In a first for India and Asia, a woman has given birth after receiving a uterus transplant. In Pune, yesterday, Meenakshi Walan, of Vadodara, gave birth to a baby girl less than a year and a half after receiving a uterus transplant. The womb donor was Walan’s mother.

The baby, conceived via in vitro fertilization (IVF), was delivered via C-section preterm, shortly after seven months gestation, and is reported to be healthy. Eleven other post-transplant pregnancies and births have occurred, in Sweden and the US.

While news reports are hailing the procedure as a proud milestone for India, it’s important to remember that uterine transplants are an ethical gray area. While of course anything that expands women’s reproductive options and control is a good thing, it’s questionable whether uterine transplants actually do this. For starters, the cost-benefit is in question: a uterine transplant costs more and carries many more risks than IVF, or surrogacy — there are major health risks for the donor, who must undergo invasive surgery and can experience, among other things, a decrease in sexual satisfaction following a hysterectomy; and risks to the recipient, who must also undergo surgery, take anti-rejection medication before and throughout pregnancy, and then undergo another surgery to deliver the baby. There are also risks to the fetus, especially when born preterm.

On top of this, it is questionable whether women are actually in control of the experience. As Sharrona Pearl explains in an Aeon essay earlier this year, often the decision lies not with the woman, but with a medical committee, which decides if a woman is physically and mentally fit to receive a uterine transplant, and thus, to be a mother. (It is unclear what kind of screening Walan underwent before being approved for the procedure last year.)

Finally, “the uterus transplant supports the social norm of pregnancy as fundamental to being a woman, and offers tremendous financial resources to that end,” Pearl writes. “Situating the pregnancy experience as a need that justifies multiple elective risks reinforces existing and deeply pervasive narratives about womanhood as constituted and constrained by biology.”

This narrative — that you’re not really a woman unless you are able to and/or already have children — is deeply problematic and one of the most damaging, pervasive mindsets that ultimately holds women responsible for children and family life and serves to keep them from the same opportunities as men.

Pearl notes that similar arguments on both sides were common upon the advent of IVF and later, surrogacy, and in some ways, these discussions are inevitable, and important, whenever reproductive science advances.

But there is a fundamental difference between IVF and surrogacy — the end goal of which is a baby — and uterine transplants — the aim of which is pregnancy. This is not to minimize the anguish some infertile women may feel at never experiencing pregnancy, but there are many experiences that are limited or proscribed by biological realities; most people will never have the physical capability to be a professional athlete, for instance. An average woman, undergoing a risky procedure that endangers their own and another’s life, to achieve peak athletic fitness, would be scorned. Why does society think pregnancy is more important for women, than other physical experiences?

“The procedure prioritises the experience, and only the experience, of pregnancy over safety. It puts infertile women’s bodies on the line, and insists that it is worth it in order to fulfil women’s alleged biological destiny as carriers of future children,” Pearl writes.

For Walan, it seems to have been well worth it, and congratulations to her. But what needs to be discussed more — and accepted — is the fact that for many women, it may not be. If we’re ever to expand the definition of womanhood, and separate it from motherhood (and indeed, to expand the definition of motherhood, too), we have to start heralding uterine transplants not as a breakthrough for women’s reproductive control, but as a mere breakthrough in medicine.

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