For the first time in the United States, a woman born without a uterus gave birth to a healthy baby, according to a new report released in December.
The woman, who remains anonymous, was part of a small trial studying uterine transplantation and pregnancy in women with Absolute Uterine Factor Infertility—meaning their uterus either does not function properly or is nonexistent—at Baylor University Medical Center at Dallas.
A 36-year-old mother of two donated her uterus to the recipient, according to Time magazine. Doctors transplanted the donated uterus last year and then later implanted an embryo conceived using in vitro fertilization (IVF). (The women in the trial all have functioning ovaries that are not attached to the donated wombs, so IVF is necessary.) The recipient became pregnant and carried the baby to term. Last month, doctors successfully delivered the baby—reportedly healthy and screaming—by cesarean section.
The achievement is astounding both personally for this new family and professionally for the team of doctors who oversaw the transplant, pregnancy, and birth. An estimated 50,000 women in the United States could be candidates for a uterus transplant, according to The New York Times.
Yet despite its feel-good nature, this story raises serious ethical concerns.
The Baylor transplant is the first in the United States, but doctors in Sweden have led the way. In 2014, Sweden was home to the first baby in the world born from a transplanted womb. Seven more babies have since been born in further trials.
Following those births, medical ethicists started sounding alarm bells, asking to what lengths and at what costs medicine should go for women to experience pregnancy. They warned that amidst the excitement of a new fertility technology, the significant costs and ethical implications of uterine transplantation were being ignored.
The health risks of womb transplants are serious and far-reaching. Uterus transplants are not life-saving, so all the risks are undertaken by women—both recipients and donors—who would otherwise lead healthy lives. The five-hour surgery on donors is more complex and invasive than a typical hysterectomy. Recipients run the risk of organ rejection, which can cause serious medical problems. The immunosuppressive drugs to prevent organ rejection can have serious side effects, so the uterus is taken back out after one or two pregnancies.
Baylor’s current trial involves a total of 10 transplants. So far eight have been completed, with three of those failing and one other woman becoming pregnant.
There are also ethical and moral implications. Uterus transplant pregnancies require IVF, a process that often results in additional embryos being destroyed. The whole process costs hundreds of thousands of dollars, expensive for a non-lifesaving measure when other options, like adoption, exist. Also, some ethicists worry that if the technology continues to develop, women could be exploited for their uteruses, similar to concerns about poor women being exploited for surrogacy.
Scientists also have suggested that they hope to use the technology so that men who identify as women can experience pregnancy, a development that would pose serious risks to the baby and radically depart from God’s design for sex and childbearing. Last month, Richard Paulson, a doctor and president of the American Society for Reproductive Medicine, said of transgender uterus transplants, “You could do it tomorrow,” according to The Telegraph of London.
These concerns outweigh any benefits of uterine transplants, according to Christian doctor and medical ethicist Paige Comstock Cunningham in an article for the Center for Bioethics and Human Dignity.
“Infertility must be understood within the context of the sin and brokenness that mars all of creation,” she wrote. “From our limited human perspective, it is regrettable that for some couples, biological children may not be part of God’s good and gracious will.”
But Cunningham noted that God calls us to humility and trust, a pattern that is “radically at odds with the aggressive, and extravagantly costly, pursuit of a ‘child of one’s own’ via uterus transplantation.”
Cunningham added that while babies born from transplanted wombs are “precious little ones, made in God’s image,” the “serious identified ethical concerns counsel that womb transplants should not be continued.”
— by Kiley Crossland