Imagine Giving Birth in Space

The moment has arrived at last. A woman in a hospital gown steels herself, ready to push. A nearby monitor displays her baby’s heart rate in big, neon numbers. A nurse in crisp scrubs coos in her ear, offering words of encouragement, advice. The scene would resemble any other delivery room if it weren’t for the view outside the window: the soft curvature of the blue Earth against the blackness of space, 250 miles below.

Delivering a child in microgravity may sound like science fiction. But for one start-up, it’s the future.

SpaceLife Origin, based in the Netherlands, wants to send a pregnant woman, accompanied by a “trained, world-class medical team,” in a capsule to the space above Earth. The mission would last 24 to 36 hours. Once the woman delivered the child, the capsule would return to the ground. “A carefully prepared and monitored process will reduce all possible risks, similar to Western standards as they exist on Earth for both mother and child,” SpaceLife Origin’s website states. The company has set the year 2024 as the target date for the trip.

The concept raises a host of questions—we’ll get to those later—but perhaps the most immediate may be this: Why?

Egbert Edelbroek, one of the company’s executives, says spacefaring childbirth is part of creating an insurance policy for the human species. Should a catastrophe someday render Earth unlivable—climate change, Edelbroek suspects—he hopes the human species will move off-world and settle elsewhere. Wherever they land, they will plant roots, build homes, and start families.

“Human settlements outside of Earth would be pretty pointless without learning how to reproduce in space,” Edelbroek says.

Fair enough. If human beings someday venture far beyond this planet and land on another—not to visit but to stay—it’s not impossible to imagine that a pregnancy could occur during the journey or on the ground. One can picture toddlers in puffy spacesuits running around on Mars, the oxygen packs on their backs rattling with each leap.

Of course, this future assumes that human beings have resolved many other challenges that come with traveling to other worlds. Scientists are still trying to figure out how to keep adult humans healthy during long stays on the International Space Station, which is indeed in space, but still within Earth’s magnetic field, an invisible bubble that protects the station and its inhabitants from the worst of space radiation. On top of that, the technology for deep-space travel doesn’t exist. Human beings are a long way from becoming an interplanetary species, and reproduction is just one rung on a very tall ladder.

Edelbroek says he has met with private spaceflight companies that may be willing to launch the delivery mission, and with people who will pay for it. He’s visited survivalist communities in the United States; he believes “preppers” are more likely to appreciate the company’s ethos, and some are quite wealthy, spending thousands of dollars on high-end shelters. He’s even chatted with some women who are interested in claiming the historic title, for themselves and their offspring.

Let’s say Edelbroek gets all three: money, a rocket, and a volunteer. What happens then?

Long before anyone gets off the ground, SpaceLife Origin will face a barrage of questions from regulatory authorities, perhaps even from more than one nation. Commercial space travel is not confined by national borders, and it’s not uncommon for customers in one country to pay the government of another to launch their payloads. SpaceLife Origin’s ambitious mission could include an American woman, in a Japanese capsule, on an Indian rocket, accompanied by a team of doctors from multiple nations.

In this scenario, it’s difficult to say who will regulate what. The pregnant woman’s actions may be subject to regulation, too. In the United States, women are harassed and even arrested for leaving their kids unattended, shamed for apparently putting young children in danger. Space is far more dangerous than the sidewalk outside a store. Would the law consider a woman’s decision to give birth there a criminal act?

Read: “Free range” parenting’s unfair double standard

Even if SpaceLife Origin finds a willing participant—and Edelbroek stresses that she will be calling the shots—would it be ethical for the company to send her? The doctors who would supposedly accompany her, too, might risk violating the physician’s oath: “First, do no harm.” It seems difficult to make the case that helping launch a pregnant woman into space follows this promise.

“Most of the pregnant women I know feel great comfort in knowing that they have access to medical help if there’s an issue during a delivery—or prior to a delivery, or after a delivery,” says Virginia Wotring, a professor of space medicine at Baylor College of Medicine. “Putting people in a situation where they are many, many, many miles away from medical help does not seem to be advisable.”

Let’s set aside, for a moment, the question of how SpaceLife will time labor contractions with a rocket launch to get their participant into space just in time for delivery. Astronauts usually experience three times the force of gravity during the ascent to orbit. In the case of a botched launch and emergency landing, that force triples. It’s unclear what effect such extreme pressure could have on a pregnant person.

There’s little in the literature to guide us on what may transpire in orbit. Experiments on reproduction have been conducted in space, but they have been limited to mice, fish, lizards, and invertebrates. In the 1990s, pregnant rats gave birth after a week on a U.S. space-shuttle mission. Each rat pup was born with an underdeveloped vestibular system, the inner-ear structure that allows mammals to balance and orient themselves. As scientists suspected, the absence of gravity had thrown the pups off-kilter. The animals’ sense of balance recovered not long after birth, but the lesson was clear: Animal infants need gravity.

Imagine childbirth without it. The expectant woman would be unable to take walks to ease the pain of labor, to take advantage of gravity’s downward tug as she pushed. The thought of administering an epidural seems terrifying; the anesthesiologist would have to make sure her patient didn’t float away as she carefully weaved a needle toward the spinal cord. Bodily fluids would clump into blobs and glide through the capsule.

When the time came, the baby’s first breaths would suck in the air of a sealed metal box, composed of oxygen made by complex artificial systems, not plant life.  “A baby might be breathing a gas mixture that is different from Earth air,” Wotring said. “Adult humans seem to handle it just fine, but if you’re using your lungs for the very first time, would it make a difference? I don’t know.”

After the delivery is over, mom and baby would have to survive the descent back to Earth. For current astronauts, that involves a bone-rattling free fall through the atmosphere, followed by a parachute landing in the Kazakh desert. On the ground, the team would be faced with yet another unusual question: Where do you get a birth certificate for someone born in space?

Read: A birth certificate is a person’s first possession

The list of unknowns goes on and on. SpaceLife Origin seems like an unusual player in such a perilous endeavor. The top three employees named on the company’s website are business executives with no experience in medicine or spaceflight, including Edelbroek, whose biography describes him as a “serial entrepreneur.” Five advisers are listed, two of them women. (Edelbroek says the company is working with dozens more, but declined to name them.) Edelbroek says his interest stems in part from his experience as a sperm donor, which led him to father several children and learn about in vitro fertilization techniques. Another of SpaceLife Origin’s missions involves launching sperm and egg cells into space to form an embryo and returning it to Earth for implantation.

Gerrit-Jan Zwenne, one of SpaceLife Origin’s advisers and Edelbroek’s cousin, is convinced that if this company doesn’t do it, another will. Zwenne, a law professor at Leiden University, cited the case of He Jiankui, the Chinese scientist who announced in late November, to the world’s surprise, the alleged birth of healthy twins whose embryos he had altered with a gene-editing technique known as CRISPR. The news prompted international outcry. His work, conducted in near-secrecy, flouted conventional norms in gene-editing technology, a fast-moving field that has avoided attempts at modifying human embryonic cells.

“I think at some point this will happen anyway, so we better do it in a very open and transparent manner,” Zwenne says. “If it’s somebody working on his own, in isolation, not in contact with the rest of the world, you may discover that something happens and you can’t reverse it.”