Only the sun comes up for free.
Moderator Action: Thread moderation is also done for free. Stop with the useless comments in an RD thread. ~ Arakhor
Last edited by a moderator:
[RD] Abortion, once again
- Thread starter Angst
- Start date
Moderator Action: Thread moderation is also done for free. Stop with the useless comments in an RD thread. ~ Arakhor
Lexicus
Deity
look, I'm a soft body, i'm hesitant to kill cockroaches in my own apartment. Who does the violence isn't really relevant to what I'm saying.
But if you're accusing me of thinking violence is justified when it's justified, and unjustified when it's unjustified, then yes, you got me.
The state enforces laws (including the laws against abortion, drug use while pregnant etc that you say should exist) through violence. Like, bear with me here, most states actually have a group of people who wear uniforms and carry guns, called the "police", that enforce laws, and sometimes when people disobey them they get shot and killed.
Who said anything about me? You haven't figured out yet that I talk big but don't actually do anything?
If I were inclined to do violence to chuds, I'd be out there doing it instead of posting here.
The only person I'm speaking on behalf of is myself btw.
Finally, by way of friendly advice, some radlib undergrad might be bamboozled by you throwing "bigot" back in his face, but you're dealing with elite Communist online argument special forces cadre here. Calling me a bigot is like when the street punk tweaker in Collateral tries to rob Tom Cruise.
Moderator Action: Warned for trolling. The_J
Last edited by a moderator:
You jump to conclusions here.
Did I ask anyone to shoot and kill a pregnant woman? (reads back.... no, no I didn't.)
So, saying something should be illegal, I want 'violence'? That's weird.
Because then the phrase "shoplifting construction hard hats should be illegal" would be asking for violence against construction workers.
(by the way, I said I understand that tampering with a dead body is illegal, not abortion... but you understood that nuance.)
Laws are not enforced by violence. Violence is a product when you disobey the police, but you said that already.
Good!
Ah communism. The system where everyone is equal. And some more equal than others.
Worked out so well in the past, didn't it? I remember the stories my grandmother told me. How everyone had everything they needed. And everyone from capitalist countries wanted to flee to their communist country to enjoy the endless supply of great things they had created. The endless supply of brown and grey boots, the diesel guzzling machines the size of houses that cut pies into 3 pieces, even though they were designed to cut the pies into 4 pieces.
Great times.
All law enforcement is backed by the explicit threat of violence.
Row over British Journal of Psychiatry abortion paper saw panel quit
Lawfare in science is a new low, to me at least
An independent panel resigned in a row over controversial research about the impact of abortion on the mental health of women, BBC News can reveal.
The research, which is still being used in US legal cases about limiting access to abortion, was published in the British Journal of Psychiatry, in 2011.
Last year the panel, which was set up to investigate complaints about the paper, recommended it be withdrawn.
But journal-owner, the Royal College of Psychiatrists, overruled it.
The 2011 paper is a systematic review conducted by US psychologist, Prof Priscilla Coleman. It concludes that women who've had an abortion have an 81% increased risk of developing mental health problems.
Prof Coleman worked for 20 years as a Professor of Human Development and Family Studies, at Bowling Green State University, in Ohio. Her research appeared in a brief submitted to the US Supreme Court as part of successful efforts to overturn the historic Roe v Wade judgment, which guaranteed a constitutional right to an abortion in the US.
In April, the paper was also cited by a judge in Texas, when concluding one of the two main drugs used for medical abortion in the US, Mifepristone, should have its approval suspended. The case is ongoing.
When Prof Coleman's paper was first published in 2011, 10 letters were sent to the British Journal of Psychiatry criticising the quality of the research. Two called for its retraction.
"We don't believe that the results are reliable or credible", said one signatory, Prof Julia Littell, an expert at Bryn Mawr College. She argued it did not meet best practice standards of the time.
"I've never called for the retraction of a paper before," she has since told the BBC. "This is a very serious lapse of scientific integrity."
A review published three months later in December 2011, co-authored by the Royal College of Psychiatrists, also found that methodological problems brought into question the paper's results and conclusions.
Some panel members have expressed concern that legal threats may have influenced the College's actions.
When the British Journal of Psychiatry told Prof Coleman they wanted to put a notice on her article to raise awareness about a possible problem, her lawyers responded that any such notice would cause "serious harm and direct damage to her reputation".
The letter, seen as part of an investigation by Newsnight and the BMJ, said Prof Coleman would take "any and all legal options available".
A second legal letter, sent a month later, repeated the threat, if the journal was to retract the paper. Ultimately no notice of concern was placed on the work.
Prof Coleman has started legal action against another journal, Frontiers in Psychology, after it retracted one of her earlier papers. So far those actions have been rejected by a Swiss court.
Dr Tsai said the row risked undermining confidence in the journal's ability to "police the content that it publishes", adding: "[A] journal that does not uphold editorial independence is probably not long for this world."
Lawfare in science is a new low, to me at least
An independent panel resigned in a row over controversial research about the impact of abortion on the mental health of women, BBC News can reveal.
The research, which is still being used in US legal cases about limiting access to abortion, was published in the British Journal of Psychiatry, in 2011.
Last year the panel, which was set up to investigate complaints about the paper, recommended it be withdrawn.
But journal-owner, the Royal College of Psychiatrists, overruled it.
The 2011 paper is a systematic review conducted by US psychologist, Prof Priscilla Coleman. It concludes that women who've had an abortion have an 81% increased risk of developing mental health problems.
Prof Coleman worked for 20 years as a Professor of Human Development and Family Studies, at Bowling Green State University, in Ohio. Her research appeared in a brief submitted to the US Supreme Court as part of successful efforts to overturn the historic Roe v Wade judgment, which guaranteed a constitutional right to an abortion in the US.
In April, the paper was also cited by a judge in Texas, when concluding one of the two main drugs used for medical abortion in the US, Mifepristone, should have its approval suspended. The case is ongoing.
When Prof Coleman's paper was first published in 2011, 10 letters were sent to the British Journal of Psychiatry criticising the quality of the research. Two called for its retraction.
"We don't believe that the results are reliable or credible", said one signatory, Prof Julia Littell, an expert at Bryn Mawr College. She argued it did not meet best practice standards of the time.
"I've never called for the retraction of a paper before," she has since told the BBC. "This is a very serious lapse of scientific integrity."
A review published three months later in December 2011, co-authored by the Royal College of Psychiatrists, also found that methodological problems brought into question the paper's results and conclusions.
Some panel members have expressed concern that legal threats may have influenced the College's actions.
When the British Journal of Psychiatry told Prof Coleman they wanted to put a notice on her article to raise awareness about a possible problem, her lawyers responded that any such notice would cause "serious harm and direct damage to her reputation".
The letter, seen as part of an investigation by Newsnight and the BMJ, said Prof Coleman would take "any and all legal options available".
A second legal letter, sent a month later, repeated the threat, if the journal was to retract the paper. Ultimately no notice of concern was placed on the work.
Prof Coleman has started legal action against another journal, Frontiers in Psychology, after it retracted one of her earlier papers. So far those actions have been rejected by a Swiss court.
Dr Tsai said the row risked undermining confidence in the journal's ability to "police the content that it publishes", adding: "[A] journal that does not uphold editorial independence is probably not long for this world."
Angst
Rambling and inconsistent
best benefit of the doubt i can give is that anecdotically, people who get abortions tend to really think it over, it's a heavy choice, and it's never easy to make. but it's similar to... well, breaking up with someone you like, but know it's not working out with? it's a heavy choice, but... mental problems? what would that mean exactly?
Lexicus
Deity
Prof Coleman should be charged criminally for misuse of the legal system.
Broken_Erika
Play with me.
Nebraska teen sent to 90 days in jail over abortion
A US teenager was sentenced to 90 days in jail after taking abortion pills to end her pregnancy and disposing of the foetus with her mother's help.Celeste Burgess, now 19, pleaded guilty to illegally concealing human remains after she had an abortion around 28 weeks of pregnancy when she was 17.
Her mother, Jessica Burgess, 42, faces up to five years in prison for helping her daughter and violating Nebraska's abortion law.
Nebraska now bans abortion at 12 weeks.
Police opened the investigation into the mother and daughter in June 2022, before the Supreme Court overturned the nationwide right to abortion and left it to states to determine whether or how to allow the procedure.
At the time, both mother and daughter resided in Nebraska, where abortions had been banned at 20 weeks from conception. Earlier this year, Nebraska lawmakers passed an abortion ban at 12 weeks after conception.
Court documents alleged Celeste Burgess was around 28 weeks pregnant when she consumed the abortion pills, making the procedure illegal as per Nebraska law.
When initially confronted by police, the teen allegedly told authorities that she had delivered a stillborn foetus. But, according to court documents, she and her mother had discussed how to obtain the abortion pills and "burn the evidence" over Facebook messages.
In May, Burgess pleaded guilty to a felony charge of removing or concealing human skeletal remains. Two other misdemeanour charges against her - concealing the death of another person and false reporting - were dropped. In addition to serving three months in jail, she faces two years of probation.
Her mother has pleaded guilty to providing an illegal abortion, making false statements to authorities and tampering with human skeletal remains. Her sentencing begins in September.
The case has been closely watched by abortion advocates as a slew of states move to restrict abortion access after the Supreme Court's 2022 ruling.
Late term abortions are uncommon. Before the end of Roe V Wade, the majority of abortions happened before the 13 week of pregnancy, according to the US Centers for Disease Control and Prevention.
https://www.bbc.com/news/world-us-canada-66271537
Cloud_Strife
Deity
Just a genuinely vile place
Broken_Erika
Play with me.
Ahead of Ohio abortion vote, Republicans try to change the rules
A pro-choice referendum looked poised to win in the conservative state of Ohio this November. Now, Republican state legislators are accused of moving the goalposts.Last summer, just like every summer for the past 22 years, Michael Curtin spent his days on the assorted baseball fields of central Ohio, acting as umpire for high school and college games.
Mr Curtin, retired after a 38-year career in journalism and another four in state politics, loves the game. But this summer, Mr Curtin's umpire equipment has been neglected, shoved somewhere in the basement of his Columbus home so he could focus on the rules of Ohio politics instead.
"I'm not doing one game," he said. "And I miss it. But this fight's too important to lose."
The fight in question is over Issue 1, a deceivingly dull and procedural-sounding referendum on the minimum threshold required to pass constitutional amendments.
The premise is simple: voters will decide on 8 August whether that threshold should remain at 50% plus one, or be raised to 60%.
But Ohio's vote has become a proxy war over abortion, one of the many state-wide battles that have broken out since the US Supreme Court rescinded the nationwide right to abortion last June.
That's because Issue 1 is not the only referendum looming. In November, Ohioans will vote on another constitutional amendment, one that would protect abortion access up until foetal viability, around 24 weeks of pregnancy.
The proponents of issue 1 claim that Tuesday's vote is simply to protect the state's constitution from outside influence.
But its opponents - a diverse coalition featuring political wonks like Mr Curtin, a retired Supreme Court judge and all of Ohio's past living governors - have called foul. They claim Issue 1 is a backhanded attempt to change the rules mid-game, raising the voter threshold just in time to thwart the abortion vote.
"Look, everybody knows what's going on here. Everybody knows," Mr Curtin said. "This was just bad faith."
Since Roe v Wade was overturned last June, the country's abortion fight has increasingly played out in state ballot initiatives. There have been six so far, each one a win for abortion rights.
If Ohio's vote is passed, it will be the most sweeping affirmation of reproductive rights in a state controlled by a firm Republican majority, said Mary Ziegler, a law professor at the University of California, Davis and a leading authority on the US abortion debate. "It will confirm that there's some sort of consensus around abortion rights, even in conservative states."
And according to recent surveys, if all Ohioans were to show up for the vote now, abortion would win. The constitutional amendment is supported by 58% of Ohioans, with 32% opposed, according to a July poll from USA Today and Suffolk University.
But if Issue 1 is passed first, and the threshold is raised to 60%, the abortion rights amendment may be finished.
"They [anti-abortion campaigners] very clearly looked at this and said: we cannot win if we don't change the rules," said Kellie Copeland, executive director of Pro-Choice Ohio.
Issue 1 has had the full-throated support of Ohio's chief election official, secretary of state Frank LaRose.
"To allow a bare majority of 50% plus one to change the very ground rules that the state operates on is just not good public policy," he told the BBC.
Mr LaRose, 44, is a veteran of the US Special Forces and now an enthusiastic envoy for the Republican Party, crisscrossing the state for more than 65 pro-Issue 1 events. He is charming, conservative and politically ambitious. Next spring, Mr LaRose will be on the ballot in an already competitive Republican primary for the US Senate seat.
In public, Mr LaRose has kept the focus squarely on the constitution. But at a fundraising dinner in May, Mr LaRose made explicit the importance of Issue 1 for the anti-abortion movement.
"I'm pro-life. I think many of you are as well," Mr LaRose said, in a video recorded by Scanner Media. "This is 100% about keeping a radical pro-abortion amendment out of our constitution. The left wants to jam it in there this coming November."
In an interview with the BBC, Mr LaRose acknowledged that the "looming abortion amendment" helped bring the Issue 1 vote forward. "But that's not the only reason," he said.
To his opponents, Mr LaRose had been caught saying the quiet part out loud.
"There's an old standard that our grandparents taught us that bears repeating: if you want any credibility in life... never deny the obvious," Mr Curtin said. "Here is Mr LaRose denying the obvious."
There have been other accusations of hypocrisy. Earlier this year, Republicans passed a law eliminating nearly all August elections, citing their high cost and low turnout. Then, in an apparent u-turn, they put Issue 1 on the calendar for 8 August.
Even some of Mr LaRose's fellow Republicans have spoken out against Issue 1.
"You're talking about changing a part of the Ohio constitution that has been in effect for well over 100 years," said former Ohio Governor Bob Taft, a Republican. "And it's worked, it's worked well, the system is not broken."
In the 111 years since Ohio first granted voters the power to introduce citizen-led amendments, just 19 of 71 proposed measures have passed. Ohio's current policy requiring a simple majority is in line with most of the 17 US states that allow citizen-initiated amendments. And in 2015, Ohioans added a new restriction, passing an amendment that prohibited anyone from changing the constitution for their own financial benefit.
"This is an elaborate scheme to suppress the vote of Ohioans… It's unconscionable," said former Ohio Supreme Court Chief Justice Maureen O'Connor, also a Republican.
Whatever Mr LaRose's motivations, Issue 1 has been embraced by Ohio's anti-abortion lobby. Mike Gonidakis, president of Ohio Right to Life, said he "led efforts" to get signatures from state politicians to put the measure on the ballot.
"In speaking with Frank LaRose I said 'now's our time to do this'," he told the BBC.
Mr Gonidakis, like Mr LaRose, rejected criticism that Issue 1 was underhanded. "It's not changing the goalposts if Ohioans weigh in and vote on it," he said.
Experts said they see Ohio's Issue 1 as part of a broader tactic employed by anti-abortion advocates to circumvent public opinion in service of their ultimate goal, outlawing abortion entirely - a goal that is unsupported by most Americans.
"They think if voters had a straight up and down decision on abortion it wouldn't go their way, so they're trying to do what they can to prevent that from happening," said the University of California's Ms Ziegler.
As a result, anti-abortion leaders and their Republican allies have found paths around popular support - either relying on the court system or on politicians willing to promote abortion policy regardless of voters' wishes.
These manoeuvres are possible, Ms Ziegler said, because in so many cases Republican politicians fear the anti-abortion lobby more than their own constituents.
And the strategy suits the movement's internal logic, in which banning abortion is seen as the worthiest cause.
"There's a sense in which winning is more important than democracy," she said.
https://www.bbc.com/news/world-us-canada-66375877
EgonSpengler
Deity
- Joined
- Jun 26, 2014
- Messages
- 12,260
So the South Carolina legislature - which, according to Google, is 86% male in a state that is 46% male - replaced the last female judge on that state's Supreme Court with a man (she had reached the mandatory retirement age), to make it the only Supreme Court in the country that is entirely male, and then that Court reversed its own decision from earlier this year and restricted abortion after 6 weeks.
Congratulations, South Carolina. Awesome job.
apnews.com
Congratulations, South Carolina. Awesome job.
South Carolina's new all-male highest court reverses course on abortion, upholding strict 6-week ban
South Carolina's newly all-male Supreme Court has reversed course on abortion, upholding a ban on most such procedures after just weeks of pregnancy.
apnews.com
EgonSpengler
Deity
- Joined
- Jun 26, 2014
- Messages
- 12,260
It's worth noting here that, iirc, all of the women who were allowed to participate in this process opposed this change to South Carolina's abortion laws and wanted them to remain as they were*. I believe every single woman in the legislature - all 20 of them, or whatever the number is - voted against the new law, across both parties. iirc, the women in the SC legislature are about 2/3rds Republican, but they 100% voted against this bill. Also, the judge on the SC Supreme Court who wrote the opinion that blocked the law initially was the woman who had to retire. (It's also worth noting that South Carolina enshrines the right to privacy in its Constitution, which the United States Federal Constitution notably does not. So good for them, for that nice little bit of foresight. Fat lot of good it did them, but still.)So the South Carolina legislature - which, according to Google, is 86% male in a state that is 46% male - replaced the last female judge on that state's Supreme Court with a man (she had reached the mandatory retirement age), to make it the only Supreme Court in the country that is entirely male, and then that Court reversed its own decision from earlier this year and restricted abortion after 6 weeks.
Congratulations, South Carolina. Awesome job.
South Carolina's new all-male highest court reverses course on abortion, upholding strict 6-week ban
South Carolina's newly all-male Supreme Court has reversed course on abortion, upholding a ban on most such procedures after just weeks of pregnancy.
You have to think that if the South Carolina government were merely 50% women (which still wouldn't be representative) and if the state's Supreme Court had 2 women (out of 5 judges - again, still wouldn't be representative), this law would've gotten stomped like a narc at a biker rally. I expect it wouldn't even have been a close vote. And I expect the
* To be clear, this wasn't an effort to make S.C.'s abortion laws more permissive or progressive. They just wanted to leave well enough alone.
EDIT: Okay, I had to look it up. 25 women out of 170 - 15 Republicans, 9 Democrats and 1 Independent - according to the Center for American Women and Politics at Rutgers University.
Last edited:
Latest work on making not really foetuses. It is quite possible that we will become accidentally able to make babies from discarded skin cells while developing laboratory techniques.
The paper is open access and the writeup is paywalled, in a reversal of the usual situation.
Stem cells used to model a two-week-old human embryo
Ask a person on the street what a 13-day-old human embryo looks like, and you might hear a broad range of answers. Some might imagine a formless clump of cells, others a fetus-in-miniature with recognizable features such as limbs, eyes or a heart. In truth, the architecture of the two-week-old embryo is more like a series of nested cellular bubbles, or fluid-filled cavities, that support the development of a relatively simple cell layer that will eventually give rise to a fetus. Similar structures have been made entirely from stem cells, as reported in Nature by Oldak et al.1, by Pedroza et al.2 and Weatherbee et al.3.
Complete human day 14 post-implantation embryo models from naive ES cells
The ability to study human post-implantation development remains limited owing to ethical and technical challenges associated with intrauterine development after implantation. Embryo-like models with spatially organized morphogenesis and structure of all defining embryonic and extra-embryonic tissues of the post-implantation human conceptus (that is, the embryonic disc, the bilaminar disc, the yolk sac, the chorionic sac and the surrounding trophoblast layer) remain lacking. Mouse naive embryonic stem cells have recently been shown to give rise to embryonic and extra-embryonic stem cells capable of self-assembling into post-gastrulation structured stem-cell-based embryo models with spatially organized morphogenesis (called SEMs). Here we extend those findings to humans using only genetically unmodified human naive embryonic stem cells (cultured in human enhanced naive stem cell medium conditions)4. Such human fully integrated and complete SEMs recapitulate the organization of nearly all known lineages and compartments of post-implantation human embryos, including the epiblast, the hypoblast, the extra-embryonic mesoderm and the trophoblast layer surrounding the latter compartments. These human complete SEMs demonstrated developmental growth dynamics that resemble key hallmarks of post-implantation stage embryogenesis up to 13–14 days after fertilization (Carnegie stage 6a). These include embryonic disc and bilaminar disc formation, epiblast lumenogenesis, polarized amniogenesis, anterior–posterior symmetry breaking, primordial germ-cell specification, polarized yolk sac with visceral and parietal endoderm formation, extra-embryonic mesoderm expansion that defines a chorionic cavity and a connecting stalk, and a trophoblast-surrounding compartment demonstrating syncytium and lacunae formation. This SEM platform will probably enable the experimental investigation of previously inaccessible windows of human early post implantation up to peri-gastrulation development.
I think the best image of what a pretend 2 week old embryo looks like is the cover of nature
The paper is open access and the writeup is paywalled, in a reversal of the usual situation.
Stem cells used to model a two-week-old human embryo
Ask a person on the street what a 13-day-old human embryo looks like, and you might hear a broad range of answers. Some might imagine a formless clump of cells, others a fetus-in-miniature with recognizable features such as limbs, eyes or a heart. In truth, the architecture of the two-week-old embryo is more like a series of nested cellular bubbles, or fluid-filled cavities, that support the development of a relatively simple cell layer that will eventually give rise to a fetus. Similar structures have been made entirely from stem cells, as reported in Nature by Oldak et al.1, by Pedroza et al.2 and Weatherbee et al.3.
Complete human day 14 post-implantation embryo models from naive ES cells
The ability to study human post-implantation development remains limited owing to ethical and technical challenges associated with intrauterine development after implantation. Embryo-like models with spatially organized morphogenesis and structure of all defining embryonic and extra-embryonic tissues of the post-implantation human conceptus (that is, the embryonic disc, the bilaminar disc, the yolk sac, the chorionic sac and the surrounding trophoblast layer) remain lacking. Mouse naive embryonic stem cells have recently been shown to give rise to embryonic and extra-embryonic stem cells capable of self-assembling into post-gastrulation structured stem-cell-based embryo models with spatially organized morphogenesis (called SEMs). Here we extend those findings to humans using only genetically unmodified human naive embryonic stem cells (cultured in human enhanced naive stem cell medium conditions)4. Such human fully integrated and complete SEMs recapitulate the organization of nearly all known lineages and compartments of post-implantation human embryos, including the epiblast, the hypoblast, the extra-embryonic mesoderm and the trophoblast layer surrounding the latter compartments. These human complete SEMs demonstrated developmental growth dynamics that resemble key hallmarks of post-implantation stage embryogenesis up to 13–14 days after fertilization (Carnegie stage 6a). These include embryonic disc and bilaminar disc formation, epiblast lumenogenesis, polarized amniogenesis, anterior–posterior symmetry breaking, primordial germ-cell specification, polarized yolk sac with visceral and parietal endoderm formation, extra-embryonic mesoderm expansion that defines a chorionic cavity and a connecting stalk, and a trophoblast-surrounding compartment demonstrating syncytium and lacunae formation. This SEM platform will probably enable the experimental investigation of previously inaccessible windows of human early post implantation up to peri-gastrulation development.
I think the best image of what a pretend 2 week old embryo looks like is the cover of nature
Spoiler Here is an image from the paper :
Last edited:
Ohio got legal abortions and weed in one night!
CBS said:
So Ohio has put abortion in the constitution, but they have used the viability threshold. I think in this day and age that is a mistake, as the tech is advancing such that "viability" may well mean something quite different in a decade than it does today. Why they could not have used something more fixed, like developmental stage or age of pregnancy I do not know.Human trials of artificial wombs could start soon
A hairless, pale-skinned lamb lies on its side in what appears to be an oversized sandwich bag filled with hazy fluid. Its eyes are closed, and its snout and limbs jerk as if the animal — which is only about three-quarters of the way through its gestation period — is dreaming.
The lamb was one of eight in a 2017 artificial-womb experiment carried out by researchers at the Children’s Hospital of Philadelphia (CHOP) in Pennsylvania. When the team published its research1 in April of that year, it released a video of the experiments that spread widely and captured imaginations — for some, evoking science-fiction fantasies of humans being conceived and grown entirely in a laboratory.
Now, the researchers at CHOP are seeking approval for the first human clinical trials of the device they’ve been testing, named the Extra-uterine Environment for Newborn Development, or EXTEND. The team has emphasized that the technology is not intended — or able — to support development from conception to birth. Instead, the scientists hope that simulating some elements of a natural womb will increase survival and improve outcomes for extremely premature babies. In humans, that’s anything earlier than 28 weeks of gestation — less than 70% of the way to full term, which is typically between 37 and 40 weeks.
The CHOP group has made bold predictions about the technology’s potential. In another 2017 video describing the project, Alan Flake, a fetal surgeon at CHOP who has been leading the effort, said: “If it’s as successful as we think it can be, ultimately, the majority of pregnancies that are predicted at-risk for extreme prematurity would be delivered early onto our system rather than being delivered premature onto a ventilator.” In 2019, several members of the CHOP team joined a start-up company, Vitara Biomedical in Philadelphia, which has since raised US$100 million to develop EXTEND. (Flake declined to comment for this article, citing “conflicts of interest” and “restrictions on proprietary information”. His co-authors on the 2017 paper did not respond to Nature’s request for comment.)
The US Food and Drug Administration (FDA) will convene a meeting of independent advisers on 19–20 September to discuss regulatory and ethical considerations and what human trials for the technology might look like. The committee’s discussion will be scrutinized by the handful of other groups around the world that are developing similar devices, and by bioethicists exploring the implications for health equity, reproductive rights and more.
“This is definitely an exciting step and it’s been a long time coming,” says Kelly Werner, a bioethicist and neonatologist at Columbia University Medical Center in New York City, who is not affiliated with groups developing artificial-womb technology. “Clinicians who work with premature babies will be closely following this meeting,” she says.
Early start
Preterm birth, defined by the World Health Organization as birth before 37 weeks of gestation, can happen spontaneously or because some conditions — such as an infection, hormone imbalance, high blood pressure or diabetes — can turn the womb into an inhospitable environment for the fetus.
It poses an enormous global health problem. Preterm birth is the largest cause of death and disability in children under five. In 2020, there were about 13.4 million such births worldwide, and complications related to preterm birth caused about 900,000 deaths in 2019.
Mortality is strongly linked with the baby’s gestational age at birth. At or before 22 weeks — considered the cusp of fetal viability — few fetuses survive outside the womb. By 28 weeks, most can survive, but often require significant life support. Artificial-womb technology aims to improve outcomes for preterm babies who are born in the period between 22 and 28 weeks, for whom survival has improved, but long-term health issues are frequent.
In a study2 of 2.5 million people in Sweden, for example, 78% of people born before 28 weeks of gestation had some sort of medical condition — ranging from asthma and hypertension to cerebral palsy and epilepsy — by the time they were adults. For full-term births, that rate was 37%.
Death and disability, especially in babies born at younger gestational ages, often occur because the lungs and brain are among the last organs to fully mature in humans. That’s why obstetricians try to prevent preterm birth whenever possible — the longer fetuses can safely stay in the womb, the higher their odds are of long-term survival and good health.
In a natural womb, a fetus receives oxygen, nutrients, antibodies and hormonal signals and gets rid of waste through the placenta, a transient organ in which fetal blood interacts with maternal blood. Of these various roles, artificial-womb technology is most focused on providing oxygen and removing carbon dioxide, replacing the mechanical ventilators that are often used for neonates. These can damage fragile developing lungs that would otherwise still be filled with amniotic fluid.
The artificial womb “would bridge a baby born extremely premature through those days and weeks when they’re most at risk for lung and brain damage”, Werner says. The CHOP group has signalled that it would wean babies off its system after a few weeks, when their organs are more fully developed and their likelihood of healthy survival is higher.
The group’s system would work by placing extremely premature babies into what it calls a Biobag, filled with an electrolyte-laden fluid designed to mimic amniotic fluid. Surgeons would connect the blood vessels in the umbilical cord to a system that oxygenates blood outside the body. The fetal heart would still pump blood as it does in the natural womb.
Making the connection with blood vessels in the umbilical cord is difficult, because the arteries are tiny and begin to contract as a baby is delivered. So, surgeons will need to hook up the vessels to the system within minutes. The process “has got to be really slick”, requiring deft surgical skills and speedy transitions, says Anna David, a maternal–fetal specialist at University College London.
Flake and his colleagues have been testing the system on lambs, which are often used in fetal research because they are developmentally similar to humans. Sheep typically gestate for about 5 months; the lambs that the researchers used were the equivalent of a human fetus at 23 weeks of gestation. In 2017, the team reported that it kept eight lambs alive for up to four weeks using the artificial womb1. In that time, the animals sprouted wool and their lungs and brains grew to maturity. After four weeks, the researchers euthanized the animals so they could study how the system had affected organ development.
Since 2017, the researchers have been testing various ways to connect the animals to the oxygenation machine, and they have been in conversation with the FDA about starting clinical trials.
Varying approaches
Researchers who spoke to Nature say that the CHOP group’s system is probably closest to human trials. But groups in Spain, Japan, Australia, Singapore and the Netherlands are also developing artificial-womb technology. A team led by fetal surgeon George Mychaliska at University of Michigan Health in Ann Arbor refers to its device as an artificial placenta. And even though in practice it serves the same purpose as EXTEND, the teams’ approaches are starkly different (see ‘Life support’).
The Michigan device doesn’t surround babies with fluid, but instead fills only their lungs though an endotracheal tube. And it uses a pump to draw blood from the jugular vein, oxygenate it outside the body and send it back in through the umbilical vein; the CHOP group hooks its device up to both the umbilical arteries and the vein.
Each approach comes with its own pros and cons, which the groups highlighted in a pair of commentaries in July3,4. Currently, the CHOP device necessitates delivery by caesarean section, because the umbilical arteries start closing quickly during birth, and natural labour can take a long time. But the risks of an elective c-section for a pregnant person are not trivial and must be factored in to the equation, David says. In its July article3, the CHOP group acknowledges this risk, but notes that up to 55% of extremely premature babies are already born by c-section.
By contrast, clinicians using Michigan’s approach could deliver a premature baby naturally and determine whether the infant can breathe unaided. If not, they could still hook it up to the system, because the umbilical vein doesn’t close as quickly as the arteries do, says Robert Bartlett, a surgeon at the University of Michigan who works with Mychaliska. But the external pump for moving blood around carries a risk of straining the heart or causing brain bleeds. According to published data, the Michigan group has so far sustained lambs for about two weeks5, compared with the CHOP group’s four weeks. (Mychaliska did not respond to e-mails asking for comment.)
Although the groups disagree on the best approach, Bartlett says he hopes the CHOP group successfully secures FDA approval for human trials. He and his colleagues at Michigan plan to seek FDA approval in about a year, he adds.
Eduard Gratacós, a fetal-medicine specialist at the University of Barcelona in Spain who is also developing an artificial womb, acknowledges that his group is years behind the CHOP group. But if clinical-trial results look promising, he says, “we’re going to need several of these systems in the world”.
A leap from lambs
Even as excitement mounts about this type of technology, however, questions remain about what data will be required to get the green light for human trials. “It’s a big leap to go to humans from lambs,” Gratacós says.
Lambs at the same stage of development as extremely premature babies are two to three times larger, meaning that researchers would need to further tweak the already-tiny equipment necessary for the artificial womb. Fetal pigs are more similar in size to human fetuses, but they are harder to work with than lambs, Bartlett says. Non-human primates are a gold-standard animal model to precede clinical trials because of their physiological similarities to humans, but their fetuses are even smaller than those of humans, and the ethics of conducting such experiments are complex.
Guid Oei, an obstetrician at Eindhoven University of Technology in the Netherlands, and his colleagues have been developing their own artificial-womb system alongside simulation dolls that allow clinicians to practice transferring a fetus. “You only have one chance to do it right, and the learning curve should not be on actual human beings,” he says.
Nevertheless, to Matthew Kemp, an obstetrician at the National University of Singapore, “the data aren’t there from an ethical position” to justify the launch of human trials, unless “someone is sitting on a bunch of data that isn’t published”. Kemp, who is also developing an artificial-womb system, hopes to see data on how the experimental animals fare in the long term, as well as data from non-human primates, before clinical trials begin. (The CHOP group hinted at “extensive unpublished data prepared for regulatory approval” in its July commentary3.) “It’s a new treatment modality,” Kemp says. “The bottom line is they’ve got to make a really strong case that it’s better and safer in the short and long term” than the current life-saving measures used.
Ethics and more
Safety questions won’t be the only ethical concerns. The development of artificial wombs represents a “big transformational leap” that “solves lots of issues”, says David. But, she adds, “it also opens up a whole new slew of issues”. After the 2017 study1 generated extensive media coverage, fears spread that artificial wombs could one day replace pregnancy.
But researchers discount these concerns. This idea “is so far in the distant future that it’s not worth discussing its implications in relation to the current technology”, Werner says.
Those developing artificial wombs in the United States will also have to contend with a politically charged environment for reproductive rights. Flake and Mychaliska have been careful not to give any indication that an artificial womb could change the definition of fetal viability — which has enormous implications after the US Supreme Court struck down the 1973 landmark abortion decision Roe v. Wade in June last year. Previously, the 1973 ruling had protected abortion until the fetus is viable outside the womb.
Even what to call the entities in these devices is fraught, says Chloe Romanis, a biolawyer at Durham Law School, UK. They’re not fetuses in the conventional sense because they are no longer in the womb, she says. And some argue that they are not neonates, which, by the Latin root of the word, assumes they’ve been born. “The name we give to these new unprecedented patients has implications for rights that the law and society affords,” Werner says. The CHOP group has proposed a new name altogether: fetal neonates, or fetonates for short.
Some researchers also worry that artificial wombs would represent an expensive technological solution to a deeper problem. Michael Harrison, a fetal surgeon at the University of California, San Francisco, sometimes called the ‘father of fetal surgery’, says the data he has seen so far have been promising. But he questions whether it’s worth “throwing all that money and tech” on babies that have a poor likelihood of survival instead of finding ways to improve pregnancy support or standard techniques for preterm critical care, which could reduce the need for artificial-womb technology in the long run.
David agrees, adding that there is insufficient research and funding to understand why women go into labour early and how to prevent it. “We need to get real with this,” she says. “Artificial wombs will impact only a tiny fraction of the problem.”
Bartlett says that systemic measures are important, but he argues that better treatment is urgently needed for extremely preterm babies. “A silver bullet that prevents prematurity doesn’t exist and is unlikely to exist in our lifetimes,” he says. “These technologies are what we need when the systemic measures fail.”
EgonSpengler
Deity
- Joined
- Jun 26, 2014
- Messages
- 12,260
I was thinking along those lines, too. Is this really something we need in our constitutions? I think I mentioned elsewhere that, if I were to rewrite the US Constitution, I would want to somehow include general rights to bodily autonomy, privacy, and dignity, which I think would all apply here. I haven't really sat down and figured out how I'd word it, but now that this has happened, I guess I do feel like a constitution seems like a weird place for something so specific as the viability threshold on medical abortions. (I guess I also feel like having to put "don't be [stink]heads" into your constitution isn't something a people should be proud of. Whatever satisfaction I might get from our 13th Amendment is overshadowed by the fact that we needed it in the first place. I mean, we really had to carve it in stone for people that, "no, you can't own people as property, you [flipping] donkeys.")
You need it in the state Constitution to protect the right from those in the legislature or on various courts.
Lexicus
Deity
Yeah, basically 2 choices: disenfranchise everyone who's arbitrarily "pro-life" (impractical at best) or state it plainly enough in the Constitution that a far-right court can't "interpret" it into meaninglessness.
Farm Boy
I hope you dance
- Joined
- Sep 8, 2010
- Messages
- 28,269
So the law protects the right to abortion, in the state constitution, at any point before viablity - that's the change. And we're not satisfied with the outcome for 2023?
Gogogadget late-term abortions. Whee.
Americans would still support a 15 or 16 week national law. But, you know, congress.
Isn't this what we were supposed to be upset, changed?
Gogogadget late-term abortions. Whee.
Americans would still support a 15 or 16 week national law. But, you know, congress.
