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Paper short abstract

Uterus transplantation enables pregnancy through the transfer of a uterus from donor to recipient. This paper examines UTx as a practice of delegating reproductive labour across bodies and countries asking what becomes visible or obscured as risk, care and responsibility are redistributed globally.

Paper long abstract

Uterus transplantation (UTx) has emerged as a groundbreaking reproductive technology for women with absolute uterine factor infertility (UFI), involving the transplantation of a uterus from a donor to a recipient, enabling pregnancy. This paper approaches UTx as a broader practice of delegating reproductive work across bodies, families and healthcare systems, and situates it within wider debates on outsourcing.

Conceptualising UTx as a form of reproductive outsourcing highlights how the work of pregnancy, along with medical risk and ethical responsibility, is fragmented and redistributed. The ability to carry a pregnancy is detached from one body and reattached to another through complex clinical, legal and ethical frameworks. In this process, certain forms of labour (e.g., surgical, institutional etc.) might be visible, while others, particularly those of donors and their families, may become obscured. Placing UTx in a global health context further reveals how outsourcing logics intersect with unequal geographies of care. As the procedure expands beyond highly regulated research settings, concerns arise around access, consent, reproductive tourism and the potential commodification of reproductive organs. These dynamics raise questions about whose bodies bear risk, whose reproductive aspirations are prioritised, and whose contributions remain invisible.

This paper asks about the ethical limits of what can be outsourced in medicine by examining UTx as a practice of delegating reproductive labour and business of transplanting uteruses. It argues that without attention to power, inequality and visibility, UTx risks creating new patterns of extraction while reframing them as technological progress.