number of waiting couples, and waiting couples wait an average of three years (possibly more now). So after year one, you have a glut of infants if every current abortion turns into a live birth.
Second, to the cost, the cost of adoption is already subsidized via a tax credit. And its already enough that many couples shy from adopting kids due to the cost. Transplants are very expensive - a cheap transplant is a quarter of a million dollars (kidneys are cheap), you are talking surgery on two people and a six figure or more procedure.