Artificial Womb Technology in Human Babies: Prospective Methods to Engage Parent Stakeholders

Artificial womb technology (AWT), by which the fetus develops outside the womb in an environment which mimics the uterus/placenta, has been tested in animal models and is nearing human trials with the goal of mitigating the risks of extremely preterm birth.

Ethical exploration of AWT has largely focused on the moral status of the infant and on risk/benefit modeling to identify the population of preterm infants with uncertain enough outcomes to justify this experimental intervention. Missing from this dialogue is the voice of parents as stakeholders in research and clinical decision-making.

Perinatal counseling for threatened delivery at the limits of gestational viability explores ethically appropriate options for care in the context of available data and parents’ values. These conversations are often fraught with the fluidity of real-time clinical status changes and considerable ambiguity. Expansion of this counseling to include recruitment for first-in-human AWT trials, and later, AWT as an option for medical care, will further complicate these conversations.

In addition to the medical risks of AWT, this highly instrumented environment has the potential to amplify well-described trauma and adverse mental health outcomes among parents of extremely preterm infants. The constraints of AWT, including further disruption in positive parent-infant interactions that benefit the infant and bolster parental resilience, must be considered as inherent risks of AWT research and treatment. A robust mixed-methods approach to engage and amplify the views of parent stakeholders in this space is a critical next step in AWT research.

Marin Arnolds, MD – Clinical Assistant Professor, Neonatal-Perinatal Medicine, University of Michigan; Naomi Laventhal, MD – Associate Professor, Neonatal-Perinatal Medicine, University of Michigan