L’auteure de cet article, sage-femme et conseillère conjugale et familiale, s’attache à l’étude de l’objet placenta et l’analyse sous plusieurs formes : le point de vue ethnologique, le point de vue historique, le point de vue psychanalytique. Elle répertorie les différentes représentations qu’il revêt et indique des rites auxquels il est soumis. Elle étudie et analyse les raisons qui ont poussé les soignants actuels à le soustraire rapidement à la vue et encourage le lecteur à le penser différemment. Elle (...) amène, par la réflexion à laquelle elle le soumet, à lui redonner sa dimension symbolique de double de l’enfant nouvellement né, et à lui accorder la place importante qu’il mérite. (shrink)

This paper was prompted by some striking similarities between both the ritual and the medical use of placenta in Ming China and in premodern Europe. Contrary to most accounts, which focus either on the rise of chemiatric medicine or on the growing interest in “exotic” substances, the seventeenth century in Europe also reveals a revived interest in substances from animals, including materials from human bodies. The paper will analyse the use of words signifying the placenta, and follow the (...) trace of vernacular knowledge about the placenta and its role in birth-giving, and in medieval medical texts on women's medicine. I will then analyse how the placenta is treated in systems of signatures in the age of alchemy and will try to trace the advent of more complicated preparations in the seventeenth century, and how between the eighteenth and the twenty-first century, the placenta meandered between a token of folk medicine (re)productive material and pharmaceutical resource. (shrink)

This article examines the human placenta not only as a scientific, medical and biological entity but as a consumer bio-product. In the emergent placenta economy, the human placenta is exchanged and gains potentiality as food, medicine and cosmetics. Drawing on empirical research from the United States, the United Kingdom, Denmark and Japan, the authors use feminist cultural analysis and consumer theories to discuss how the placenta is exchanged and gains commodity status as a medical supplement, smoothie, (...) pill and anti-ageing lotion. Placenta preparers and new mothers cite medical properties and spirituality as reasons for eating or encapsulating the placenta, reinstating ideas of the liberated good mother. Meanwhile, the cosmetics industry situates the placenta as an extract and hence a commodity, re-naturalizing it as an anti-ageing, rejuvenating and whitening bio-product. The authors conclude that, in the emergent bio-economy, the dichotomy between the inner and the outer body is deconstructed, while the placenta gains clinical and industrial as well as affective value. (shrink)

In this paper, we explore how the prospect of artificial placenta technology (nearing clinical trials in human subjects) should encourage further consideration of the loss experienced by individuals when their pregnancy ends unexpectedly. Discussions of pregnancy loss are intertwined with procreative loss, whereby the gestated entity has died when the pregnancy ends. However, we demonstrate how pregnancy loss can and does exist separate to procreative loss in circumstances where the gestated entity survives the premature ending of the pregnancy. In (...) outlining the value that can be attached to pregnancy beyond fetal-centric narratives, we illustrate how pregnancy loss, separate to procreative loss, can be experienced. This loss has already been recognised among parents who have experienced an unexpected early ending of their pregnancy, resulting in their child being cared for in neonatal intensive care unit. Artificial placentas, however, may exacerbate these feelings and make pregnancy loss (without procreative loss) more visible. We argue that pregnancy is an embodied state in which gestation is facilitated by the body but gestation itself should be recognised as a process—and one that could be separable from pregnancy. In demarcating the two, we explore the different ways in which pregnancy loss can be understood. Our objective in this paper goes beyond contributing to our philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding the artificial placenta. We make recommendations including the need for counselling and careful consideration of the language used when an artificial placenta is used. (shrink)

De Bie et al. (2023) propose an organizing framework for different stages of human gestational development from conception to the viable premature. They also identify ethical considerations and con...

The authors respond to a recent consensus statement on maternal–fetal vital conflicts. Sound ethical analysis must depend on accurate medical facts, but there appear to be inconsistencies in the medical analysis. The consensus statement says that the specific threat to the health of the mother immediately subsides following detachment of the placenta from the uterus. The authors refute this assertion, since death from peripartum cardiomyopathy may occur months to years following delivery of the neonate or following termination. The authors (...) assert further that the placenta is an organ of the fetus and that any act on the placenta is a direct act on the fetus itself. National Catholic Bioethics Quarterly 15.1 : 31–37. (shrink)

Deux figurines en terre cuite découvertes à Thasos, l’une votive, l’autre funéraire, nous conduisent, par leur ambiguïté, à se demander si les artisans ont donné une forme plastique au placenta humain alors même que les organes internes du corps ne sont presque jamais représentés. L’observation anatomique de l’« organe » comparée aux sources littéraires, médicales, épigraphiques et archéologiques offre des arguments valables pour appuyer l’hypothèse qu’il n’en a existé que des figurations indirectes, opérées à travers des métaphores imagées, selon (...) le mode connu en anthropologie de l’image grecque. Les figurines en mettant le placenta humain sur la même échelle que les fruits, les céréales, les gâteaux et l’enfant, tous pensés comme relevant d’un processus de cuisson correspondant à la vie civilisée, nous permettent de saisir des éléments essentiels autour desquels la cité se structure et font de cet organe un symbole de la fécondité. Aussi, le placenta devient-il fruit offert à Déméter, gâteau associé à la naissance pour Artémis ou signe des rites de passage de la jeune fille destinée à procréer des enfants légitimes.Two terracotta figurines found in Thasos, one from a votive, the other from a funerary context, invite us, by their ambiguity, to question whether craftsmen did represent the human placenta in a time when internal organs are almost never depicted. The anatomical observation of this bodily part, compared with literary, medical and epigraphic sources, supports the idea that indirect, metaphorical representations did exist and conform to the anthropological logic of Greek imagery. The figurines place the placenta at the same level as fruits, cereals, cakes and the child, all seen as the result of a cooking process corresponding to civilized culture. Thus, the placenta becomes a fruit offered to Demeter, and a cake associated with childbirth, when offered to Artemis; it is also the sign of the rites of passage for girls who will give birth to legitimate offspring. (shrink)

Historians of medicine and generation have long demonstrated how the female body was conceptualized as a site of secrecy in early modern Europe. This essay explores one oft-overlooked organ of the female body—the placenta, which was considered by early modern anatomists to be a particularly challenging secret to uncover. Anatomists who investigated this organ discovered that it was largely absent from the ancients’ accounts of their knowledge of generation, and their own studies of its structure and function revealed a (...) complexity difficult to understand. Through an analysis of anatomical treatises and midwifery guides, this essay investigates how textual and visual knowledge about the placenta was produced and shared by anatomists, medical practitioners, and female midwives. It argues that the secrets of the placenta presented a lucrative opportunity for anatomists to expand their intellectual and financial riches. The study provides fresh insights for historians of science, medicine, and gender and new perspectives on the history of reproduction and embryology. (shrink)

The mammalian placenta exhibits elevated expression of endogenous retroviruses (ERVs), but the evolutionary significance of this feature remains unclear. I propose that ERV‐mediated regulatory evolution was, and continues to be, an important mechanism underlying the evolution of placental development. Many recent studies have focused on the co‐option of ERV‐derived genes for specific functional adaptations in the placenta. However, the co‐option of ERV‐derived regulatory elements could potentially lead to the incorporation of entire gene regulatory networks, which, I argue, would (...) facilitate relatively rapid developmental evolution of the placenta. I suggest a model in which an ancient retroviral infection led to the establishment of the ancestral placental developmental gene network through the co‐option of ERV‐derived regulatory elements. Consequently, placental development would require elevated tolerance to ERV activity. This in turn would expose a continuous stream of novel ERV mutations that may have catalyzed the developmental diversification of the mammalian placenta. (shrink)

The placenta arose during mammalian evolution, which is recent in evolutionary terms. Genetic changes underlying placental development remain identifiable by the new science of comparative genomics (approximately post‐2000). Randomly arising features of genomes including endogenous retroviruses and transposable elements have provided structural genes and gene‐regulatory motifs responsible for innovations in placental biology. Stochastic genetic events indeed contribute to new functionality. Theologically, random mutations are part of the strategy by which the divine purpose for humanity is attained. Placental function critically (...) underlies human brain development, and suboptimal function, associated with environmental conditions and maternal distress, contributes to mental health deficits in the offspring. Many enter life with handicaps arising from contingent events in utero, mandating understanding, compassion, and socioemotional support, imperatives native to moral including biblical values. The extended period of development afforded by placentation enables prenatal parenting, with implications for sensitive and devoted parental commitment. (shrink)

Artificial placentas (APs) are technologies that mimic the human placenta to treat extremely preterm infants. Being an invasive and risky technology, it will raise important ethical questions for human trials. Hence, in this Topic Piece we provide a blueprint of further issues to investigate. First, counselling will have the double role of providing trial information as well as (non) treatment counselling. This requires extra training and the development of ad hoc decision aids to support counselling and parents’ decision-making. Second, (...) more stakeholder involvement is needed. Direct stakeholders, such as parents, clinicians, and researchers, can help develop the decision aids and provide insight on potentially overlooked issues. Society should also be involved to determine whether AP trials and implementation should be subsidized, and the ethical implications of not subsidizing. Third, a proper cost-benefit analysis should be conducted to determine the exact cost of the technology. (shrink)

This article builds on feminist scholarship on new biologies and the body to describe the temporal politics of epigenetic research related to the human placenta. Drawing on interviews with scientists and observations at conferences and in laboratories, we argue that epigenetic research simultaneously positions placenta tissue as a way back into maternal and fetal bodies following birth, as a lens onto children’s future well-being, and as a bankable resource for ongoing research. Our findings reflect how developmental models of (...) health have helped recast the placenta as an agential organ that is uniquely responsive to environments during pregnancy and capable of embodying biological evidence about the effects of in utero experiences after birth. We develop the concept of ‘recursive embodiment’ to describe how placenta epigenetics is reimagining relationships between bodies and environments across developmental, epigenetic, and generational time, and the impacts this has for experiences of pregnancy and responsibilities related to children’s health. (shrink)

In this essay, some of the signatories to “Medical Intervention in Cases of Maternal–Fetal Vital Conflicts: A Statement of Consensus” respond to “The Placenta as an Organ of the Fetus: A Response to the Statement of Consensus on Maternal–Fetal Conflict,” both recently published in this journal. The response examines Bringman and Shabanowitz’s claims and assumptions about the morally relevant pathologic condition in some cases of peripartum cardiomyopathy complicated by a subsequent pregnancy, the moral status of a normally functioning (...) class='Hi'>placenta, and the use of the principle of double effect in these cases. The signatories’ response sets out to demonstrate how Bringman and Shabanowitz do not engage the essential points of the statement of consensus and how their argument is premised on false assumptions. National Catholic Bioethics Quarterly 15.2 : 241–250. (shrink)

Artificial placenta technologies (also termed ‘artificial wombs’) for use in place of conventional neonatal intensive care are increasingly closer to first-in-human use. There is growing ethical interest in partial ectogestation (the use of an artificial placenta to continue gestation of an underdeveloped human entity extra uterum), however, there has been little reflection on the ethical issues in the design of the technology. While some have noted the importance of such reflection, and others have noted that a ‘value sensitive (...) design’ approach should be preferred, they have not elaborated on what this means. In this article, we consider what a value sensitive design approach to artificial placenta design might encompass. We believe that applying this framework to the topic at hand raises theoretical and substantive ethical questions that merit further elucidation. Highlighting that there is a careful need to separate preferences from values and that our intervention should be considered only a starting point, we explore some of the values that could be used to make ethical design choices about the artificial placenta: efficacy, compassion and accessibility. (shrink)

This study explores materiality and material cultures of human placenta in Ming China (1368–1644), for it perfectly displays Chinese ambiguous attitudes towards the human body parts between living and non-living. For a long time, the Chinese had widely applied human body parts in medical treatments and ritual healings. Numerous evidences in relation to their collection, production, efficacy and application are widely recorded in medical works, in particular those found in materia medica. In the sixteenth century, the Bencao gangmu (Systemic (...) Materia Medica, 1596) illustrates thirty-five “human body drugs.” Of those, the placenta was believed effective for curing illnesses, nourishing the body and prolonging life. The questions to be answered include: how is the placenta perceived in medical and religious discourses? What is its “materiality” and “efficacy” when it becomes a drug? What ethical issues and moral concerns are involved with eating the placenta? Last but not least, how was the placenta ritually buried after childbirth in premodern China? In so doing, this essay aims to provide a better understanding of the placenta situated in both material and cosmological worlds. It helps us rethink the multiple relations of human body part to part, part to whole, and body to body. (shrink)

During gestation, fetomaternal exchange occurs in the villous tree (labyrinth) of the placenta. Development of this structure depends on tightly coordinated cellular processes of branching morphogenesis and differentiation of specialized trophoblast cells. The basal chorionic trophoblast (BCT) cell layer that localizes next to the chorioallantoic interface is of critical importance for labyrinth morphogenesis in rodents. Gcm1‐positive cell clusters within this layer initiate branching morphogenesis thereby guiding allantoic fetal blood vessels towards maternal blood sinuses. Later these cells differentiate and contribute (...) to the syncytiotrophoblast of the fetomaternal barrier. Additional cells within the BCT layer sustain continued morphogenesis, possibly through a repopulating progenitor population. Several mouse mutants highlight the importance of a structurally intact BCT epithelium, and a growing number of studies addresses its patterning and epithelial architecture. Here, we review and discuss emerging concepts in labyrinth development focussing on the biology of the BCT cell layer. (shrink)

Preterm birth is defined as delivery occurring before 37 weeks gestation.1 Infants born prematurely have increased risks of morbidity and mortality throughout life, especially during the first year. These risks increase as the gestational age at birth decreases.2 Additionally, there are significant racial and ethnic differences in preterm birth rates. In 2022, the rate of preterm birth among non-Hispanic black women was approximately 50% higher than that observed in non-Hispanic white women.1 The outcomes for these infants are also disparate–preterm birth (...) and low birth weight are the second-leading causes of infant mortality (deaths before 1 year of age). Notably, among preterm neonates, infants born to non-Hispanic black women have a mortality rate more than double that of infants born to non-Hispanic white mothers.3 Importantly, there is a small but significant group of neonates that can be classified as severely premature (those born <28 weeks). Infants born before 28 weeks have varied and uncertain outcomes. While this group accounts for only 0.4% of preterm births, it also accounts for 40% of deaths among preterm neonates.4 As noted by Romanis and Adkins, the advent of artificial amnion and placenta technology (AAPT) holds promise for its potential to address the physiologic complications and mortality risks of extreme prematurity by introducing amniotic substitutes that mimic in vivo placental oxygenation and substrate delivery. In contrast …. (shrink)

The metaphysical status of the placenta has bearing on several ongoing discussions within Catholic moral theology. Numerous bioethicists and theologians have touched on this topic briefly, but to date no robust metaphysical argument appears in the literature. The authors aim to provide such an analysis. First, they provide an overview of the existing literature on the topic. Second, they briefly review the anatomy and physiology of the placenta. Third, they provide metaphysical and biological reasons why the placenta (...) cannot be a part of the fetus, a part of the mother, simultaneously a part of both, the border at which mother and fetus meet, or a separate individual substance. Finally, they provide reasons that support their claim that the placenta is a quasi-substance that exists in symbiosis with mother and child. National Catholic Bioethics Quarterly 14.2 : 295–333. (shrink)

One of the most intriguing bio-objects in the emerging field of regenerative medicine is umbilical cord blood. Employed in existing haematological therapies, but also loaded with potentialities for future uses, cord blood has been lately the focus of a regulatory debate which confronts public and private forms of biobanking. This article explores the political and anthropological side of this debate, describing the ways in which different health practices related to the umbilical cord (and to its symbolic sibling, the placenta) (...) have been involved in processes of societal production and reproduction. Through the use of ethnological and historical data, and their comparison with current practices, I contend that the technical manipulation of cords and placentas goes much longer into the past than what a first glance suggests, and that these two objects can be understood as biological spaces in which forms of social belonging and versions of the societal bond are at play. The current conflict between public and private cord blood banks is therefore interpreted as part of a longer history of bodily practices, and as reflecting recent mutations in the biopolitical constitution of advanced liberal societies. (shrink)

Romanis and Adkins discuss pregnancy loss in relation to artificial amnion and placenta technology (AAPT) for treatment of extremely preterm infants.1 I agree with the authors that AAPT, although it is expected to provide better care for extremely preterm infants, will also be challenging for parents. I, therefore, commend Romanis and Adkins for promoting a more holistic care that includes parents and pregnant persons. However, I believe that they create two false dichotomies, one between the pregnant person/parent and the (...) fetus/child and one between current neonatal intensive care unit (NICU) and AAPT that hinder holistic care. Romanis and Adkins correctly point out that much of the discourse and care surrounding preterm deliveries focuses mainly on the infant. I agree with Romanis and Adkins that true holistic care should also include the parents rather than focusing exclusively on the child. However, the language they use to petition for more inclusive care can be problematic and counteractive to achieve holistic care. The problem is that they accuse any fetal/child consideration of being fetal-centric and, in the same breath, they state that it is something to be challenged. This attitude is problematic as it feeds into the rhetoric of the maternal–fetal conflict. This is a common rhetoric in reproductive and neonatal care used mainly in situations …. (shrink)

Resumen En este artículo nos proponemos mostrar que el nacimiento virginal de Jesús se ha constituido, en su sentido dogmático, a partir de una obliteración de la placenta. Para las culturas primitivas, la placenta era considerada un doble o un gemelo del feto. Mostraremos que el peligro de introducir la figura de la placenta en los relatos del nacimiento virginal implicaba la posibilidad de que existiese un doble o un a/ter ego del Salvador. Para nosotros, este doble (...) o gemelo coincide con la figura del Anticristo.This article aims at demonstrating that the virgin birth of Christ has been construed, in its dogmatic sense, based on the obliteration of the placenta. Primitive cultures regarded the placenta as a double or twin of the fetus. We will demonstrate that introducing the placenta into virgin birth narratives dangerously implied the potential of a double or alter ego of the Saviour. In our view, this double or twin brother refers to the Antichrist. (shrink)

Although there is discussion among ethicists about the permissibility of actions on the antenatal placenta, these discussions rarely take seriously the metaphysics involved. Rather, authors resort to opinion on how the placenta comes to be and for whose good it exists. This paper takes these metaphysical questions seriously. Through discussion of the biology of the placenta, I conclude that it is a shared organ of the mother and the fetus. In an analogy to the ethics of conjoined (...) twinning, I conclude that actions on the placenta must take the good of both the mother and the fetus into account. (shrink)

Transposable elements (TEs) have emerged as important factors in establishing the cell type‐specific gene regulatory networks and evolutionary novelty of embryonic and placental development. Recently, studies on the role of TEs and their dysregulation in cancers have shed light on the transcriptional, transpositional, and regulatory activity of TEs, revealing that the activation of developmental transcriptional programs by TEs may have a role in the dedifferentiation of cancer cells to the progenitor‐like cell states. This essay reviews the recent evidence of the (...) cis‐regulatory TEs (henceforth crTE) in normal development and malignancy as well as the key transcription factors and regulatory pathways that are implicated in both cell states, and presents existing gaps remaining to be studied, limitations of current technologies, and therapeutic possibilities. (shrink)

The placenta invades the adjacent uterus and controls the maternal immune system, like a cancer invades surrounding organs and suppresses the local immune response. Intriguingly, placental and cancer cells are globally hypomethylated and share an epigenetic phenomenon that is not well understood – they fail to silence repetitive DNA sequences that are silenced in healthy somatic cells. In the placenta, hypomethylation of retrotransposons has facilitated the evolution of new genes essential for placental function. In cancer, hypomethylation is thought (...) to contribute to activation of oncogenes, genomic instability, and retrotransposon unsilencing; the latter, we postulate, is possibly the most important consequence. Activation of placental retrotransposon-derived genes in cancer underpins our hypothesis that hypomethylation of these genes drives cancer cell invasion. This alludes to an interesting paradox, that while placental retrotransposon-derived genes are essential for promoting early hominid life, the same genes promote disease-susceptibility and death through cancer. Placental and cancer cells fail to silence retrotransposons that are normally silenced in healthy tissues. This has created new genes that are essential for placental function, yet they are also expressed in cancer. We hypothesize that active retrotransposons are a double-edged sword, contributing both adaptive and deleterious functions to biology. (shrink)

Novel forms of assisted gestation—uterus transplantation and artificial placentas—are highly anticipated in the ethico‐legal literature for their capacity to enhance reproductive autonomy. There are also, however, significant challenges anticipated in the development of novel forms of assisted gestation. While there is a normative exploration of these challenges in the literature, there has not yet, to my knowledge, been empirical research undertaken to explore what reproductive rights organisations and advocates identify as potential benefits and challenges. This perspective is invaluable. These organisations/individuals (...) have an awareness not only of the needs of individuals but also of the political landscape in which regulatory decisions are made and which individuals navigate when seeking reproductive assistance. In this study, data was generated from two semi‐structured focus groups (n = 11). Reflective thematic analysis was used to examine the views raised by study participants in these focus groups. This paper explores two of the themes constructed in the data. First, the equality‐enhancing potential of assisted gestation exploring the multifaceted ways in which assisted gestation has structural benefits for marginalised groups. Second, realising the equality‐enhancing potential of assisted gestation explores the intersecting barriers to access to reproductive technologies and how they may impede the benefits of these technologies in practice. These results can enhance conceptual understanding of the importance of novel forms of assisted gestation and ensure that attention is paid to practical barriers in further normative research. (shrink)

DNA methylation is a repressive epigenetic modification that is essential for development and its disruption is widely implicated in disease. Yet, remarkably, ablation of DNA methylation in transgenic mouse models has limited impact on transcriptional states. Across multiple tissues and developmental contexts, the predominant transcriptional signature upon loss of DNA methylation is the de‐repression of a subset of germline genes, normally expressed in gametogenesis. We recently reported loss of de novo DNA methyltransferase DNMT3B resulted in up‐regulation of germline genes and (...) impaired syncytiotrophoblast formation in the murine placenta. This defect led to embryonic lethality. We hypothesize that de‐repression of germline genes in the Dnmt3b knockout underpins aspects of the placental phenotype by interfering with normal developmental processes. Specifically, we discuss molecular mechanisms by which aberrant expression of the piRNA pathway, meiotic proteins or germline transcriptional regulators may disrupt syncytiotrophoblast development. (shrink)

In the future, full ectogestation – in which artificial placenta technology would be used to carry out the entirety of gestation – could be an alternative to human pregnancy. This article analyzes some underexplored objections to ectogestation which relate to the possibility for new and continuing forms of social oppression. In particular, we examine whether ectogestation could be linked to an unwarranted de-valuing of certain aspects of female reproductive embodiment, or exacerbate objectionable kinds of scrutiny over the reproductive choices (...) of gestating persons. Without discounting the potential benefits of full ectogestation, we conclude that the socially oppressive potential of ectogestation, on top of other concerns, warrants further critical ethical reflection. (shrink)

A new interpretation of human menstruation is presented, resulting from a cross‐disciplinary investigation of evolution, developmental biology, and physiology. A process evolutionarily associated with childbirth expresses itself as menstruation in women for whom frequent and continual failure to conceive has become the default situation. In humans and Old World primates, contractile uterine spiral arterioles evolved as the complement of the highly invasive hemochorionic placenta and is the selected phenotype. Placental progesterone withdrawal during the last stage of birth leads to (...) arrested blood flow through maternal spiral arterioles, allowing detachment of the deciduous placenta with minimal maternal hemorrhage. In nonpregnant females, progesterone withdrawal from a degenerating corpus luteum initiates menstruation and stops blood flow through uterine spiral arterioles. Both events share similar physiological mechanisms and sequences. This explanation may improve our understanding of a recurrent event experienced by half of the human population and for a quarter of their adult reproductive life. (shrink)

The placenta’s role as a mediating passage between bodies has been a conceptual resource for feminist theorists and philosophers interested in developing more nuanced explanations of the maternal–fetal relation, a relation that has tended to be identified with maternal and fetal bodies rather than with the placenta between them. I draw on efforts by philosopher Luce Irigaray and her readers to theorise placental relations as a model for the negotiation of differences. In her more recent work, Irigaray figures (...) the placenta as an enveloping space of metaphorical enclosure. The placental relation in Irigaray’s work thus offers insights into the temporal structure of her theory of becoming and can inform a more ‘materialist’ account of pregnancy. I then consider how placental relations are conceptual resources for re-imagining relations of self–other in pregnancy, and for addressing emergent ethical concerns over the transformation of the placenta into a scientific object. (shrink)

Breast milk and the placenta are phenomena of female human embodiment that challenge the philosophical notion of separate, sovereign subjects independent of other human be­ings and an objective world “out there.” A feminist phenomenological analysis, indebted to Merleau-Ponty and Irigaray, reveals placenta and milk to be intercorporeal, “chiasmic” forms of shared organic existence. This analysis is a philosophical and psychological exploration of “matrotopy,” i.e., the fact that humans eat their mothers through breast milk and placenta. This exploration, (...) however, requires an understanding of the larger environmental field which sustains the female body and its offspring. Environmental degradation, particularly through estrogen mimicking substances in plastics and pesticides, targets the endocrine system of developing fetuses and endangers the future of the human species from the inside. Invisible organo-chemical technologies pose a new and immediate danger and ethical challenge to women and men in the twenty-first century. A “placental ethics” respects the insertion of the human being into the dynamic field of nature; it calls for an awareness that, unless we develop a changed attitude toward technology, the gradual extinction of our species continues to happen in female bodies today. (shrink)

The placenta has played an important role in feminist theories of subjectivity; however, the placenta of feminist theory has been the fully functional placenta of what is considered a successful full-term pregnancy. Pregnancy loss, a topic that has been generally overlooked within feminist scholarship, is absent from feminist theories of the placenta. This article uses early placental development, particularly development that takes place before the placenta becomes fully functional as an organ for hormone production and (...) interchange, as a space through which to consider theorising subjectivity, reproduction and relation through pregnancy loss. In so doing, I argue that turning our attention to the placenta’s early development, regardless of outcomes, allows us to reimagine the role of process for feminist theories of subjectivity while also making room for a wider array of pregnancy outcomes, reinvigorating our ability to think about relations and models of hospitality that do not end as we might imagine. (shrink)

Christian pro-lifers often respond to Thomson’s defense of abortion that the violinist is allowed to die while the embryo is killed. Boonin and McMahan counter that this distinction does not provide an objection to extraction abortions that disconnect embryos and allow them to die. I disagree. I first argue that letting die and killing are not to be distinguished by differences between acts and omissions, moral and immoral motives, intentional or unintentional deaths, and causing or not causing a pathology. I (...) offer a taxonomy in which hysterotomies turn out to be killings. I then argue that if either the placenta is considered an organ of the embryo or the embryo is construed as a part of the pregnant woman, then abortion pills kill rather than allow death. So, assuming that killing people is morally worse than letting them die, extraction abortions can be condemned to the same degree as other abortions. (shrink)

Since the early 1980’s, with the clinical advent of in vitro fertilization resulting in so-called “test tube babies,” a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved (...) method of neonatal care through AWT, but instead to the remote scenario of “complete ectogenesis” that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate. (shrink)

In their paper, Romanis and Adkins delve into the potential impact of artificial amnion and placenta technology (AAPT) on cases of pregnancy loss1 that do not involve procreative loss. First, they call for more recognition of the negative feelings a person might have due to the premature end of their pregnant state. They claim that, should AAPT minimise concerns about prematurity as anticipated, individuals might feel pressured to opt for partial ectogestation to preserve their or their fetus’ well-being; moreover, (...) they point out that the feelings of loss in the context of AAPT are likely to be worse than the ones reported in neonatal intensive care units cases. Finally, they advocate for care pathways focusing on how the transfer of a fetus to the AAPT could affect the pregnant person, with particular attention to managing the grief potentially caused by the pregnancy loss. I praise the authors for such a call to action—especially since partial ectogestation is expected to become a reality in the short-term future—and I share their demands for additional and more attentive care of (formerly) pregnant patients. However, I am concerned that their approach is so focused on negative feelings towards pregnancy loss that it risks becoming …. (shrink)

Romanis and Adkins explore the near-term prospect of artificial amnion and placenta technology (AAPT) which is being developed to supplement the gestational process following the premature ending of a pregnancy.1 While fetal-centric narratives prevail in discussions surrounding AAPT, the authors subvert this trend by centering the experience of pregnant persons with respect to pregnancy loss. The overarching aim of their paper is to move beyond a ‘philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding [AAPT]’ (Romanis (...) and Adkins,1 p1). This commentary will critically examine the viability of this aim. Romanis and Adkins use the term ‘pregnancy loss’ to refer to the phenomenon where individuals experience a complex set of emotions following the premature ending of pregnancy, despite the survival of the gestated entity. Following Golish and Powell, the authors note how parents may experience contradictory emotions, such as joy mixed with grief, as well as a range of negative feelings including shame, disappointment and a sense of failure.2 At present, this phenomenon has been recognised among parents, particularly the (formerly) pregnant person, in the context of neonatal intensive care units (NICUs) when the infant survives preterm delivery and …. (shrink)

Feminist scholars have long argued that the pregnant body is erased – both literally and discursively – from mainstream foetal representations. Janemaree Maher argues that the placenta, as point of distinction and connection between pregnant women and foetuses, has the radical potential to refigure understandings of pregnant embodiment and subjectivity, and offer ‘a way to begin thinking through the impasse of pregnant representation’. Drawing on Maher's notion of the ‘placental body’, this article will examine the place of the (...) class='Hi'>placenta in the practice of non-diagnostic 4D ultrasound scanning. The analysis seeks to connect Maher's theoretical perspective, and the rich feminist literature around foetal imaging, with observational data from my study of 4D scans. I will argue that the capacity of 3- and 4D sonography to image the placenta and umbilical cord in a way that is newly intelligible to lay viewers might present an opportunity for thinking differently about the interconnections – material and social – between pregnant women and foetuses and to relocate women as the subjects of their pregnancies. (shrink)

A large body of literature considers the ethico-legal and regulatory issues surrounding assisted conception. Surrogacy, however, within this body of literature is an odd-fit. It involves a unique demand of another person—a form of reproductive labour—that many other aspects of assisted conception, such as gamete donation do not involve. Surrogacy is a form of assisted gestation. The potential alternatives for individuals who want a genetically related child but who do not have the capacity to gestate are ever increasing: with the (...) advent of uterus transplantation, and the anticipated development of artificial placentas.In this paper, I highlight the pertinent conceptual differences between technologies assisting conception and those assisting gestation to demonstrate that distinct issues arise when assisted gestative technologies are used. I argue that there is utility in considering AGTs as a genus of technologies. These technologies perform the same function from the perspective of putative parents and might exist on a spectrum of alternatives when they become more available. Moreover, since many of the same or very similar ethical, social and legal issues are raised by surrogacy, UTx and ectogestation, analysis of these issues will be better contextualised by considering these technologies together. Many of the matters currently being highlighted for reform in the context of surrogacy will inevitably impact on how other forms of assisted gestation are governed. The conversation should be broadened; we should consider how far other emerging technologies might be accommodated in revised regulatory schemes. (shrink)

In their article, Romanis and Adkins delineate pregnancy loss and procreative loss to show that the former is possible without the latter, as in the case of artificial amnion and placenta technology.1 Here, we are interested in examining the reverse—procreative loss without pregnancy loss—to further tease apart these two types of loss. We discuss two cases: being forced to continue a pregnancy despite fetal demise due to abortion restrictions and choosing to selectively reduce a multifetal pregnancy. Our analysis buttresses (...) the authors’ conclusion: due to our fetal-centric conception of pregnancy, we are only able to value pregnancy instrumentally (ie, for the fetus), not intrinsically. Understanding pregnancy as an embodied state rather than a process that not only acknowledges the intrinsic value of pregnancy for pregnant people but also encourages society to intrinsically value pregnant people is important. In 2022, the Supreme Court of the United States removed the constitutional right to an abortion in Dobbs v Jackson Women’s Health Organization, shifting the responsibility of determining abortion regulations to individual US states.2 Due to the Dobbs decision, there …. (shrink)

The molecular evolution of pituitary growth hormone and prolactin in mammals shows two unusual features: episodes of markedly accelerated evolution and, in some species, complex families of related proteins expressed in placenta and resulting from multiple gene duplications. Explanations of these phenomena in terms of physiological adaptations seem unconvincing. Here, I propose an alternative explanation, namely that these evolutionary features reflect the use of the hormones (and their receptors) as viral receptors. Episodes of rapid evolution can then be explained (...) as due to “arms races” in which changes in the hormone lead to reduced interaction with the virus, and subsequent changes in the virus counteract this. Placental paralogues of the hormones could provide decoys that bind viruses, and protect the foetus against infection. The hypothesis implies that the extensive changes introduced into growth hormone, prolactin and their receptors during the course of mammalian evolution reflect viral interactions, not endocrine adaptations. (shrink)

Despite the therapeutic potential of human embryonic stem (HES) cells, many people believe that HES cell research should be banned. The reason is that the present method of extracting HES cells involves the destruction of the embryo, which for many is the beginning of a person. This paper examines a number of compromise solutions such as parthenogenesis, the use of defective embryos, genetically creating a "pseudo embryo" that can never form a placenta, and determining embryo death, and argues that (...) none of these proposals are likely to satisfy embryoists, that is, those who regard the embryo as a person. This paper then proposes a method of extracting HES cells, what might be called the Blastocyst Transfer Method, that meets the ethical requirements of embryoists, and it considers some possible concerns regarding this method. It concludes by encouraging future HES cell research to investigate this method. (shrink)

This paper re-examines the question of whether quirks of early human foetal development tell against the view (conceptionism) that we are human beings at conception. A zygote is capable of splitting to give rise to identical twins. Since the zygote cannot be identical with either human being it will become, it cannot already be a human being. Parallel concerns can be raised about chimeras in which two embryos fuse. I argue first that there are just two ways of dealing with (...) cases of fission and fusion and both seem to be available to the conceptionist. One is the Replacement View according to which objects cease to exist when they fission or fuse. The other is the Multiple Occupancy View – both twins may be present already in the zygote and both persist in a chimera. So, is the conceptionist position tenable after all? I argue that it is not. A zygote gives rise not only to a human being but also to a placenta – it cannot already be both a human being and a placenta. Neither approach to fission and fusion can help the conceptionist with this problem. But worse is in store. Both fission and fusion can occur before and after the development of the inner cell mass of the blastocyst – the entity which becomes the embryo proper. The idea that we become human beings with the arrival of the inner cell mass leads to bizarre results however we choose to accommodate fission and fusion. (shrink)

E-Co-Affectivity is a philosophical investigation of affectivity in various forms of life: photosynthesis and growth in plants, touch and trauma in bird feathers, the ontogenesis of human life through the placenta, the bare interface of human skin, and the porous materiality of soil. Combining biology, phenomenology, Ancient Greek thought, new materialisms, environmental philosophy, and affect studies, Marjolein Oele thinks through concrete, living places that show the receptive, responsive power of living beings to be affected and to affect. She focuses (...) on these localized interfaces to explain how affectivity emerges in places that are always evolving, creative, porous, and fluid. Every interface is material, but is also "more" than its current materiality in co-creating place, time, and being. After extensively describing the effects of the milieu and community within which each example of affectivity takes place, in the final chapter Oele adds a prescriptive, ethical lens that formulates a new epoch beyond the Anthropocene, one that is sensitive to the larger ecological, communal concerns at stake. (shrink)

The commentaries in response to our feature paper1 are indicative of the varied perspectives that can be taken towards artificial amnion and placenta technology (AAPT) and more specifically its relationship with pregnancy (loss). Kennedy rightly argues that empirical research is essential for understanding the experiences of pregnancy loss and AAPT2 and our own advocacy of empirical research is evident in previous work.3–5 Kennedy also acknowledges the current impossibility of researching AAPT experiences since it has not yet been applied in (...) clinical settings. It is precisely for this reason that we draw on the reported experiences of neonatal intensive care (NICU) parents since they present the closest analogy which can be drawn with the technology.1 What we reject in Kennedy’s response, however, is the claim that the experiences of NICU parents have been ‘exploited’ by us.2 Studies documenting the experiences of NICU parents were drawn on to indicate that our considerations are more than mere speculation. As stated, the experiences of NICU parents, particularly the pregnant individual who experiences pregnancy loss, are the closest indication we have of how AAPT and what it entails may be experienced. To claim that this data is being exploited by us is to undermine the very purpose that such research is undertaken—to indicate how future care may be improved. It would be much more harmful to not use this information. While we believe that experiences of …. (shrink)

Issues surrounding human embryos are poignant and profound. Should research be conducted on them? Should they be discarded? Should they be donated to infertile couples? The Warnock Report was a landmark in providing guidelines limiting experimentation on human embryos to the first 14 days after fertilization, at which time implantation of the embryo is complete and the primitive streak has appeared.2 However, these embryological features were not considered sufficiently distinctive to bestow upon this 14‐day period a separate classification. This situation (...) changed when, in 1986, Anne McLaren suggested the use of the terms ‘pre‐embryo’ or ‘conceptus' to designate “the entire product of the fertilized egg up to the end of the implantation stage” and the term ’embryo‘ for “that small part of the pre‐embryo or conceptus, first distinguishable at the primitive streak stage, that later develops into the foetus.”3 In this paper we look critically at the term ‘pre‐embryo’, and we shall present the case for an alternative set of terms, namely, embryo‐placenta and embryo‐fetus. We consider this latter to be biologically‐based terminology, that does not have any connotation of restricted moral value as the term pre‐embryo does for some. (shrink)

Assisted conception can be distinguished from assisted gestation.1 These processes have tended to be grouped together under the generic term assisted reproductive technology in the bioethical literature. According to Chloe Romanis, however, it is worth distinguishing interventions such as surrogacy, uterus transplantation, and potentially artificial placenta technology, as falling under the genus assisted gestative technologies. This is because gestation carries unique ethico-legal implications as compared with conception. The proposed genus of assisted gestative technologies is a helpful first step in (...) the endeavour to distinguish between the different ethico-legal landscapes across various ‘assisted reproductive technologies.’ I am generally in favour of adopting AGT as a term which separates various forms of gestational services from other kinds of reproductive technologies. Yet, if assisted gestative technologies can be considered a genus of assisted reproductive technologies, we might consider surrogacy, UTx, and artificial placenta technology their individual species. Between these various species of AGTs, I would argue, there remains enough ethico-legal diversity to warrant independent discussion about the descriptive and normative functions of each AGT and the relationship between gestation, genetic relatedness and legal/moral parenthood. Chloe Romanis claims that legal and social issues about attribution of parenthood and the importance that might be placed on information about gestational origins affect all forms of AGTs.1 I take it ethical ambiguities arise because the relationship between who gestates, genetic relatedness to the prospective child, and claims to legal/moral parental responsibility can be disrupted or made ambivalent with the involvement of third-party support. For many of those who do not require reproductive assistance, the gestational labour, genetic relatedness and parental responsibility would traditionally …. (shrink)

This paper brings feminist public health ethics and feminist analytic tools to bear on mainstream medical research. Specifically, it uses these approaches to call attention to several problems associated with “The Placenta Harbors a Unique Microbiome,” a recent study published in Science Translational Medicine. We point out the potential negative consequences these problems have for both women’s health and their autonomy.Our paper has two parts. We begin by discussing the study, which examines the composition of the placental microbiome, that (...) is to say, the communities of microorganisms that live in the placenta. Among other things, this study considers two different relations: a correlation.. (shrink)

In the paper Assisted Gestative Technologies, Elizabeth Chloe Romanis advocates for the creation of a new category, which includes technological interventions that allow ‘persons who want to reproduce, potentially using their own genetic material, but are unable, or potentially unwilling, to undertake gestation’.1 Romanis conceptualises these technologies as a unified kind, a ‘genus’, and argues that they ‘collectively raise distinct ethical, legal and social issues from those related to assisted conception’.1 As I understand Romanis’ paper, her aims are twofold. The (...) first is conceptual: Romanis construes assisted gestative technologies as a separate kind with shared attributes and purposes, which differ from those of technologies that enable conception. The second is normative: Romanis champions the distinction between AGTs and other technologies as a useful way to tease apart relevant ‘ethical, legal and social issues’ that specifically concern AGTs. The reason for this, according to Romanis, is that gestation is ‘such a unique and demanding form of labour’.1 I agree with Romanis: gestation is indeed a unique and demanding form of labour, one with associated biological, cultural and political specificities with distinctive moral significance. It is for this very same reason that I believe that AGTs should not conceptually be considered as a unified category and should not be morally appraised as such, for relevant political and moral aspects of these technologies would be overlooked in the process. To clarify: Romanis’ use of genealogy to aid normative inquiry is a worthy endeavour. And I concur with the very convincing case she makes for the distinction between conception and gestation. My disagreement with Romanis rather concerns the conceptualisation of technologies such as gestational surrogacy, uterine transplantation and artificial placentas as a unified category, and the normative inquiry grounded in …. (shrink)