In his recent publication, The Day It Finally Happens, journalist Mike Pearl envisions scenarios that might seem far-fetched today but could become a complex reality in the future. One such scenario involves the birth of a baby on the moon.

“You can exit the delivery room whenever you wish,” Nurse Collins repeatedly assured Alexandria. “It’s your choice.”

However, leaving the delivery room was not an option for Alexandria; it simply didn’t make sense. While the moon's reduced gravity—only one-sixth of Earth's—made physical movement easier, she found herself questioning where she would go after leaving.

Giving birth in the hallway of Moon Base Hispaniola’s medical center wouldn’t be practical, as Collins would still be there with her paperwork. They could rush out the automatic lobby doors, but what then? Would they deliver the baby themselves in Concourse A? Or should they return to their living quarters to fill a bathtub for a water birth? Such options posed numerous issues, not the least of which was the waste of precious water resources.

Ultimately, she felt trapped, bound by the stipulations of the lengthy consent forms. According to the regulations outlined in the Hispaniola Residential Compact, childbirth was classified as elective medical care. Ironically, once pregnant, the act of giving birth was anything but elective. Abortions, on the other hand, were covered.

Alexandria had medical insurance through her job, but the specifics of her coverage for childbirth remained ambiguous. Her brother Marco, a lawyer, had reassured her that giving birth on the moon was legally permissible. Yet, the Hispaniola council had put forth a non-binding resolution advocating for abortion.

Feeling her baby move, she realized that time was running out. It took immense effort to resist the urge to push.

“They’re setting a precedent,” Francisco remarked. “While they can’t outlaw childbirth, they’ve discovered a loophole: making it financially prohibitive.”

“That’s not accurate,” Marco countered. “These regulations were established long before her employer created these insurance plans. They should have been clearer. You can have them cover this.”

“What can I do? The baby is coming!” Alexandria exclaimed, overwhelmed by the absurdity of the situation. How can one control the birth of a new life on the moon? They had been assured that the Residential Compact mirrored the rights afforded by the U.S. Constitution, yet it appeared to impose a significant penalty for childbirth: burdensome medical expenses.

While it is obviously troubling, requiring all lunar inhabitants to agree to a contract prohibiting reproduction might be a prudent strategy for the initial decades.

“Just give me the paperwork! I’ll sign it,” Alexandria insisted.

Nurse Collins handed her the clipboard, and she signed at the designated spot. “Initial here,” Collins instructed, and Alexandria complied. “And here,” she added, signaling to a gynecologist who entered the room, accompanied by a hospital administrator with a small camera.

“It’s for the media. They’ll want to cover this back on Earth,” the administrator explained.

“Looks like we’re making history today!” the doctor exclaimed, eliciting a silent smile from Alexandria.

For much of my life, I imagined that if the moon were colonized, those who ventured there would be altruistic pioneers on a quest for knowledge and discovery, backed by a coalition of nations striving for humanity's advancement. However, organizations like NASA and the China National Space Administration are increasingly delegating space exploration to private enterprises such as Elon Musk’s SpaceX and China's OneSpace, both of which are solidifying plans for permanent lunar bases within the next few decades.

When a lunar colony eventually materializes, its inhabitants will likely fall outside any nation's social safety net, yet still be governed by legal statutes. Few have seriously contemplated how this framework will function, but American space attorney Jim Dunstan has been considering these issues for an extended period. His 1991 article, “From Flag Burnings to Bearing Arms to States Rights: Will the Bill of Rights Survive a Trip to the Moon?” addresses key questions from an American viewpoint. For instance, will moon residents possess the right to bear arms? The paper suggests that while this might be permissible, regulations could prevent open carry, as long as firearms are securely stored for potential militia use.

What about reproductive rights on the moon? In the Roe v. Wade case, American courts argued that the Ninth Amendment guarantees a right to privacy that protects women from reproductive interference. Dunstan concurs, stating in his article, “The Ninth Amendment has been interpreted to encompass a fundamental right to procreation and personal sexual expression.” He warns that as time progresses, the core principles of the Bill of Rights may face challenges but questions, “If one cannot be free in their own bedroom, what remains of freedom?”

Currently, Dunstan serves as general counsel for TechFreedom, a free-market advocacy organization. In our discussion, he provided a broader legal perspective on life in a lunar settlement and its implications for the first lunar mother.

He stated that for a woman to give birth on the moon, “There would need to be a law permitting pregnancy in that environment.” He anticipates that before moon residents are permitted to reproduce, either legislation or a contract will require individuals capable of pregnancy to use contraceptives or agree to terminate any pregnancy.

In his book, Building Habitats on the Moon: Engineering Approaches to Lunar Settlements, aerospace engineering professor Haym Benaroya from Rutgers University emphasizes, “Pregnancy in a low-gravity setting presents significant challenges for both women and fetuses.” Research on the long-term effects of low gravity, as observed in Russian cosmonaut Valeri Polyakov during his record-breaking 14-month space mission, raises concerns. Effects include fluid redistribution, which can lower blood pressure and lead to serious health issues like headaches, fatigue, and seizures.

Other space-related consequences could hinder fetal development. Benaroya notes that bone density decreases in microgravity, with astronauts experiencing one to two percent annual bone loss in critical areas such as the pelvis and spine. As lower body bones weaken due to lack of use, upper body bones paradoxically become denser.

Moreover, muscle atrophy occurs in low gravity. It's crucial to consider that lunar residents will need to engage in rigorous exercise routines akin to those of International Space Station occupants, raising fears that a child born and developed in reduced gravity may lack the muscle mass necessary for survival on Earth. This includes muscle development in the legs, lungs, and heart, the adequacy of which remains uncertain.

While these concerns might seem overly cautious, research indicates that animals raised in space often encounter significant challenges upon returning to Earth. A 1994 study published in Advances in Space Research revealed mixed outcomes for animals born in space. Pregnant guppies exposed to five days of spaceflight conditions had normal offspring, but some produced underdeveloped embryos. Only a fraction of Japanese quail eggs hatched successfully after incubation in space, while fruit flies exhibited decreased reproductive rates.

It's not hard to envision someone conceiving in what is currently a less-than-ideal environment.

The researchers also conducted experiments with jellyfish polyps reproducing in space, resulting in varied outcomes. Unfortunately for the space polyps, some displayed defects due to irregularities in their neuromuscular systems related to microgravity.

Does this imply that a mother cannot have a healthy baby in space? No, but it does suggest that there are legitimate concerns regarding potential complications.

Before the baby arrives, the mother may undergo extended periods of gravity simulation to enhance the likelihood of a favorable outcome. Benaroya mentions research on the effectiveness of artificial hypergravity to mitigate adverse effects but speculates that over time, society might become accustomed to adapting to life on the moon, possibly leading to future generations with less developed lower bodies.

In summary, it will likely take considerable time before the lunar community feels prepared to welcome a newborn. As unsettling as it is, requiring all lunar residents—regardless of gender—to sign a contract prohibiting reproduction may be a wise precaution for the initial few decades of the colony's existence.

It stands to reason that the first lunar birth will not occur until the “base” evolves into a more complete community with essential comforts and medical facilities. Nevertheless, live births will still pose risks that corporate overseers of the outpost may find unappealing. Dunstan envisions that animal research could precede human births. Yet, the innate human desire to reproduce will undoubtedly lead to pregnancies occurring even in less-than-ideal circumstances.

At that point, questions will likely revolve around bureaucracy. Would a lunar-born child be able to identify “moon” as their nationality? Dunstan believes the answer is no; it's more plausible that the child's citizenship would be claimed by the mother’s country to prevent population loss and maintain tax revenue.

If the parents are American, securing a Social Security number for the child should pose no issues, as the process is already digitized. The birth certificate would reflect lunar time, but will the moon develop its own clocks and calendars? Given that lunar “days” are approximately 27 to 29 Earth days long, it seems likely that lunar residents will align their timekeeping with Earth’s 24-hour cycles. Dunstan suggests that the first computer operator on the moon will set the time zone based on Earth’s clock.

Here’s a thought-provoking scenario: if the baby’s parents have a lunar mailing address, they might be tempted to include it on the birth certificate. This could lead to complications regarding proof of citizenship if the baby later moves to Earth. It might be wiser to use the parents' home country address.

Returning to the lunar delivery room, what about the astronomical costs associated with the medical services? According to Dunstan, it’s reasonable to predict that lunar healthcare will mirror American economic models, including the medical industry’s economic dynamics. As he put it, it’s likely that someone will end up paying for “the most expensive forceps in the galaxy.”