Biotechnology, Gestation and the Law
By Dr Elizabeth Chloe Romanis
Published by Oxford University Press
ISBN-10: 0198873786, ISBN-13: 978-0198873785
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Dr Elizabeth Chloe Romanis' first monograph makes a significant and comprehensive theoretical contribution regarding conceptual and legal understandings of gestation and pregnancy, focusing on the law in England and Wales. Adopting a transdisciplinary approach drawing on the biological sciences, philosophy (metaphysics, feminist phenomenology, and feminist theory), anthropology, and law, Dr Romanis provides a ground-breaking exploration of the evolving landscape of gestation, propelled by advancements in biotechnology.

'Biotechnology, Gestation, and the Law' is divided into eight chapters and could be seen as divided into two main parts. The first part (Chapters 2 and 3) establishes the transdisciplinary approach adopted, whereas the second part (Chapters 4-7) applies this framework to scrutinise pressing socio-legal concerns related to access, parenthood, and abortion.

In Chapter 2, Dr Romanis disentangles the 'considerable ontological confusion about pregnancy, gestation, and birth'. Drawing on Professor Elselijn Kingma's parthood model, Dr Romanis distinguishes between pregnancy, as 'a state of being', and gestation, as 'a generative process of formation'.

From here, Dr Romanis investigates the metaphysical assumptions underpinning the law, revealing what socio-cultural conditions pervaded lawmakers' sense of the world. How law describes pregnancy – and the relevant legal, social, ethical, and political questions about pregnancy resulting from this description – shapes the broader context in which individuals live their pregnancies.

Dr Romanis demonstrates how the law does not fully endorse the parthood model, instead embracing the container model of pregnancy, wherein 'the fetus is imagined as a separate individuated entity that is merely contained by a pregnant person'.

Chapter 3 considers how various biotechnologies potentially fundamentally alter the nature of gestation. Dr Romanis presents a taxonomy of technologies enabling gestation as a genus, using an inductive classificatory analysis of surrogacy, uterus transplantation, ectogenesis, and reciprocal effortless IVF.

Most compelling in this taxonomy was her discussion on this latter technology, which uses intravaginal culture to support two people assigned female at birth to 'carry' a pregnancy: Dr Romanis applies her conceptual distinction (presented in Chapter 2) to argue that reciprocal effortless IVF is better classified within the genus of technologies enabling conception, due to the lack of implantation, required for gestation qua generative process and to alter a person's physiological state of being in a way that establishes their pregnancy.

The second half of Chapter 3 considers the differences in procreative experiences when technologies enabling gestation (surrogacy, uterus transplantation, and ectogenesis) are used, thereby demonstrating how they serve different procreative needs.

Chapter 4 considers the right to procreate (morally and legally) and whether it encompasses the right to make decisions about gestation, before moving on to the need to ensure that access to technologies enabling gestation is not dictated by biological essentialism.

Critiquing the legal framework regulating assisted conception (the Human Fertilisation and Embryology Acts 1990, 2008), Dr Romanis argues that narrow notions of 'biological need' viewed through a cis-heteronormative lens have limited access to technologies enabling conception for marginalised groups. Dr Romanis adds to the well-rehearsed critiques of the legal framework (eg, the repeated calls to tackle the IVF postcode lottery (see BioNews 1120 and 1224)), arguing that addressing the extra-legal barriers to technologies enabling conception is necessary to ensure that technologies enabling gestation do not exacerbate existing disparities.

In chapter 5, Dr Romanis criticises the argument that technologies enabling gestation allow for gender equality. Dr Romanis argues this 'misguided and reductive' claim is underpinned by significant biological essentialism, necessarily implying the gender and sex of those able to gestate and their inherent inferiority. Instead, she posits the appeal of technologies enabling gestation hinges on their disruptive 'unsexing' of generative labour.

Chapter 6 illustrates the justifications underpinning gestation as determinative of legal motherhood, before discussing the challenges to legal motherhood posed by the potential future divisibility of gestational work. Dr Romanis' critical exploration of the oft-repeated legal maxim mater semper certa est (the mother is always certain) demonstrates how it is 'not as historically rooted as is often claimed' and questions whether gestation can remain as the anchor criterion it is, given novel technologies enabling gestation.

Dr Romanis uses chapter 7 to illustrate how arguments against abortion in the advent of technologies enabling gestation are unpersuasive, given the importance of bodily autonomy and reproductive rights for people undertaking pregnancies. Dr Romanis argues technologies enabling gestation do not change the moral permissibility of abortion but instead offer a useful springboard for imagining better procreative futures which necessarily encompass the decriminalisation of abortion.

Chapter 8 concludes the monograph, summarising the earlier substantive chapters.

While there are many strengths to Dr Romanis' monograph, one stood out in particular: her deft interweaving of social and legal reform proposals in each chapter. Often, such calls for reform are relegated to the final chapter(s). However, Dr Romanis' meticulous analysis and fluid writing ensured that her calls for reform did not feel forced or rushed.

Overall, 'Biotechnology, Gestation, and the Law' is a pioneering and insightful text that will undoubtedly become foundational reading for legal scholars, bioethicists, policymakers, and anyone interested in the future of human reproduction.

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