Future human races may live extra-terrestrial lives on the Moon, Mars, or if some have their way, even on Venus. But how will we reproduce and continue survival once we're up there? What happens to our reproductive systems? Are babies in space even possible?
To find out, we spoke to space gynaecologist (yes, you read that right) Dr Varsha Jain from the University of Edinburgh about women in space and reproductive health.
You are a space gynaecologist. What does that actually mean?
A space gynaecologist is someone who has an interest in space medicine (understanding how astronauts are affected by the space environment) and someone who is a gynaecologist (who looks after women and their health). It's a title that was given to me a few years ago, but it seems to have stuck – and I quite like it!
As far as I know, I'm the first person to have been bestowed with it. I think it stems from the fact that I wanted to take an academic approach to women's health related to astronaut health. I started doing that about ten years ago.
We’ve made huge leaps for womankind in space – but the history of this begins with some pretty mind-boggling myths. Could you tell us about some of those?
It's those myths that actually led to a really huge delay from the first woman going into space (Valentina Tereshkova) to the first American woman in space (Sally Ride) about 20 years later.
The reason is that no one knew back then what would happen to women's periods when they went into space. There was a big concern that, instead of coming out of the body, the blood would flow inside the body: a process called retrograde menstruation.
There was also a big conversation around how many menstrual products astronauts would need. Famously, the astronauts were asked whether they would need about 200 tampons per menstrual cycle. For the majority of women that I see in clinic, two hundred tampons is definitely too much!
Has the attitude to women in space changed?
It’s drastically improved. I think a big part of that has been the attitude that NASA has taken towards women's health: they want to talk about women's health, and for it to be open-access and evidence-based. They support the idea of egg freezing, for example, before a female astronaut goes into space.
What does happen to our reproductive systems in space?
Before I answer, it’s important to say that astronauts are in space to do their job – meaning they are not research participants. We've got to accept that when we have information and data from astronauts, they're volunteering that information.
It’s also a very small pool for us researchers to work with: overall, about 650 people in US and European data have been into space. Only 10 or 11 per cent of those are female – so it’s not characteristic of the Earth-based population.
That said, what we do know is that our reproductive health is governed by our hormones, and the hormone cycles don't appear to change in space. That means menstruation if there’s not a pregnancy – and, theoretically, if there was a conception, potentially a normal pregnancy.
So it’s possible to conceive, get pregnant, and give birth to babies in space. Or is it?
Because we know women can have their periods in space, it’s definitely possible for ovulation to occur. This means that the lining of the womb has grown, so it's preparing for pregnancy. Therefore, technically fertilisation might occur as well.
Whether that's actually possible is a real unknown. I'm not privy to that information, if that sort of research is even happening.
Right now, there’s a focus on how we can keep astronauts healthy. I think that needs to be a priority for us rather than finding out if we can have babies in space.
The effects of space on pregnancy have been studied on animal models, but nothing yet on human models. In animals, we know that the pregnancies can continue and deliver because rodent pups have been delivered in space.
So in terms of reproductive health, it may be possible to do these things, but are we there yet? We may not be there to get those exact answers that we're looking for. But as hypotheticals – yes, potentially, they could happen.
What do we know about risks to women’s bodies and pregnancies in space?
A woman on Earth would be advised not to get an X-ray because of the potential impact on the baby. On a mission to space, however, we don’t know how the background radiation will impact things – and we don’t want to cause a negative impact to an unborn child.
Radiation impacts our genetic makeup – the code that determines who we are. When you have excessive amounts of radiation, it can change that code and can cause mutations. A fetus’s genetic code is very susceptible to radiation and very liable to damage. This could lead to differences in how the child may develop.
Of course, when we talk about an X-ray versus a space mission, a six-month mission is not as bad as a single X-ray. But if we’re talking about a pregnancy in space, it’s probably in the context of a longer mission to the Moon or Mars, where the person's likely to be there for a longer period of time.
Plus, we've got to factor in the travel time – so to get to Mars, we're looking at almost a year. It’s a lot of radiation if we add it all up. Plus, it's the kind of radiation that we have no idea how it would affect an unborn child. That's what makes it dangerous.
If we can get past the radiation, are we in the clear?
Well, there's also a huge gravitational load on the body when you go into space and come back. As a doctor, I would never send a pregnant woman on a fighter jet plane, for example, where there are increased loads – or on a roller coaster. Where you get that feeling at the pit of your stomach that you're going down really fast, that's gravitational load. You want to avoid those sorts of situations as a pregnant woman.
The other impact is the weightlessness of the space environment; we already know that astronauts lose bone and muscle when they go into space.
But there's also an impact on the blood and heart system within the body. And even though the reproductive system doesn’t change in space, it does need all those other systems to work.
When women get pregnant, they need an effective blood supply so they can get nutrients to the baby. But in space, your overall blood volume is reduced. So would the baby get enough nutrients? There are so many unknowns.
How realistic are plans to start extra-terrestrial human colonies, given there are still so many gaps in our knowledge?
Well, never say never! When it comes to space exploration, the reason that it's advanced so much is because of human curiosity. So I think at some point, and I don't know whether it will be in my lifetime, there will be a time when we have human colonies on other planets or on the Moon.
That said, I think there's a lot of research that needs to be done to ensure that human beings who do travel to other planets are safe and that we're not putting anyone at risk.
How might space tourism impact what we know and don’t know? Or (to put it more bluntly) could frisky space travellers be the first to conceive in space – and then teach us about their, ahem, discoveries?
Space tourism is likely to involve members of the public who are not at the peak of fitness – compared to astronauts. And who knows if, depending on their age, that would have an impact on their fertility.
But, as a researcher, it’s a really interesting question – could we use this opportunity with spaceflight tourism to actually get some answers to these questions? And, if human beings are going to do what human beings do, could we see if that gives us some information that perhaps the space agencies are not allowed to look into? It's actually quite an opportunity.
Are citizens, scientists and even nations racing to have babies in space – to be the first to touchdown in a new space avenue?
Reproductive health in space may seem sexy because it could mean a baby in space.
As far as a headline-grabbing moment goes, the first baby in space will be a really big deal. But there’s a lot of funding needed to get to that point, and I'm not sure reproductive health will get that amount of funding.
I feel that reproductive health overall is understudied here on Earth – it’s often forgotten and underfunded.
If we're going to be looking at this area, we also need to be funding reproductive health on Earth and trying to understand what's actually happening in female bodies. We need to know what's 'normal' to know what's going to be changing in the space environment.
About our expert
Dr Varsha Jain is a space gynaecologist at the University of Edinburgh. Her research has been published in the journals npj Microgravity, International Journal of Gynecology & Obstetrics, and Developmental Cell.
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