“Outer Origin: A Birth Story” by Laura Johnson Dahlke
Outer Origin unofficially originated the first time I experienced labor. Racked with pain and the inability to push past it, I clung to the edge at nine-and-a-half centimeters. I still had what is often referred to as a cervical “lip,” which needed to thin and open before I started pushing. I looked at my midwife, Roberta, from that cliff, not able to reach “complete.” I rocked. I swayed. I moaned. I moved from birth ball to the toilet, back to the birth ball. Nothing was working.
While I was naked, on all fours, my entire existence held in my uterus, she decided to intervene.
“Just let me hold the cervix back while you push,” she said with encouragement. “Can you try that?”
I nodded, looking in her eyes the way many women in labor look at their midwives—through an endorphin-induced, otherworldly trance, searching for acknowledgement, guidance, and understanding. She gazed back at me with reassurance from that same spiritual realm, a shaman leading the way.
Roberta put on a sterile glove, moistened it with jelly, and held back my cervix while I pushed. Together, we made it disappear.
“It’s gone,” she said after one try, relieved and smiling. My cervix was complete.
Once I’d reached ten centimeters, my contractions eased. In this latent phase of the second stage, which not everyone experiences in labor, I sat up in a queen-sized bed against pillows, ate a tablespoon of honey, drank vitamin C, and breathed deep. Being at a birth center, unconnected to a continuous monitor or IV, helped me fully embrace this moment of rest.
After about thirty minutes, I was ready to continue, resolved to get the baby out.
Pushing was deep and awkward. I never had the urge, so it was a conscious effort without that guide. I pushed, made progress, waited, and pushed more. This was exhausting, but not as painful as before.
Then, crowning began. With two nurses by my side, my midwife waiting to catch, my husband cheering me on, I panted and pushed without wanting to feel the sting of my body ripping open.
Dazed, I talked to myself, saying out loud, “How can I do this? This is impossible! I can’t do this!”
Everyone around me shouted, “Yes you can! You’re almost there!” So, I pushed in the way someone might if they were going to knife themselves. I thrust onto the sword just to finish the job.
“Is the head out?” I wanted to know, passing in and out of awareness. It was.
At this point, it became important to get the baby out in less than a minute. So, I pushed without a contraction, but nothing happened. I waited for one, but it didn’t come.
“We need to get the baby out now, Laura,” Roberta said seriously. I understood and tried again, but the baby wasn’t moving. Without another attempt, she rolled me onto my side to apply downward pressure to the baby’s head.
Finally, the baby’s blood and mucous-covered body emerged from me, slippery and alien and very much alive.
*
The birth of my oldest child, Julia, transformed me. I not only became a mother, but I also gained a profound awareness of my physical capacities and self-determination. These insights emerged from the overwhelming corporeal experience of giving birth, a complex mixture of managing pain and exhaustion with both courage and surrender. It was one of my first lessons in the power of what I could do and what I must accept, something that has informed my life ever since.
I was so moved by this awe-inducing event that it sent me on an ongoing inquiry about all things related to pregnancy and childbirth. Julia’s birth and the insights my other four children’s deliveries imparted, along with many years of study, were the impetus for embarking on a PhD in humanities to formally write about childbirth and maternity care. Perhaps counterintuitively, because it is outside the confines of the body, my focus expanded to ectogenesis. While studying the philosophy of technology, which questions and elucidates the role of technology in human life, I began to contextualize pregnancy, childbirth, and modern obstetrics through this lens. I took seriously the idea that as a human race “besotted with technology, we seem almost eager to narrow our conception of what it means to be human” and accept this without interrogation. Using childbirth as a guide, I agreed with Joshua Rothram when he said, “we need to reinvest in the vocabulary of human value before our machines rob it of its meaning.”
I became increasingly interested in obstetrical tools and techniques, from which the topic of artificial wombs emerged. My decision to write about creating life outside the confines of the body was informed by novels like Brave New World and Frankenstein, books that also investigate what it means to be fully human. I quickly became abreast of the current scientific research on the topic and began to understand artificial wombs within a larger epoch of reproductive intervention. I would eventually call this extra-uterine destining. I additionally learned that if humanity does not value the reproductive process and what it can offer, it might be lost forever to technological means. In modernity, we must insist on its value, and our own, in order to preserve what makes us unique.
Excerpt from Outer Origin
JASON: What we poor males need
is a way of having babies on our own—
no females, please.
Then the world would be
completely trouble free.
—Euripides, Medea, 431 BCE
Imagine it is the year 2050. For the first time in human history, a baby has grown from embryo to infant entirely outside of a woman’s body in an artificial womb. Reports abound, much like those of Louise Brown’s birth on April 25, 1978, the world’s first “test-tube” baby. Headlines read: “First Ectogenetic Arrival: SUPERBABE”; “And here she is . . . THE LOVELY LENINA”; “Grown Safe—The World’s First Baby in a Bottle weighs in at 5 lbs. 12 oz.” She is the “baby of the century.”
While this fictious example might seem implausible, ectogenesis was swiftly becoming a medical reality in 2024. In fact, Alan W. Flake, renowned pediatric and fetal surgeon from the Children’s Hospital of Philadelphia, and his colleagues have developed what they call an EXTra-uterine Environment of Neonatal Development (EXTEND) artificial womb technology (AWT). This device would initially be used to decrease the morbidity and mortality of extremely premature infants and potentially increase viability from the current limit of twenty-two weeks. The device, also known as a Biobag, would “immerse the preterm fetus in simulated amniotic fluid, with oxygenated blood being pumped through by the fetus’ own heart rather than mechanically.” Human use may begin soon, with clinical trials currently under consideration by the Food and Drug Administration. While not its implicit intention, systems such as EXTEND could potentially replace women’s uteri altogether. Flake says the “whole idea” is for the wombs to “support normal development; to recreate everything that the mother does in every way” in order to “support normal fetal development.” EXTEND has been called a “technological miracle” by Jay Greenspan, who claims this is “something we’ve been trying to do for many years.”
And by many, we might say at least several hundred years. Ectogenesis was likely first given attention by Paracelsus in the sixteenth century. He speculated that “there was no little doubt and question among some of the old Philosophers, whether is was possible to Nature and Art, that a man should be begotten without the female body and the natural womb.” The alchemist provided a formula for a “homunculus” a man with no soul, grown in an artificial womb.” This formula perhaps began in earnest the idea that science could in fact create another human within an artificial uterus.
The impetus for such an idea, however, may also have emerged from broader notions of women’s bodies being cast as inferior. Dating back to Aristotle, the female form was often viewed as less important than a man’s for reproduction. The ancient Greek philosopher used the metaphor of carpentry to explain conception in which the woman contributes only the wood, much like a tree. Nancy Tuana explains Aristotle’s view this way: “but it is the male, similar to the carpenter, who determines the function of the object to be produced and gives it form. The female body thus becomes the workplace and source of raw material out of which the male crafts a human life.” Not only does the male craft the life, but Aristotle also posited that the male imparts the “principle of the soul” on the future offspring. The inferior female is relegated to being, ironically, the least important contributor in reproduction, serving as a mere host for a male to use for his creation.
In addition to casting the female body as a vessel, there are numerous concomitant myths about male appropriation of birth. In these, the principle actor in birth is the male god. Barbara G. Walker writes that “[s]ince birth-giving was the only true mark mark of divinity in primitive belief, the first gods to claim any sort of supremacy had to claim also the ability to give birth. In fact, usurpation of the feminine power of birth-giving seems to have been the distinguishing mark of the earliest gods.” Without uteri or a vagina, many of these gods gave birth from their mouths, stomachs, penises, or thighs. What male gods and human men lack biologically is overcome through myths and later, through actual appropriation of the process via technology. Pregnancy, gestation, and birth were and remain a highly desired power.
These examples illustrate how removing women or limiting their contribution to the reproductive process has been a powerful narrative and goal throughout history. The ubiquitously referenced story of Victor Frankenstein in Mary Shelley’s gothic masterpiece points to such a desire. Her famous character (whose name is often confused with the creature) says that, similar to a god’s ability, he was “animated by an almost supernatural enthusiasm” when creating the monster. Victor also thinks that “bestowing animation upon lifeless matter” has been “the study and desire of the wisest men since the creation of the world.” He was enraptured with the belief that a “new species would bless [him] as its creator and source; many happy and excellent natures would owe their being to [him].” It is evident that he exemplifies one of the primary goals of hu(man)kind—to create life outside the limitations of reproductive biology. To have the power to create life without a woman.
Removing the maternal body from the process is one of the main objectives of artificial womb technology. Though ectogenesis could be liberating to women by redistributing the natural inequality of what some feminists like Shulamith Firestone call the “tyranny” of reproductive biology, it also has the power to diminish or erase women’s valuable and unique contributions to human generation. Jennifer Block’s questions, posed about women’s healthcare more broadly, are applicable here: “Do we sometimes confuse medical technology with empowerment? Does regarding our bodies as oppressive render us more vulnerable to the overuse of medical technology?” This study argues this is true. The maternal body, and women’s lived experiences, therefore, need reclaiming from the Western philosophical and scientific canons that devalue their importance. Women should remain skeptical of the belief that artificial wombs will serve as liberation.
Modern obstetrical practices also promote the development of artificial wombs. When labor can be manipulated and altered with pharmacology and surgery, a woman’s body no longer becomes critical to the process. The infant can arrive without contractions, cervical dilation, or a woman’s personal desires, determination, and courage. Maternal-fetal medicine doctor Lauren A. Plante recognizes this by saying, “women can be processed through the childbirth machine and handed a baby, stripping them of their central role at the heart of things. . . .” She believes that because of the history of American childbirth in the hospital, and this study would argue an even broader historical context of reproductive imagination and control, that “childbirth moves, first, out of the home and now, out of the vagina.” Of course, this study further argues there is yet another stage—that childbirth may also move out of a women’s body entirely. Paul Tesar’s statement exhibits this idea when he says, “it is not unreasonable that we might have the capacity to develop a human embryo from fertilization to birth entirely outside the uterus.” Human development in an outer origin should no longer be considered the subject of mere imagination, but instead, a real-life product of contemporary science and technology.
Women’s bodies, the very flesh and blood that has sustained humanity since time immemorial, will be increasingly replaced by machines. Women’s valuable experiences of growing life and giving birth, though sometimes met with health risks, morbidity, and death, deserve preservation, and celebration of life on Earth can continue. If one day humankind must merge with technology for survival, biologic pregnancy and childbirth would be a distant relic of the past. But if Homo sapiens can remain embodied, women ought to be wary of machines taking their place. History suggests that what at first glance seems like a tool designed to be used sparingly to save extremely premature infants will likely become be the standard of care. Society must seriously wonder if ectogenesis will bring women into the light or cast a dark shadow over their existence.
Adapted from Outer Origin: A Discourse on Ectogenesis and the Value of Human Experience by Laura Johnson Dahlke. © 2024 Laura Johnson Dahlke. Published by Pickwick Publications. All rights reserved.
Laura Johnson Dahlke, PhD, is a writer and scholar who is passionate about topics relating to pregnancy, childbirth, and reproductive technologies. In her work she synthesizes complex ideas from various disciplines such as medical science, philosophy, literature, and psychology with clarity and readability. Along with writing, she teaches English courses at the University of Nebraska at Omaha. In her spare time, Laura practices Iyengar yoga, bakes sourdough bread, and avidly reads books on positive psychology and human potential. She lives in Omaha, Nebraska, with her family, after having spent many years on both the east and west coasts.
