In confronting the problem of mortality and the falling human population, a radical solution has been floated: Allow women to deliberately become pregnant and give birth. NewLives, an advocacy group in favor of the motion, is coordinating campaigns in multiple countries. It’s not just advocates though—thousands of women have signed up, willing to risk their lives. The campaign has support in over a hundred countries, and multiple national governments are set to debate legalization within the coming months.

We spoke to Alexis McPhearson, 23, a volunteer and student at the University of Toronto, about why she would want to take such a risk. She says there are multiple reasons, including not only bolstering the population, but also the potential for deep personal meaning. She says that the disappearance of several cultures in the last decade sent her into a deep depression and the idea of creating new life gave her a sense of purpose.

When asked about the risks, she says that the probability of her dying is so low, the chance of creating new life is worth it. “It comes down to the math of it. The risk of death is about as low as dying from donating a kidney. If we can get support for childbirth, I’ll receive the best medical care in a devoted facility, in which case it will be even lower. For me, the substantial probability of adding one life to the world is worth the small risk of losing one.”

Not all people think of it in terms of probabilities, however. Bioethicists are split on the merits of pregnancy. Brian Garcia, MD, a tentative supporter, calls it a necessary evil. “Now, this isn’t something you’d normally consider,” he says over the phone. “But given the slow cratering of the earth’s population, sometimes you have to allow altruists to take risks.”

On the other hand, Jacob Strickland, MD, is skeptical. “Obviously, new life would be beautiful. But even with the best medical care there is still the chance of death during childbirth. So I just don’t see how you ethically could allow a pregnancy.”

Strickland goes on to detail the potential effects that can result from even a successful pregnancy, based on studies in the animal world. “Increased risk of cardiovascular disease, weight gain, bladder dropping, rectocele. We also suspect there can be ongoing psychological effects. It’s not clear to me that volunteers are fully cognizant of all the risks they’d be taking on.”

McPhearson, for her part, says she knows of and accepts the risks, considering them to be worthwhile compared to the potential gains. NewLife has proposed limiting pregnancy to those in the lowest risk bracket. This means women in their late 20s. It is also formulating what it calls a strong informed consent procedure. “We are very aware of the risk, and we believe that if a volunteer is also fully aware, then it’s their choice to make and we want to advocate for them,” says John Swift, the director of NewLife. “We certainly don’t want to downplay the risk and are working to create a process that would rigorously inform potential volunteers.”

Even so, the fraught history of pregnancy has many observers worried. “There have been many cases in the past where women didn’t know about the risks they were getting into with pregnancy. There wasn’t informed consent. Women have died because of it,” says Strickland.

If childbearing is to become legal, it will only be after concerns like these have been adequately addressed. This means extensive vetting by medical professionals and potentially bitter debate in national legislatures. McPhearson is hopeful that she can ‘conceive’ (become pregnant) by the end of the year. In the meantime, she is planning out what she would do during her pregnancy. She ends our phone call by telling me the probability of twins (0.45%).

…Luckily, we live in a world where the idea of pregnancy being illegal is both ridiculous and horrifying. Unfortunately, we live in a world where such a campaign is necessary for human challenge trials, which could help end the pandemic sooner. While we accept that people can take a small risk of death in order to create a life, we are much, much more cautious about letting people try to save lives. If you would like to learn more about advocacy efforts for challenge trial volunteers, please check out 1Day Sooner and consider joining!