What are options for married couples struggling with infertility? After examining the use of in vitro fertilization, artificial insemination, and ovulation enhancing drugs, this article maintains that reproduction technologies are not for Christians.

Source: Australian Presbyterian, 2001. 4 pages.

Baby Non-Boomers What if unto us a son is not given?

Reflections of the Meaning of Children, from the Blessing of Love to the Child Factory🔗

It is probably natural to want a child of one’s own. Is it also good? Perhaps if it is truly natural, in accord with our created nature, it must also be good. But the seemingly innocent desire to have “a child of one’s own”, combined with the high-tech possibilities of modern medi­cine and the ever-present pursuit of com­mercial gain, has fashioned a world in which we regularly create moral conun­drums that are beyond our ability not only to solve but even to name. The things we are willing to do tell a story — a story about the point of having children.

Consider the following cases, all roughly adapted from “real life”, chosen almost at random:

  • A woman unable to have a child “of her own” had her ovum fertilised with her husband’s sperm in the laboratory. The resulting embryo was then implanted in the womb of the woman’s mother, who, having carried the pregnancy to term, gave birth to her own “grandchild”.
  • A husband and wife who thought they wanted a child “of their own” contracted for the conception of a child who would be conceived from sperm and ovum that came from anonymous donors and who would then be gestated in the womb of a hired surrogate. Shortly before the child was born, the husband and wife who had wanted this child divorced. A judge felt compelled to rule that the baby girl actually had no legal parents at all.
  • A woman undergoing infertility treatment in order to have a child “of her own” conceived triplets. For medical reasons she was advised that it would be safest if she were to undergo “fetal reduction” — that is, reduce by abortion the number of fetuses she was carrying to one. She did, but weeks later, having undergone amnio­centesis, she learned that the one remain­ing fetus had a genetic anomaly. She therefore aborted that fetus as well.
  • An infertile married couple desiring a child “of their own” underwent in vitro fertilization (IVF) and conceived a child. Four-and-a-half months into the preg­nancy they learned from amniocentesis that the child they had wanted so badly and worked so hard to make had Down’s syndrome. Having learned that, they decided to abort.
  • A 63-year-old woman, wanting a child “of her own” had implanted into her hor­monally primed uterus an embryo made in the laboratory from her husband’s sperm and an ovum from a younger donor. She then completed the pregnancy and gave birth to a child.

Such cases could be multiplied almost without end, and we may sometimes find it hard to remember or believe that the first “test tube baby” was born less than 25 years ago, in 1978. Two decades later we live in a world in which a woman can give birth to her own “grandchild”; in which a child can have as many as five “parents” (the donors of sperm and ovum, the surrogate who carries the child during pregnancy, and the two “rearing parents”); in which people can “have children” posthumously; in which parents can go to great trouble and expense to conceive a child whom they then abort if prenatal diagnosis shows that the child is “defective” in some way; in which quite soon it may be possible to give birth to identical twins born years apart; and in which it may soon be possible for a woman without ovaries to receive an ovary transplant from an aborted fetus, making that fetus the biological mother of her child.

Taken together, these cases display the story we have begun to tell each other about the meaning of children. The story line is, roughly, as follows: Because having children is something many people want for their lives to be full and complete, and because it is such a fundamental aspect of human life, we ought to use our skills to help them achieve that desired fulfillment. Indeed, having children is an entitlement to which there are few limits.

Of course, we ought not exercise this right in a way that directly harms children, but in many cases, after all, the children would not even exist were it not for the use of new reproductive technologies. If the suffering that infertility brings can be relieved, and if children are not harmed, then high-tech reproductive medicine is a good thing. This is the story that, more and more, we tell ourselves in this society.

Is there a different image of the child, an image that tells a different story about what it means to have children? Christians should hope so, and they should search for it. The poet Galway Kinnell, in a wonderful poem titled After Making Love We Hear Footsteps, pro­vides such an image: The child is, he writes, a “blessing love gives again into our arms”.

What makes this a better image than that emerging from the examples with which I began? What story of the meaning of a child underlies this image? One way to think about such questions is to reflect upon the desire to have “a child of one’s own”. This desire, which is simultaneously quite natural and problematic, needs examination.

Christians have a story to tell, a story we regularly teach to our children — of an infertile woman who deeply desired a child of her own, how her wish was granted, and what she then did. It is the story of Hannah, her husband Elkanah, and their son Samuel (1 Sam. 1-2). Why did Hannah want a child of her own? In part, it seems, it was because she suffered the scorn of Peninnah, Elkanah’s other wife, who had children. But that only presses the question a step further. Why should this be an occasion for scorn? What is so important about hav­ing a child? Why do people care so deeply?

Sometimes today, when we ask such questions, answers of the following sort come back: “I desire the experience of pregnancy and childbirth.” “Having a child is an important part of defining who I am.” No doubt there is some truth about us buried in such answers. There are deep psychological, and even biologi­cal, imperatives at work in the impulse to give birth.

But such answers, which make of the child a means of meeting our needs, can­not be satisfactory. To think that way is already to begin to think of children as products made to satisfy some of our desires. And, of course, if and when the product turns out not really to satisfy us, we may be hard pressed to muster the kind of unconditional love children require if they are to flourish.

There are, though, deeper and better reasons for having children. We would make a little moral progress were we to say, “I want a child because I want a link to future generations.” Surely that was part of Hannah’s desire — it is of con­siderable human significance. We are not angels or free spirits who can choose to be whatever we wish; rather, we are embodied creatures, located in a particular time and place. In part, at least, it is lines of kinship and descent that identify us.

To learn to affirm and give thanks for our place in the world is part of growing up — and, more important, part of learning how to receive the mysterious gift of life. It is, therefore, quite natural that we should want to give life even as we have received it. That takes us some considerable way beyond the narcissism of want­ing a child simply as a means to fulfilling ourselves.

But it does not take us quite far enough, for it continues to think simply of a child of my own, still part of the pro­ject by which I make my way in the world. We get much closer to a satisfactory understanding if we think of a child of our own. Elkanah is already a father, but he and Hannah together — as one flesh — are not parents. Even in so ancient a story as this one, there are hints that this too is part of the reason for wanting a child. We are specifically told that Elkanah loved Hannah. He himself tells her that she is more to him than 10 sons.

Their love-giving has not yet been life-giving, however. It is natural that they should want a child, for that child would be the sign that the love by which they give themselves to each other is creative and fruitful.

Indeed, this last step — in which they seek a child not of his own or her own but of their own — begins to take them still further. It presses almost toward elimina­tion of that little word “own”.

In the passion of sexual love a man and woman step out of themselves, so to speak, and give themselves to each other. That is why we speak of sexual ecstasy — a word that means precisely standing outside oneself. No matter how much they may desire a child as the fruit of their love, in the act of love itself they must set aside all such projects and desires. They are not any longer making a baby of their own. They are giving themselves in love.

And the child, if a child is conceived, is not then the prod­uct of their willed creation. The child is a gift and a mys­tery, springing from their embrace – a blessing love gives into their arms. They could and should, if they think the matter through, quite rightly say that they had received this child as a gift of God, as the biblical writer says of Hannah: “The LORD remembered her”. Samuel is neither Elkanah’s “own”, nor Hannah’s “own”, nor even “their own”. He is “God’s own” — asked of the Lord and given by the Lord. He is not, therefore, simply Hannah’s or Elkanah’s to hold on to; rather, he must be offered back to God, as Hannah does. Lent to the Lord, for as long as he lives.

Christians, then, do not underestimate the sheer human significance of biological ties. We understand the deep desire to have children. But we must also con­stantly remind ourselves that children are not our possession; they are gifts of God. They exist not simply to fulfill us but as the sign that, by God’s continued bless­ing, self-giving love is creative and fruitful.

And what if the Lord does not “remember” us as he remembered Hannah? That is reason for sadness, but it is not reason to take up the “project” of making a child. The couple who can­not have children may adopt children who need a home and parents, or they may find other ways in which their union can, as a union, turn outward and be fruitful.

If this is how Christians understand the meaning of the presence of children, how shall we evaluate the vast array of new reproductive technologies — not, for the moment, as a matter of public policy, but simply as possibilities within our own lives?

The first thing to note is that many of the new techniques involve parties other than husband and wife in the reproductive process. Artificial insemi­nation and in vitro fertilisation very often involve sperm and egg from anonymous donors, and there is an irony here that we should not ignore. If what infertile couples want is a child “of their own” in the genetic sense, techniques using donated gametes will not provide it. They are, in a sense, deceiv­ing themselves. In the name of having a child of their own, they fail, in fact, to honor the importance of biological con­nection, of kinship and descent.

I can think of one possible exception to the claim that Christians ought not participate in new reproductive technologies that involve sperm or ovum from third parties. A couple might “adopt”, gestate, and rear a donated embryo. In such a case, unlike sperm or egg donation, the child will not be genetically linked to either par­ent. We might think of it as adoption that occurs before rather than after the child’s birth.

But if we are looking for needy children to rescue, they are, alas, all around us in our foster-care system. Prebirth embryo adoption is not likely to signal similar attempts at rescue. It is far more likely to be one more way of exercising quality control, of finding the child whom we want — rather than loving the child we have been given.

In short, many of the new reproduc­tive technologies will involve the use of third parties. In doing so, they break the connection between love-giving and life-giving in marriage. That is not just a minor nuance, for it is this connection that teaches us to think of the child as a gift, that keeps us from thinking of children as our project, as existing for the sake of satisfying our desires. It is no accident, then, that these technologies usually encourage genetic diagnosis — whether before implantation or after — of the “fitness” of the embryo or the fetus. If we understand the child as our project, if we accept that kind of responsibility, then we may inevitably find that “quality control” seems like an obvious — perhaps even imperative — part of the process. This is a journey we ought not even begin.

But what if no third parties are involved? There are certainly some circumstances in which an infertile couple might make use of new reproductive technologies while using only their own sperm and ova. Women may take drugs to influence ovulation. This may be com­bined with assisted insemination — when the sperm are placed directly in the vagina, cervix, or even uterus if the man’s sperm count is low. It is even possible now, within the IVF procedure, to inject a single sperm into the ovum.

Even when no third parties are involved there are serious moral concerns in the use of new reproductive technologies. The couple will be encouraged to “screen” the embryos formed in the laboratory, to consider whether a particular embryo is really the child they desire.

If more embryos are produced than are implanted in the woman’s uterus, they will have to ask themselves what should be done with the extras. Even apart from any IVF procedure, the use of ovulation-enhancing drugs alone means that the possibility of multiple fetuses — triplets and even higher-order multiple births — is greatly increased, and such pregnancies involve significant risks for the children conceived.

In general, and even entirely apart from the use of donated sperm or eggs, it becomes increasingly difficult to think of the child as a gift and not a product. These are simply some of the hazards of the road they are traveling.

When we remember again the num­ber of needy children who go unadopted precisely because of their needs, when we consider the degree to which new reproductive technologies have — in a very short time — begun to teach our society to think of reproduction as a right to which everyone is entitled, when we ponder the implications of these technologies for our society’s under­standing of children, we must ask whether Christians should not call a halt — at least for themselves.

We do not have a story that teaches us to think of children as our entitlement or our possession. Indeed, the story we tell goes even beyond that of Hannah, Elkanah, and Samuel. For knowing as we do that God has already provided The Child, we can free ourselves of the fever­ish need to have a child of our own, whatever the cost. Perhaps the greatest service we can perform for our own children and for the world into which they will be born is to live in such a way that we remind ourselves and others that each child is indeed not our product, our project, or our possession, but a “bless­ing” that “love gives again into our arms”.

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