Bryan Caplan  

The Demand for Ectogenesis

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Ectogenesis basically means the creation of new human life without pregnancy. Instead of incubating the fetus in a mother's womb, there'd be an artificial incubation tank. Prospective parents would go through the first stages of in vitro fertilization; but instead of implanting the embryo into his mother's womb, he'd be placed in an artificial womb. Nine months later, and wa-la! You've got a new baby.

Questions:

1. If this technology were safe and effective, what fraction of prospective parents would pay an extra $10,000 to avoid pregnancy?

2. If insurance covered ectogenesis, what fraction of mothers would still opt for a traditional pregnancy?

3. How much do you think the availability of ectogenesis would affect family size?


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COMMENTS (19 to date)
Todd writes:

Shooting from the hip based on what I hear from the women I know who talk about pregnancy:

1) At least half of those that could afford it. Probably closer 3/4.

2) Less than 10%

3) Increase the average family size by .25 kids.

Great scenario by the way.

Bob Knaus writes:

As I recall, Brave New World covered this pretty well back in the 1930s, and raised a far more important question than your three:

4. What if the government could produce humans to order, by efficient industrial means?

Vasco writes:

Also, what would this do for abortion ethics? If there was also a way to transplant a fetus from a mother's womb to an artificial one, would there be any moral justification left for abortion?

liberty writes:

(1) It would start out lower, and increase. Then the natural birth would come back in style as women realized what they were missing out on. This is also in sci-fi movies and books, isn't there one where the natural birth guy without genetic engineering is shunned by society?

(2) I agree that this kind of thing could go terribly wrong in government's hands.

Horatio writes:

The only data point I have says no. Even if she could afford it, she feels her bond with the child would suffer. We can probably expect women who are more traditionally maternal to avoid it, but career women who forego children now will suddenly start having many more kids.

1. Among dedicated career women, Todd's 3/4 is probably an underestimate.

2. I think most would still prefer a traditional pregnancy.

3. A great deal here in the west. Those childless yuppies would start having bigger families at younger ages than they do (or don't at all) now.

Robinson writes:

"Also, what would this do for abortion ethics? If there was also a way to transplant a fetus from a mother's womb to an artificial one, would there be any moral justification left for abortion?"

I agree that it weakens the case, but it depends on your previous moral beliefs about abortion, as well as the cost of transplanting the fetus. Someone putting no value on the fetus's life might find it immoral to force an unwilling mother to choose this transplantation rather than a traditional abortion.

Also consider what will happen to the child once it is born. Assuming that only a small portion of mothers that would have otherwise had an abortion would claim their children afterwards, this would lead to a massive increase in orphans. I don't see this as a particular problem (there's a good market for adoption), but many might.

Good question though.

John McSorley writes:

Ok nice questions but isnt there a couple of issues that bear on this? Maybe not economics per se but still relevant.

1) Too posh to push. The allegation has been made that some women (particularly those with a high profile media job) have opted for C Sections rather than go through the indignity of natural birth. The proffered reasons vary ranging from tight scheduling to fear of photo's appearing in the press but those people would snatch at it
2) Image - would a women whose face is her fortune risk the potential of stretch marks?
3) Whilst death during childbirth is rare it still happens so this may be a safety issue for some women
4) Malpractice - what if this is perfectly safe? how many doctors would push or demand this rather than stumping up the malpractice fees?
5) Miscarriage - How many would use it for getting round this (actually thinking about it this would be amongst the reasons it was developed in this brave new world)

In answer to your questions
1) Surely this is better thought of as a percentage of average income? ie how many people would pay 1% of annual income (as opposed to 10% say) to having a child? if it was a fixed amount might this lead to a diffrent question about family size for rich familys and small?
2)as mentioned above costs to health for normal pregnancy. At 1,000 might be cheaper and so pushed by insurance but at 10,000. I have no idea what the price sensitivity would be on that.
3) See my answer to 1?

Patri Friedman writes:

1. In the US, 20% (mainly based on income)
2. In the US, 20% (the religious and those concerned about health risks from the process)
3. It would significantly increase it, both by reducing the cost of pregnancy, and by enabling women who can't have children for medical reasons (w/o an expensive surrogate) to have kids.

Since you didn't call this device a "uterine replicator", I take it you have not read Lois McMaster Bujold. I'm shocked! She's my favorite SF author, and it's no accident that she's tied w/ Heinlein for the most Hugos for best novel.

jebs writes:

1. 70% of those who could afford it would do it.

2. If insurance covered ectogenesis for everyone, I think only 10 - 15% would have children naturally. My guess is that carrying a child would become a yuppie fad like natural childbirth, organic produce, or yoga. It would be the province of the trendy, plus a small handful of diehards who felt it helped them bond with their children. But most women would use the technology.

3. I think you would see the birthrate increase on the order of 0.25 - 0.5 per woman.

Most of the women I interact with are young (20 something) educated professionals, and the desire to avoid exposing their bodies to the ravages of pregnancy and childbirth is a significant aspect of their low desired family size.

My wife would have ectogenesis in a heartbeat.

Most of the young female doctors I know plan to deliver by caesarean, and they would jump all over ectogenesis.

In your example, this technology is assumed to be safe. But these sorts of medical procedures almost always have unforseen consequences. I suspect that when ectogenesis actually becomes available, it will have adverse health effects, and it will probably take decades to figure out what they are. I therefore don't expect it to be widely used immediately.

Michael A. writes:

Go read Lois MacMaster Bojold's Vorkosighn Saga books. She pretty much covered everything about it's use.

Did a dandy job of trashing Andrea Dworkin's critizism of the technology ("projected" at the time).

Kyle writes:

Darn, Patri beat me to it. Darn lazy blog-reading seasteaders.

Vorkosigan saga novels by Bujold cover this nicely.

Emma B writes:

We already have gestational surrogates, and even most women with serious physical issues such as recurrent miscarriage or severe pregnancy complications don't use them. Expense and logistics are definitely part of it, but it's emotionally complicated too. I have personally had trouble getting pregnant, and not the easiest time staying that way, but I would adopt long before I turned to a gestational surrogate (and I'm well aware that adoption is a lot more complex than popular perception would have it).

I also seriously doubt that most women would be willing to go through the IVF process, even if cost and reliability were not at issue. It's intrusive and physically taxing to a degree that most people simply can't comprehend unless they've done it. We're talking about weeks of shots that put you into artificial menopause, followed by another ten days or so of shots that supercharge your ovaries and grow them to 5-10 times their normal size, during which time you also have transvaginal ultrasounds and blood draws every one or two days. Finally, there is egg retrieval, which is unpleasant enough that it's performed under partial or general anesthesia. Up to 10% of women undergoing IVF develop ovarian hyperstimulation syndrome, which in its milder form just leaves you feeling like you've been hit by a truck, and up to half of that 10% is severe enough to require hospitalization for fluid removal and pain management. The IVF process is on par with chemotherapy or dialysis in terms of sheer physical difficulty.

According to the CDC's ART statistics, about 1.2 million women see a doctor for infertility-related issues in any given year, yet only about 135,000 IVF cycles (which cost about $10K each) are performed annually, and many of those are on women who go through multiple cycles. If less than 10% of infertile women are able and willing to go through IVF to conceive a much-wanted baby, the percentage who would casually choose ectogenesis to avoid the hassles of pregnancy is certainly much smaller.

Finja writes:

at least in western europe, one of the main reasons why young couples don't get kids is not the cost of pregnancy, but the cost of raising the child.
as long as having kids (esp. more than one) is a poverty risk, the amount of kids per woman won't change that much...

(but it does sound like the one and only way I would ever start thinking about having kids.)

Erich writes:

1. 30%. 15% for the couple's first child and a large increase for those having subsequent children

2. 65% would opt for traditional pregnancy

3. It would increase family size by .4 children per couple, though the couples opting for this technology would be more prone to divorce. The timing of having children would also change, pushing it later as the problems of miscarriage with age are eliminated. Furthermore, mating markets would slightly shift as females become less dependent on their biological clocks forcing their hands.
I'd guess children would become a popular venture for retirees, as they come up on plenty of extra time and an outlet for their attention.

Alex writes:

One of the biggest impacts would be the age of mothers. There are many women who don't want to be mothers until they are too old or wanted to have another kid when they were young, but couldn't afford it then. By eliminating the medical risks, you'd see more older women have children.

You'd also see more women freezing their eggs for just such an event later in life.

Average increase in children per mother: .4-.6.

ZJ writes:

In the short run, this would be a tool for actresses, other celebrities and extremely career oriented women as oppose to most women.

If insurance covered the process, the option may become more attractive but one has to take into account the cultural issue. As it was pointed out earlier IVFs are not as common as one would assume. Again this is in the short run...culture and attitudes regarding this may change overtime.

I doubt it will effect family size at all. People are having less kids not only because costs of pregnancy but costs related to having kids and taking care of them for couple of decades (maybe more).

Peter St. Onge writes:

We've got a proxy with overseas surrogates; in the case of India the turnkey cost seems around $25,000. I'd guess .1% of US women do it, and I'd guess 95% can afford it.

Seems people are particularly conservative about gestational technologies. Some guesses:

a) standard conservatism related to health ("better safe than sorry" for novel treatments)

b) mothers don't like if their embryos are growing far away where they can't protect them

c) mothers may fear being seen as (or think themselves) evil/cold for handing off gestation

So my guess is that ectogenesis at your prices would eventually dominate the market, but it would be a long cultural process, maybe 2-3 generations.

8 writes:

Just as many women have children without fathers, this would allow men to have children without mothers. Men, for the first time, would be able to separate the egg from the woman, just as women have always been able to separate the sperm from their husband (cuckolds). This would level the genetic playing field, which is currently tilted in womens' favor. Therefore, although women might initially think it a good idea, the end result will be the opposite.

J writes:

Re Number 3 - Not much. People does not want children, that is the reason they are not making them. They dont want them so much that are ready to kill them before being born. Nature made us so that fertile females are in fact forced to become pregnant and give birth, if the thing depends from them, if it is voluntary or elective, humanity is doomed. Only a strong religion can make a people grow in a prosperous and free society.

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