The Table Podcast: Infertility & Pregnancy Loss

Dr. Julie Fuller and I talk with Dr. Darrell Bock about the marital, ethical, spiritual, and emotional challenges of infertility and pregnancy loss.

Hear My Story on the ReStory Podcast Today

Thanks to my friend Mary DeMuth for hosting me on her ReStory podcast. Today I'm telling my story there. Check it out.

Thinking about Freezing Your Eggs?

In this video, WFAA-Dallas explores the emotional and technical process of women freezing their eggs to ensure future fertility. What do you think?

An interview with a birth-mom who made an adoption plan: Christine Lindsay

November is Adoption Awareness Month. So I'm featuring here an author who has a book that considers all sides of the adoption triad. 

SG:You are a reunited birth-mom—a woman who made an adoption plan for her baby who has met her biological child as an adult. Was the the day you met your birth-daughter a happy one?

Christine: Sadly, no. It was as painful as the day I said goodbye to Sarah as a three-day-old baby in 1979. In fact, more painful. At least on the former day, I was filled with faith that she and I would be reunited one day when she became an adult. For the next twenty years as she grew up as another couple’s child, I prayed for the time when I would see her again. But on that day, Sarah’s mom and dad were extremely upset by my desire to meet the now-adult Sarah. They couldn’t bear the thought of meeting me nor understand why I would want to meet them. In fact her dad was very much against the whole idea of our meeting.This put a lot of pressure on Sarah, and the day we met again, she came across as very distant to me. This broke my heart, taking away all the faith that I had that she and I could develop a close birth-mother/birth-daughter relationship—one different from what she had with her adoptive parents, but special none the less.

SG:So how did you feel about adoption after you met your birth-daughter?

Christine: For the first twenty years after I said goodbye to Sarah, I considered her and her adoptive parents a package deal—something God had put together. I loved them as much as I loved her, and I wanted a relationship with them as much as I wanted a relationship with Sarah. Discovering that they did not feel the same way about me brought back all the emotional pain of the initial decision.As a birth-mom, I was already struggling with the losses of that, and the delicate but subversive ways my psyche had been affected by making an adoption plan for my child—even though I’d made that sacrifice in her best interests. Seeing my grown birth-daughter and all that I had lost, I believe I realized for the first time the full extent of my choice.The emotional pain brought on a clinical depression that lasted two or three years. I began to look at Sarah’s adoption through fractured lenses. All the joy I’d felt about giving my child a better home life than I could have offered her back then dissolved into bitterness. I suddenly felt hood-winked by God, feeling that He had tricked me into giving Sarah up. I thought He obviously gave Sarah to her adoptive parents because He didn’t consider me good enough to raise Sarah. And if I wasn’t good enough to be Sarah’s mother, I must not be good enough for the children I had with my husband.Naturally this wasn’t the truth, but when we are depressed we don’t see things clearly. At that time, I wished I could turn back the clock and keep my baby.Jealousy grew inside me at a frightening rate. There always had been a tiny bit of jealousy that someone else was raising my child, but it grew into a monster. As a Christian I was turned inside out, hating myself for this jealousy, and yet unable to pull myself out of my emotional tailspin.

SG: Do you still feel that way?

Christine: No, thank God. Depression and emotional trauma do not heal overnight, and we often need professional help. I had a great counselor who helped me move on from those destructive emotions and began to search for the real me. So often traumatic experiences stop people from reaching emotional maturity. My husband was also an amazing help, and one day he brought me a new journal and pen, and said, “Here honey, write your story.”Also, through the verse in Isaiah 49:15, 16 I realized that my crazy love for my children (including Sarah) was nothing compared to the immense love God the Father had and has for me. That was the beginning of healing.It took time, but gradually I began to lighten up on Sarah’s adoptive parents and recognize their right to their private life with Sarah. As I filled up on God’s love for me, I was able to love them again the way I first had when Sarah was a baby.

SG:How do you feel about adoption today?

Christine: I beg pregnant women today to consider adoption as an alternative to abortion. It’s a wonderful choice. But if the pregnant woman is able to keep her baby, I wholeheartedly encourage her to do so. I’ll be honest, making an adoption plan for your baby is one of the hardest sacrifices a woman can make. But I have also found that we can turn to God in our greatest need, and He is there with leagues and leagues of comfort and love, and new joys to replace our sorrows. It wasn’t easy for me, but now I can say, that because I truly love Sarah, I cannot imagine her life without her adoptive parents and brothers.

SG:Will your memoir hurt my feelings as a woman who struggled with infertility?

Christine: Since my book braids the stories of not only birth-moms and birth-families, but also that of adoptive moms and dads, I do not believe anyone will be hurt by this book. All the authors in this memoir tell their own stories in their own words, holding nothing back. So, Sarah’s adoptive mom, Anne, tells it like it was as a woman who could not bear children. She also shares openly that having me in Sarah’s life as her birth-mom is still difficult for her. She adds that if she could, she’d rather that I wasn’t in Sarah’s life at all these day, even admitting that this is selfish.I too, share honestly that I was jealous, angry with her, and selfishly thinking only of my own emotions during the years just after I met Sarah as an adult.Sarah, too, shares her journey both as an adoptee and also as a woman hurting over the loss of eight miscarriages. The pain of infertility is well shared in Finding Sarah, Finding Me.Yet while our honesty is brutal at times, it weaves a bright ribbon of hope throughout for those who might be hurting with the issues of infertility and adoption.

SG:How can your book help the various sides in adoption triads?

Christine: Finding Sarah, Finding Me can help:

• Women who are pregnant, unmarried and afraid, if they want to know the emotional truth about making an adoption plan for their baby—that while it hurts immensely, there can be joy. It is my prayer, that this will encourage more women to consider adoption instead of abortion.

• Infertile people will be encouraged to have their voice recognized.

• Adoptive parents will feel affirmed in their mixed emotions regarding the frightening prospect of adoption reunion. This memoir shows various types of reunions—some that went beautifully well and created unique blended families, and others that did not. People are made up of such different emotional stuff. Not all should go down that road.

SG:You're a fiction writer; why write this memoir now?

Christine: My desire to tell my birth-mother story got me started writing in the first place. But the timing wasn’t right after I met Sarah as an adult in 1999. It took seventeen years for the Lord to work on everyone’s heart, to heal old emotional pain, so that the memoir could be published and no one be hurt by it. During those years of healing however, the Lord encourage me to tell my story in Christian fiction, which has won numerous awards.All the spiritual depth of my heartache and depression are in my novels, in the hope of encouraging others. Life is not easy. 

Book info: Sometimes it is only through giving up our hearts that we learn to trust the Lord.Adoption. It’s something that touches one in three people today, a word that will conjure different emotions in those people touched by it. A word that might represent the greatest hope…the greatest question…the greatest sacrifice. But most of all, it’s a word that represents God’s immense love for his people.Join birth mother Christine Lindsay as she shares the heartaches, hopes, and epiphanies of her journey to reunion with the daughter she gave up—and to understanding her true identity in Christ along the way.Through her story and glimpses into the lives of other families in the adoption triad, readers see the beauty of our broken families, broken hearts, and broken dreams when we entrust them to our loving God.Read Chapter One of Finding, Sarah Finding Me: Click HERE

Author info:Christine Lindsay is the author of multi-award-winning Christian fiction with complex emotional and psychological truth. Tales of her Irish ancestors who served in the British Cavalry in Colonial India inspired her multi-award-winning series Twilight of the British Raj, Book 1 Shadowed in Silk, Book 2 Captured by Moonlight, and explosive finale Veiled at Midnight.Christine’s Irish wit and use of setting as a character is evident in her contemporary and historical romances Londonderry Dreaming and Sofi’s Bridge.A writer and speaker, Christine, along her husband, lives on the west coast of Canada, and she has just released her non-fiction book Finding Sarah, Finding Me: A Birthmother’s Story.Drop by Christine’s website www.ChristineLindsay.org or follow her on Amazon on Twitter. Subscribe to her quarterly newsletter, and be her friend on Pinterest , Facebook, and  Goodreads Purchase links:Amazon (Paperback and Kindle)Barnes and Noble

Life Is Hard, but God Is Good

In the past two months, I have buried my father and walked my daughter through open-heart surgery. The “windsock in her heart,” as her surgeon described it, that had blood flowing the wrong way, was apparently congenital, but we didn’t discover it till this past July. She is still in the hospital, but she made it great through surgery on Tuesday. So now, in my great relief, I have some time to reflect on the whirlwind that has been my life for the past two months.My overwhelming sense is that I’ve been covered in the love of God. The Almighty works with precise timing that may not always thrill us in the moment (surgery the day before my first day of classes!?), but in retrospect is always perfect, and designed for our greatest good. That my father died during the summer meant Oregon was beautiful (such beauty heals me), and I could stay as long as Mom needed me and work remotely. As for Alex’s surgery, I wanted it on Thursday instead of Tuesday, but now I’m thankful she will be stronger going into the holiday weekend, when hospital staff may not be the A Team.My second observation is that I’ve been covered in the love of Christ’s people. I spent a long time last night writing thank-you notes, and I’m sure I’ve failed to remember some folks who have helped us out. . . . And some of the people who have helped don’t even know me or that they helped. They are writers whose books have encouraged me. Three authors of two books especially come to mind.First is Dave Furman and his new work, Being There: How to Love Those Who Are Hurting (Crossway). Dave, a DTS grad, serves as the senior pastor of Redeemer Church of Dubai in the United Arab Emirates. His wife, Gloria, is a former student of mine.In 2006, Dave developed a nerve disorder in his arms that renders both of them nearly disabled—to the point where he can count on one hand the number of times he has held his four kids. In fact, they have to button his shirts for him. So he speaks with serious credibility about what does and doesn’t help. His chapter on what not to do is worth the price of the book. Our family has just come out of a season of care-giving for my Dad, and then we have been on the receiving end with our daughter. And I heartily agree with all his advice. Plus, he has a great perspective on suffering.The other two authors wrote a work that is actually not coming out till October 4 (I received an advance review copy). It’s a B&H release by Raechel Myers and Amanda Bible [yes, that's really her name] Williams titled She Reads Truth: Holding Tight to Permanent in a World That’s Passing Away. “She Reads Truth” was a community before it became a book. Four years ago, some strangers started reading Scripture daily, staying connected through the hashtag #SheReadsTruth. That gave way to a web site that led to an app. And today thousands open their Bibles and find Jesus in its pages every day.In the book by the same title, the founders share their stories about everyday life living in light of God’s permanence as the world passes away. Fathers die. Miscarriages happen. (Two stories with which I totally identify.) But God is with us, and he never changes. Nor does his love fade.What are you going through today? Christ promises, “I will be with you.” And if he is for you, who and what can prevail against you?

The Only Child: #Doesn’tPlayWellWithOthers & Other Myths

My post yesterday at christianparenting.org: 

Jairus’s daughter. John Updike. Condoleezza Rice. Cary Grant. Chelsea Clinton. My grandmother. And my mother. Do you think “most selfish people in the world” when you hear these names and labels? Neither do I. But they were or are all only children. And the stereotype of only children is that they refuse to share, act spoiled, and hog the biggest bowl of ice cream.Fortunately, this caricature of only kids as brats with tiaras or ponies on the back forty has changed somewhat in the past four decades, in part because more people have “onlies.” Whereas 10 percent of American families had an only child in 1976, by 2014 that number had doubled. Some place the percentage as high as twenty-three. And in New York City, like other urban centers, the number is closer to 30 percent.Mothers with master’s degrees have more only children than mothers with less education. But that does not necessarily mean these moms opted for education over more kids. Lots of women, myself included, pursued higher education precisely because nothing was happening in the family-expansion department. Among my colleagues and students at the school where I teach, a disproportionate number of them are childless or have only one child. Of those whose stories I know, the vast majority were not by choice.Certainly, some couples do choose education and careers over larger families. After all, it costs $245,340 to raise a child, according to the U.S. Department of Agriculture. And that’s just from birth to eighteen years. Smaller family size also stems from starting later, as many delay marriage as compared with couples in the past.Nevertheless, neither of these factors had a thing to do with my own parent-of-an-only-child status. Our small family size was due to factors other than cost or education—factors like infertility, multiple pregnancy losses, and failed adoptions, not a lack of desire.But as we’ve parented an only child, we’ve discovered that the caricature was wrong. As it turns out, only children score quite low on narcissism and high on sociability indexes, meaning that in terms of relationships with their peers, they do better than just fine. They score even higher than firstborns on leadership ability and maturity, perhaps because they have no choice but to interact with adult models who tend to cheer on their achievements and affirm their self-images. And in fact, only children have higher IQs, on average, than those with siblings.“How will she learn to share…?” people would ask me about my daughter, as if they’d never heard of a church nursery or an educational classroom. Even only children have to take turns on the swing and jungle gym.In the self-centered category, only children are basically the same as oldest children. But different. That’s the conclusion Frank J. Sulloway, author of Born to Rebel, reached. He says that, like oldest children, only children tend to be more conservative, but, like the babies of the family, they innovate more. Only kids are the wild cards, he says. They have more freedom to define themselves than do others.The Draco Malfoy stereotype of the only child stemmed from the teachings of nineteenth-century psychologist G. Stanley Hall, who labeled being an only child as a disease. At the time Hall had a voice, psychoanalysis was all the rage. Yet while his theories have been debunked in the academic world, it sometimes takes magazines and news outlets about three millennia to catch up on data.So if singletons are more slandered than exceptionally selfish, what about the image of the “lonely only?” “Aren’t you afraid she’ll be lonely?” people would ask, eying my child and then my flat belly with pity. Those who knew of our situation wisely refrained from voicing such concerns, but strangers often made assumptions.Many parents of only children do fear that their child will be lonely both in childhood and adulthood. And these same parents are also often absolutely concerned that their child will be spoiled. But parents with many kids share some of these same concerns.Parents of “onlies” also fear that they themselves will die young, leaving their child orphaned in adulthood. Or they worry that they will linger for decades in poor health, strapping their child with the double burden of caring alone for two elderly parents. In short, they may fret about the future. And some of their concerns are similar to how singles feel.Some of these concerns, also, it turns out, parents of only children share with parents who have more than one child. Who will take care of me? Will I be a burden? I expressed just such a lament to a young Christian friend recently: “Who will take care of me when I’m old?”She turned to me and with a look of hurt in her eyes, as if to suggest “why would you even wonder?” and answered, “I will, Sandi. And the body of Christ.”The Lord told the children of Israel, “Even to your old age and gray hairs I am he, I am he who will sustain you. I have made you and I will carry you; I will sustain you and I will rescue you” (Isa. 46:4). He’s the kind of God who still cares for his children today. And he does so through his people. Caring for the old and infirm among us is part of what it means to be pro-life.

In the Near Future: Uterus Transplants

The New York Times November 13 print edition ran an article by Denise Grady that announced "Uterus Transplants May Soon Help Some Infertile Women in the U.S. Become Pregnant." The Times considered the news so big that a press release came to my in-box. It's all going down at The Cleveland Clinic, where doctors expect to become the first in the US  to transplant a uterus into a woman who lacks one—whether due to congenital factors, injury, or illness. The procedure would eliminate the need for a gestational surrogate.After giving birth to one or two children—by C-section—the woman receiving the transplanted uterus would have it removed so she can quit taking anti-rejection meds. An estimated 50,000 women in the United States might be candidates. Currently, eight have begun the screening process.The transplant team would remove the uterus, cervix, and part of the vagina from a recently deceased organ donor. (The uterus, if kept cold, can survive outside of the human body for six to eight hours.) The recipient's ovaries and fallopian tubes would be left in place, and after one year of healing, she would undergo an IVF/embryo transfer procedure.Sweden is the only place where doctors have already successfully completed uterine transplants. Nine recipients have delivered four babies. Another is due January 2016. Two failed and had to be removed—one, due to a blood clot; the other, due to infection. The Cleveland doctors plan to use deceased donors, so they won't put healthy women at risk. For a live donor, the operation takes seven to eleven hours and requires working near vital organs.Recipients must have ovaries. But because the fallopian tubes won't be connected to the transplanted uterus, a natural pregnancy will be impossible. 

I Wish My Church Knew...

Recently Her.meneutics asked people to enter a summer writing contest addressing what they wished their church knew. More than 150 women with ages ranging from 16 to 70+ responded from across the world. Here is the list of topics they submitted. "I wish my church knew . . ."the pain of miscarriagethe importance of female pastors as role modelsthat we don't have all the answersthat singles need ministry toothat we can learn something from the LGBT communitythe demands of women who workthe pervasiveness of mental illnessto teach us how to arguethe forgotten power of reciting the psalmsto stop looking for the next big thingthe needs of rural womenwhat it's like to be an evangelical introverthow to talk about addictionthe ministry opportunities for adults with disabilitieshow to make disciples out of senior citizenswhat it's really like to be a pastor's kidthe pain of domestic violence victimsthe effectiveness of intergenerational ministryto value preschoolers for their sake, not to reach their parentsthe struggles of chronic illnessthe practice of healing confessionwhat it's like to walk into a barthe dangers of being middle classhow many of us are dealing with depressionthat Christians don't need to mourn the loss of Christian Americathat worship isn't about usthat I love the church just the way it isthe place for stillness in the churchnot to pretend to be perfecthow to feel like familyThe editor wrote, "Some of these topics came up over and over again, especially ones related to mental illness, singleness, and introversion. The church isn't just for happy and healthy married extroverts. . . . "Here is one of the first essays, which comes from a single mom.How would you answer the question? 

Marriage podcast: Part 2

In this episode, I talk about my own marriage and the difficulties we have faced, as well as how we handled these problems. I discuss the theological bases of marriages and how everyone’s belief can be skewed at times.You’ll Discover:The true goal and purpose of a marriageThe essential ingredients that help throughout the changing “seasons” of lifeThe number one sex problem  

Podcast: Marriage and Infertility

Join me as I speak with Belah on the Delight Your Marriage podcast about marriage and infertility.     

When Mother's Day Never Comes

Often the worst day of the year for an infertile woman is Mother’s Day. On this holiday going to a house of worship can feel more like going to the house of mourning.During the decade when my husband and I experienced infertility treatment, lost multiple pregnancies, and endured three failed adoptions, I found it difficult enough to see all the corsages on M-Day. But then the pastor asked mothers  to stand, and I remained conspicuously seated. Some years the worship leader would even call for the youngest mother to stand, and then he smiled awkwardly as a sixteen- or seventeen-year-old unmarried teen got to her feet. On such occasions I would sit wondering about God’s mysterious ways of supply and demand. Following most such services, each mother would receive a carnation as she headed out the door. But to exit she first had to answer “yes” to the question, “Are you a mother?”On a number of occasions, however, I experienced Mothers’ Day as a day of grace. On the one following my first miscarriage, a message in the church bulletin said, “The altar flowers today are given with love and acknowledgement of all the babies of this church who were conceived on earth but born in heaven and for all who have experienced this loss.” The couple who dedicated these flowers had six children, and through their validation of our pain, we caught a glimpse of the one who is acquainted with grief. The husband crossed the aisle and stood by my husband during the music. And with tears streaming down our faces, we found new strength to bring our sacrifice of praise.On several Mother’s Days, a pastoral prayer has included requests that on this special day God would bless the motherless children, those bereft of mothers, mothers estranged from their children, infertile women, and those who wish to become mothers but must wait on God’s timing. Apparently someone figured out that about half the church was mourning along with the celebration. On such occasions I felt like I belonged.One year during Mothers’ Day, I was with a mission team in Culiacán, Sinaloa, Mexico. A man stood at the door after the service handing out carnations to all the mothers. Having heard that my husband and I had just experienced another pregnancy loss, he looked at me through misty eyes and thrust his entire bouquet in my hands.My niece, who is married without children, calls the holiday “mothering day.” In this way she broadens the meaning, making it inclusive enough to include all who nurture. And this seems a fitting practice for the church. We are family. The one without a mother finds mothers in Christ. The parent without children finds children in Christ. Families of one and of twenty all find a broader family in Christ.My mourning on M-Day was not because I wished in any way to diminish our practice of honoring mothers for the thankless work they do. (I myself have one of the best moms on the planet, and it is a joy to honor her.) I wished only for the Body of Christ to find ways to acknowledge our mothers’ sacrifices without inflicting unnecessary pain on those who mourn.This Sunday, we have the opportunity once again to minister grace both to the one in six couples who experience infertility and to the rest of those who experience Mother’s Day as a day of grief. May we rise to the occasion. Because while the preacher in Ecclesiastes tells us it is better to go to the house of mourning than to the house of feasting (Eccl. 7:2), it is also better if that house of mourning is full of empathic family members. As they reach out with the arms and tear ducts of Christ, we remember what will always be true about us: We are not alone.

The Child Catchers: Rescue, Trafficking, and the New Gospel of Adoption: A response

When I used to teach marriage conferences with my late coauthor, we drew on John Gottman’s research-based work that identifies the four most damaging patterns in marriage: withdrawal, escalation, invalidation, and negative interpretation. In the case of the latter, “no good deed goes unpunished.” If a husband brings home movie tickets for his wife, she assumes he bought them only because he wanted to see the film. If she buys him a pair of boots, he assumes she did so because she thinks his shoes are ugly.  In thewords of my father, “Damned if you do; damned if you don’t.”

Negative interpretation, like the other three communicationpatterns, is lethal to a marriage. And what negative interpretation is to amarriage, Kathryn Joyce’s book The ChildCatchers is to evangelicals in the world of adoption.

That word “Gospel” in the title was clearly chosen for itssemantic domain. Indeed, the dust jacket makes the connection overtly: the abusers of the adoptionsystem are the “tens of millions of evangelicals to whom adoption is the newfront in the culture wars.”

Let me state up front that I’m the parent of an adoptee, and I believe in adoption: biasnumber one. And I’m an evangelical: bias numerodos. Yet while these two truths about me could not help but influence how I read Kathryn Joyce’sbook, I agreed with much of what she had to say. So much so that I think those involved in the adoption triand should read herwork. The fact is, Christians and adoption could benefit from acourse correction.

In my husband’s capacity as East Africa field leader forEast-West Ministries—which has a child sponsorship program in Kitale, Kenya—oneof his tasks is to find sponsors to help keep kids in school. For children withno living parents, the African nationals who do the work on the ground haveseen to it that all orphaned children stay with their extended biologicalfamilies. The child sponsorships help make this possible for poor people. And parentless children who have no extended families to care for them go to the homes of theirlocal church members. No one goes to an orphanage. And no one comes to America.We are committed to keeping these children in their home communities. Why? Noone should lose access to a family member just because that family is poor.

But enter the millionaire do-gooders. They come along and,without consulting the local churches or organizations, erect orphanages andput their names on them. And some nationals see filling those orphanages as a way to get Western funds. So the would-be saviors inflict harm and feel goodabout it.

Indeed, often Westerners’ wealth contributes tocorruption. Poverty-stricken parents may be told their children have beenoffered an education program. Only later do these parents learn that the “exchangeprogram” they signed up for legally terminated their parental rights.

About such situations Joyce writes, “Western parentscontinue to display an incredible willingness to believe the stories of theirchildren’s provenance despite the fact that so many read as remarkably the same:hundreds of children allegedly left on police station doorsteps, swaddled inblankets and waiting to be found—a modern-day version of Moses’ basket amongthe reeds. In reality, the abandonment of babies is not such a commonoccurrence.”

Up to this point in the paragraph I agreed. But then she added,“But among Christian adopters lining up, the stories usually go unchallenged”(133). Yet she knows the phenomenon is not unique to Christians.

Only a few pages earlier, she had written about abirthmother saying that “unless she placed her child for adoption with a Mormonfamily, she would not get to the highest level of heaven” (124). She lumps in Mormons with evangelicals?

Joyce tells stories of corruption and injustice that includeeven Angelina Jolie (136), whose efforts the author sees as misguided—a reference that might be fine if the bookwas broadly about adoption. But it’s about adoption andhow evangelicals have messed up.  Sobasically, the author has gathered all the negative examples she can find andblamed the entire fire in Rome on the Christians. Never mind that many of thepeople in her stories who suffer at the hands of unethical adoption brokers areChristians themselves.

At times it seems Joyce is driven to bring up every beef she’sever had with evangelicals. In one chapter she criticizes the campaign to getrid of Kony (what does that have to do with adoption?), likening it toChristian fad advocacy (40). Shemakes Christians guilty by association (there's lots of guilt by association in this book) with the “Orphan Train” of theChildren’s Aid Society (45). She accuses Rick Warren of grandstanding (53) andassigns ill motives to those whose intentions she can’t know. She describes themovement within Christendom toward adoption as “a way for conservatives todemonstrate their compassionate side, making their antiabortion activism seemmore truly pro-life (56). She cynically describes microbusinesses as  being “money-making ventures” (150). You get theidea.

If someone does approach adoption in a way that sheconsiders just or right, she uses words withnegative nuances to describe the way they dress or wear their hair. She accusesChristians of not helping birth mothers. So the reader might expect that shewould applaud the work of Pregnancy Resource Centers (PRCs) with their free servicesthat include sonograms, classes, cribs, and diaper bags. But no Christians get a free pass. Instead, Joycequotes a critic’s assessment of PRC’s: “They say they want to help people in acrisis pregnancy, but really, they want to help themselves to a baby.” Thefacts do not bear this out. Adoption discussions are rare in PRCs, which focus onhelping birthmothers parent.

Like a good journalist, Joyce interviews people onboth sides of a story. But then she always sides with the person criticizingthe adoptive parents (e.g., 122). Part of her bias is that she is self-describedas “secular and pro-choice”—so much so that she cannot seem to imagine thatsomeone else could hold an opposite point of view from her and simultaneously be a reasonable person.

All this bias is bad. Especially because she says somethings we need to hear, and her inability to judge fairly gets in the way of her journalism.

Still, I committed to sorting through her negativeinterpretations. And having done so, I found that I agreed with about 70percent of her analysis. We evangelicals have made some mistakes—some big,huge, gaping-wound ones—in the world of adoption. The following areas arewhere I had points of agreement with her.

We should be able to assume that Christians havethe highest standards of ethics and justice. But believers have often been sofocused on rescuing that we've even bent the rules, justifying our behavior bypointing to the desperate kids. In the process we hurt ourtestimony and provide an incentive for corruption.

Birthparents andadoptees need better advocates. The people in the adoption equation withmoney are usually adoptive parents, not birth parents. Thus, the laws are moreskewed toward adoptive parents’ rights, not birth parents’, and certainly notthe adoptees. Because of this power differential, Christians should be on thefront lines speaking up for those who can’t speak for themselves (Prov. 31:8).

Money corrupts. Anytimewe show up with money in a context of deep poverty, we provide an incentive forcorruption. That is not to say we should not show up. But it does mean weshould have many checks and balances in place, and we must serve the nationalson the ground who know their subcultures better than outsiders do. And weshould never give money to people to do things they could do for themselves.

It is in the bestinterest of families for them to stay together. We should be more focused on keeping families together than rushing kids into the arms of waitingfamilies. The trauma that comes from having kids taken away, from being rippedaway from parents, from losing a community connection—these stay with peoplefor life and leave gaping wounds. We should look to adoption only as a lastresort. When nations slow their process of approving international adoptions in order to better investigate the babies' backgrounds, we should be slow to criticize.

We should cry ratherthan only rejoicing. When a new family is formed by adoption, thatpronouncement evidences someone’s brokenness. And this is where human adoptiondiffers significantly from our spiritual adoption. God created us in the firstplace. So when we become his children through adoption, we are actually twicehis. Thus, spiritual adoption is a picture of restoration. Not so with humanadoption. While it reflects deep unconditional love and choice on the part ofthe parent, it still does not picture restoration. Rather, it is sometimes a goodsolution to a tragic situation. But we often deny the tragedy.

If Jesus is the truth, weshould be zealous about truth-telling. That means we stop exaggerating thenumber of children available for adoption. It also means we go to great lengthsto verify that a child actually has no parents when we classify him or her asan “orphan.”

We must stop “caringfor orphans” at the expense of widows. We wrongly separate the phrase“widows and orphans” (Jas. 1:27); the two often go together. In many parts of theworld, when the dad/husband disappears for whatever reason, the family getssplit up. So our compassion to widows should involve fighting to keep thatfamily together rather than guilting destitute moms into giving their kids a“better life.” It is bad enough to lose a spouse; but to lose a child becauseyou lost a spouse…and to lose that child only because you are poor—Christians! Wemust do a better job of speaking up for the widow! Sending such a child toricher parents is not the best way to care for widows—or orphans.

We need a moreaccurate understanding of biblical adoption. We say adoption is a biblicalconcept, but often there’s a big gap between what we mean by “adoption” andwhat the biblical writers meant. We use Moses as an example of adoption, butMoses is actually an example of a failed adoption.Through his story we see that children never stop identifying with theirpeople—a good reason to keep families together. God used Moses’s tragedy forgood, but that does not make what happened to him a beautiful thing. Moses’sseparation from his family of origin was a disaster caused by great evil.We use Esther as a biblicalexample of adoption. But Esther was raised by a family member, not strangers.Inall the laws laid out for the people of Israel, everything from instructionsabout textiles to medical concerns, not one word is written, not one lawdictated, about adoption. People dealt with infertility either by resorting topolygamy (e.g., Hannah, 1 Samuel 1) or levirate marriage. People dealt with thedeath of parents through extended family. In either case the inheritance stayedwithin the family unit.

BeforeAbraham impregnated Hagar or Sarah, he assumed Eliezer would inherit his goods (Gen.15:3). At that time, the whole point of adoption was that a man needed a maleheir—and he found an adult male if he had no son. The emphasis was on inheritance. It was not about a littlechild entering a new family and being nurtured as if that child were their own.

Somesee adoption in Psalm 2:7: “I will proclaim the LORD’s decree: He said to me, 'You are myson; today, I have become your father.'” The emphasis here is on the Father’s choice. And also on inheritance. Thinkof this in Messianic terms: The Son who was already the Son inherits all theFather has—the world.

Inthe intertestament period, Julius Caesar made provision in his will—that is,posthumously—to adopt his great-nephew, Gaius Octavius Thurinus, 19, known tous as Octavian, or more likely, Caesar Augustus. This legal pronouncement madeAugustus the heir. Everyone in the world of Paul and John, the two New Testamentwriters who spoke of adoption, would have known this.

Inthe New Testament, Paul writes, “For you did not receive the spirit ofslavery leading again to fear, but you received the Spirit of adoption, by whomwe cry, ‘Abba, Father.’ The Spirit himself bears witness to our spirit that weare God’s children. And if children, then heirs (namely, heirs of God and alsofellow heirs with Christ)…  (Rom. 8:15–17).Note the contrast with slavery and the connection of adoption with inheritance.

Inheritance is not the first thingWesterners think of when we adopt, but it would have been an integral part of theNew Testament writers’ perceptions of adoption.

InGalatians 4:4–5, Paul writes, “But when the appropriate time had come, God sentout his Son, born of a woman, born under the law, to redeem those who wereunder the law, so that we may be adopted as sons with full rights.” Notice theemphasis on rights. The contrastwould be with slavery, in which a person had no rights, not even to his or herown body.  

In Ephesians 1: 5–6 we read thatGod “did this [choosing us] by predestining us to adoption as his sons throughJesus Christ, according to the pleasure of his will— to the praise of the gloryof his grace that he has freely bestowed on us in his dearly loved Son.” Theemphasis here is on God’s choice, not ours. We did nothing.

Inshort, while biblical adoption is secondarily about love and affection, it isprimarily a picture of choice and benefits, especially of inheritance.

Some parents need torethink the language they use with adopted kids. Parents who viewthemselves as saving waifs who should be eternally grateful for the gift ofparents have it backwards. Yes, children are to honor their parents, butScripture says “Children are a giftfrom the Lord” (Ps. 127:3, italics mine). The parents are the ones who shouldbe expressing gratitude. Imagine if Pharaoh’s daughter had communicated, “Youare so lucky you got pulled away from those slaves. Here in the palace, you arerich. And loved. Your life is so much better than it would have been. Youshould act more grateful.” Our kids are better served by our grieving with themabout their loss as we express our gratitude to God that he has blessed us withthem.

Nobody should adopt akid to gain gold stars with God. Nor should they speak of adoption asrescuing, doing good works, or as anything remotely associated with charity.That’s insulting. Nor should they assume they will “save” kids spiritually byadopting them.

We should never usethe Bible as an Ouija Board. That is—opening the text and getting a“message” that has nothing to do with the context or authorial intent. Theauthor objects to this, and I agree. Some believers she interviewed spoke ofreceiving messages from God this way. Often they justified their questionable practicesbecause they said God told them to do what they were doing. Certainly God canspeak through a donkey, but that does not mean it is his preferred method. Suchan approach is not “handling accurately the Word of truth” (2 Tim. 2:15).

Children with specialneeds require a lot of extra love and affection. Let me say that again. If the kids have special needs, they require extra love and attention and services. Parents who keep adopting sixteen more kids when they have already adopted some with special needs should do so only in a context of much accountability and counsel. Because in thesame way that some people can’t seem to stop having plastic surgery, some can’tseem to stop looking for babies to adopt.  The church and adoption agencies musthelp them. We have a responsibility to the kids, if not the parents, in suchsituations.

Sometimes God chooses those who oppose us to help us see thetruth. In the ironic story of Jonah, the lost sailors were more righteous thanGod’s prophet. In the story of Baalam, the donkey—not the person chosen as God’smouthpiece—spoke the truth. In the case of TheChildcatchers, an author who negatively interprets just about everything Christiansdo still gets some things right.

Our Father twice-over accepts this as pure and faultless:that we look after orphans and widows in their distress and keep ourselves frombeing unstained by the world. May the apple start to fall a little closer to the tree.

Infertility: One Couple's Story

On and off for the past 20 years or so, I've talked with Jeff Baxter, executive producer of Day of Discovery, about doing a show devoted to infertility. Last week, this arrived in my mail box with a note that said, "I think this program will resonate with you." It did and does. But it's not just for those experiencing infertility. It's for anyone who has wrestled with longings and unanswered prayer.

Frozen Embryos: Ethical Considerations

What can we do about all the frozen embryos slated for destruction?

Avoid cryopreservation of embryos. First, we need to avoid the waste of more embryos by counseling couples pursuing assisted reproductive technologies to limit the number of eggs fertilized to the number they’re committed to carry to term. With in vitro fertilization procedures, each mature egg is placed in a separate dish. So in the case of abundant eggs, embryologists can limit the number of eggs exposed to sperm. Generally when couples request this, clinics honor their ethical desires.

Perfect the egg-freezing process so that gametes—sperm and eggs—are frozen instead of embryos. Currently freezing sperm is commonly done, but scientists are still working to improve the egg-freezing process.

Encourage embryo adoption. At the moment, such a service costs about $6,000. However, some Internet services charge less than $100 to connect couples and let them work out the details.”

—William Cutrer, M.D., and Sandra Glahn, “Of Ethics and Embryos,” Light, (Fall 2000), page 5

Hope For Infertile Men

by William Cutrer, M.D. and Sandra Glahn, Th.M.

Cigar, the retired Kentucky Derby winner, earned $9,999,815 during his legendary thoroughbred race career. But then he was discovered to be sterile. If he had been fertile, he’d be making $50,000+ in stud fees per effort. Animal husbandry research, driven by the desire for financial gain in cases such as this, has brought us numerous advancements in treating human fertility problems. In the last decade, we have seen particular progress in the treatment of male infertility, which had lagged behind treatment for female infertility.

Let’s say a husband has a very low sperm count, his specimen contains some normal motile sperm. What options are available and ethically permissable? For those who believe they must connect the sex act with conception, there aren’t any good options.

However, for those who believe technology can be employed, there are some possibilities, which would include these high tech micromanipulation procedures.

Intracytoplasmic Sperm Injection (ICSI)

Consider the chicken egg. It has an easily recognizable shell, an egg white, and the yolk. Likewise, the microscopic human egg has a “shell,” a material called cytoplasm (like the egg white), and a nucleus (like the yolk). While the human shell is not hard like the chicken egg, its “shell” cells are denser. And as a woman ages, her remaining eggs usually develop with increasingly tougher “shells.”

To aid husbands with low sperm counts or whose sperm have difficult penetrating the egg, we have ICSI. This involves injecting a single human sperm into a human egg by piercing the shell with a specially prepared microscopic needle. Specialists retrieve maturing eggs from the woman, and they obtain sperm from the male. The embryologist then selects and loads a single healthy-looking sperm into the micro-injecting apparatus.

Having loaded it into the needle, the embryologist stabilizes the egg under the microscope and pierces the “shell.” The sperm is then injected directly into the cytoplasm. From this point, the genetic material of the sperm must align with the egg’s. In a complex series of events, the egg “knows” penetration has occurred, and the genetic material of the egg, located in the nucleus, unravels and aligns with the male’s chromosomes. Only then has a unique individual emerged.

With ICSI doctors have absolute control of number of embryos replaced, so we face no worries about unintended multiple pregnancies, nor must couples face the decision of whether or not to cryopreserve (freeze) “extra” embryos. They also do not face the question of pregnancy reduction.

ROSNI (Round Spermatic Nuclear Injection)

Some men have a zero sperm count but still make sperm… sound impossible? Not really. The “plumbing”— the tubes that bring the sperm from the testicle to be delivered—can fail to develop properly. A key part of the tubing called the vas deferens can fail to develop at all, leaving sperm forever in the testicle to die and dissolve. But, now we can access these sperm with biopsy or even surgery on the testicle to obtain it for use in ICSI or ROSNI.

With ROSNI, doctors obtains immature sperm by needle aspiration via whatever part of the male tubular system has developed. They can then inject the immature sperm into the “egg” using a micromanipulative procedure, much as described in ICSI.

Doctors recommend this procedure for the husband with essentially no chance of producing a biological child otherwise. Using ROSNI, physicians fertilize eggs individually. Thus, as with ICSI, the issues of high order multiples, embryo reduction, and cryopreservation do not come into play.

So far, there is no evidence of birth defects associated with these procedures.

But they do raise some other questions: Is it acceptable to separate procreation from sexual functioning? Should it concern us that an embryologists are the ones to choose half the genetic input of a human being based on a sperm’s visual characteristics? For many sincere believers, these dilemmas are insurmountable; for others they present only minor concerns.

Both groups acknowledge the ultimate sovereignty of God over human creation: Your eyes beheld my unformed substance. In your book were written all the days that were formed for me, when none of them as yet existed (Psalm 139:16).

Again, the problem of using medical science in a situation where natural procreation can never occur may not fit your theological system. Yet ethically speaking, the sperm is the husbands (though obtaining it is quite difficult). The eggs are the wife’s, so we have not gone outside the marriage. And we have accomplished the good goal of trying to produce offspring for two people whom God has joined together.

When Father's Day Never Comes

by William Cutrer, M.D., and Sandra Glahn, Th.M.

Not that long ago, male infertility did not exist. In the “old way” of thinking, if a guy could achieve an erection, we said it must be the “woman’s problem.” But once researchers could analyze and test semen not only for “living” sperm but also count, motility, and a host of other characteristics, we discovered that fertility problems in men are as common as in women.

In the early days of male fertility treatment, we saw a variety of “creative” suggestions. These included “ice therapy,” a “sadistic torture” based on findings that sperm count and motility increase if the testicles are cooled.

Folk wisdom encouraged infertile couples to abstain from relations for two weeks, thinking that would improve the chances. Now we know that if a man with a low sperm count waits to “store up sperm” for longer than two or three days, the sperm count and fertilization potential can actually decrease owing to the increased presence of dead or immobile sperm.

Likewise for those advised to “do it more often,” a marginal sperm count can actually drop to infertile.

Precise testing has helped us to better understand male infertility and, fortunately, doctors can now successfully treat many of the diagnosable problems.

What are some of the issues that Christian couples with male factor infertility must consider?

First, the examination of the semen itself is problematic for some Christians. To evaluate the sperm the specimen must be obtained, often by masturbation, and many Christians consider this practice always wrong. In fact, some infertility clinics have a special “collecting room” equipped with pornographic videos and magazines to “assist” male patients in obtain sperm specimens. However, this clearly violates Jesus’ prohibition against lust:

Matthew 5:28 But I say to you that everyone who looks at a woman with lust has already committed adultery with her in his heart.

However, does that mean that a semenalysis is impossible for Christian couples? We would suggest that the husband could get the specimen with the assistance of his wife, focusing his thoughts on her, and thus not violating the Scriptural mandate.

For some, the procreative aspect of reproduction (babymaking) cannot be separated from the unitive (lovemaking). That is to say, some testing and treatment options are not permissable because the efforts at conception are separate from sexual intercourse. While we believe that physical intimacy is not only a beautiful part of marriage and a theological picture of Christ and the Church (Eph. 5), we are not convinced that medical technological advances cannot be employed to assist husbands and wives to achieve a pregnancy. However, we do respect those holding this view and honor their convictions not to use treatments that violate this position.

For those holding this view, a special condom has been developed to collect the semen during the act of intercourse. While this isn’t as effective medically as direct collection, it is certainly adequate. In fact, for those couples who believe the procreative possibility must always exist with the unitive, tiny pinholes can be placed in these special condoms to facilitate sperm collection while maintaining the “possibility” of conception.

If this seems extreme, or even legalistic to you, hopefully you can appreciate the profound pain of couples experiencing infertility, and the lengths they will go to arrive at a diagnosis and treatment plan while staying within the acceptable ethical boundaries of their faith systems.

Next time we’ll explore some of the treatment options for male infertility and the ethical questions they raise.

Surrogacy: Womb for Rent?

by William Cutrer, M.D. and Sandra Glahn, Th.M.

Womb for rent? Isn’t that what Abraham and Sarah tried with Hagar?

A Christian couple recently went to a surrogacy agency and paid approximately $50,000 for services. They were matched with a surrogate, who went on to carry their twins to term.

Say the word “surrogacy” and most people automatically think about nightmare court cases and convoluted family structures. Many Christians have been outspoken against surrogacy arrangements, labeling it clearly as sin.

However, the fact that there are approximately 100,000 frozen embryos slated for destruction should give us pause here. What if, instead of allowing the destruction of human life, we considered gestational surrogacy arrangements to keep these embryos from being destroyed? What may not be wise in an ideal world may actually be the best solution in this ethical dilemma.

The couple mentioned above had undergone an in vitro fertilization procedure during which multiple eggs were retrieved and six fertilized. Three embryos were then placed in the wife’s uterus, and the remaining three were cryopreserved (frozen). The wife went on to give birth, but medical complications required doctors to remove her uterus at the time of delivery. That left the couple with three frozen embryos and no means of carrying them.

Because the husband and wife believe life is precious, even at the one-celled stage, they felt they had no choice but to find a woman who would help them carry the embryos to term. For them, this was an application of their respect for life, recognizing that “children are a gift from the Lord” (Psa. 127:3).

Consider that there are two types of surrogacy arrangements.

Traditional surrogacy is generally used when carrying a pregnancy is life threatening to the mother and/or when the adopting mother has neither functioning ovaries nor uterus. The surrogate donates her own eggs and the use of her uterus. A physician inseminates her with the sperm of the husband, and the resulting child is biologically related to the surrogate (the “third party”) and the husband of the couple. Traditional surrogacy carries with it more complicated issues than sperm, ovum, or embryo donation because in a surrogate arrangement, the donor has contact with the child through the nine-month gestation and birth, and she has a biological connection to the child.

Gestational surrogacy, the arrangement used by the couple mentioned above, is an arrangement in which a surrogate provides a “host uterus” for a woman who is able to produce her own eggs. In this case, the surrogate receives the couple’s embryo conceived through an ART procedure, (reference our earlier column) and/or she receives an embryo that has been cryopreserved and would otherwise be destroyed.

The typical surrogate mother is married, has at least one child, and is between 25 and 35 years old. Many have had elective abortions in the past and volunteer to bear a child as a means of healing from past decisions.

Surrogacy is expensive. Some centers estimate it costs between $35,000 and $50,000. Most of that does not go to the surrogate. It covers counselors’, attorneys’ and physicians’ fees. Beyond the obstacle of cost comes the long process of matching.

In the case of embryo donation, Snowflake Adoption Services (which seeks to match embryos with gestational surrogates) estimates that it costs approximately $6,000 for embryo adoption through their help. However, Internet services are emerging to link couples wanting to find “parents” for their frozen embryos with couples wanting to “adopt” the embryos. In this case, the cost for matching runs about $60, and the medical details are worked out between the couples involved. In an unusual twist of events, gestational surrogacy could provide a creative means of pro-life involvement.

The issue of whether or not couples should cryopreserve embryos is a completely different debate. But in cases such as this—where embryos are suspended endlessly in a cryopreserved state—it would appear that the “sanctity of life” ethic may take precedence in favor of surrogacy arrangements. Perhaps surrogacy is sometimes the best solution in a complicated scenario.

Myths/Facts: When Mother’s Day Never Comes

A Primer on Infertility/Pregnancy Loss

by William Cutrer, M.D., and Sandra Glahn, Ph.D.

Every year on a Sunday in May, pastors ask mothers to stand. In some churches all the mothers will receive a flower. Restaurants will offer bargain meals to families honoring Mom. On Mother’s Day we honor the sacrifices our mothers have made and continue to make—and well we should. But for millions of couples, Mother’s Day is “M-Day,” the most dreaded holiday of the year. For these couples—the ones experiencing fertility problems—this day serves as a reminder of what they long to have but which eludes their grasp. A child.

When it comes to infertility, a lot of myths get passed around. Maybe you’ve heard some of them.

Myth: Infertility and sterility are the same thing.

Fact: Infertility is not sterility. Infertility is the inability to conceive after one year of unprotected intercourse and/or the inability to carry a pregnancy to term (600,000 women miscarry in the U.S. each year). Secondary infertility is when couples who have had one child (or more) are unable to conceive or carry to term again.

Myth: Infertility is rare.

Fact: Infertility is quite common. Approximately one in six couples of childbearing age experience fertility problems.

Myth: Infertility is a woman’s problem.

Fact: Infertility is shared about equally between the genders. About 30 percent of infertility problems are due to female factors, 30 are due to male factors, and 35 percent are a combination of both. The other five percent remains unexplained.

Myth: All the people in the Bible who were infertile were women.

Fact: We have to be careful to avoid viewing the Bible as an exhaustive textbook on infertility. While, the scriptures describe a number of couples who had difficulty conceiving, the stories are not about the process of infertility per se. And women are not the only infertile people. The levirate marriage laws (Deut.25:5,6) suggest male fertility problems. In addition, Ruth was married for ten years to her first husband without children. After he died, she went on to marry Boaz and give birth to Obed, King David’s grandfather. This would suggest that her initial inability to conceive was due to male factor infertility.

Myth: Infertility is caused by the inability to relax.

Fact: Infertility is not caused by the failure to relax. Ninety-five percent of the time it is due to a diagnosable medical cause. About sixty percent of all couples who seek treatment will eventually have a biological child. The percentage is much lower for couples who do not pursue medical treatment. Common causes in the female are ovulation or hormonal problems, endometriosis, anti-sperm or anti-embryo antibodies, blockage which prevents gametes from meeting, and/or structural or functional problems with the uterus or cervix. In men, it is caused by poor sperm penetration or maturation, hormonal problems, and/or blockages of the male reproductive tract.

Myth: Infertility is not any more common than it used to be; it’s just that we’re talking about it more.

Fact: The number of couples diagnosed with fertility problems is on the rise. Delayed childbearing and sexually transmitted disease are partially responsible. Environmental factors may also play a role.

Myth: Just adopt—then you’ll get pregnant.

Fact: Adoption is not a cure for infertility. Five percent of couples who end treatment and adopt end up getting pregnant. Five percent of couples who end treatment and choose not to adopt end up getting pregnant.

Myth: Couples going through infertility are having fun trying to have a baby.

Fact: Fifty-six percent of couples experiencing infertility report a decrease in the frequency of their sexual relationship. Both women (59%) and men (42%) report a decrease in sexual satisfaction, and infertile couples overall report having five times the sexual difficulties of fertile couples.

Myth: Real Christians are against any assisted reproductive technologies.

Fact: Godly people, should they choose to use assisted reproductive technologies, must do so in a way that honors the dignity of life, even at the one-celled stage.

Proverbs 30:16 says, “There are three things that are never satisfied, four that never say, ‘Enough!’: the grave, the barren womb, land, which is never satisfied with water, and fire, which never says, ‘Enough!’” Couples are often encouraged to learn from this that the deep desire of humans to have children is part of the way God has structured the world. Their stress is a normal response to an abnormal situation.

Do you know a couple struggling with fertility problems? Say a prayer for them as they face the daily heartbreak that accompanies such a loss.

A Journey through Miscarriage

by Sandra Glahn, Ph.D. and William Cutrer, M.D.

“A person’s a person no matter how small . . .”

—Dr. Seuss, Horton Hears a Who

Six hundred thousand U.S. women experience miscarriage each year.

One in every 50 couples trying to have children experience multiple miscarriages.

As many as 120,000 couples each year suffer at least their third consecutive miscarriage.

Typically, when a couple faces a pregnancy loss, they find themselves constantly analyzing what they could have done differently. They chide themselves with “I shouldn’t have used that disinfectant,” or “I shouldn’t have gone camping.” “Grandma told me not to lift my arms above my head, but I did.”

To better understand some of the anguish, we need to begin with some medical facts.

What causes it? There is no evidence that excessive work, reasonable exercise, sexual intimacy, having been on birth control pills, stress, bad thoughts, nausea, or vomiting are responsible for miscarriage. The most common reason for pregnancy loss is random chromosomal problems. Knowing this, people often say, “Miscarriage is God’s way of taking those children with serious birth defects.” This is both cruel and unhelpful. At a time like this, logic doesn’t help. It only raises more questions: “So why couldn’t God take this child before I found out I was pregnant?”

Other factors include uterine structural imperfections, environmental causes, infections, blood incompatibility, and immunologic problems. While a single pregnancy loss is more likely the result of chromosomal abnormality in the fetus, maternal factors are thought to trigger repeated losses. But in most cases, the specific reason remains unidentified. Nevertheless, it is extremely difficult to convince a woman who has lost a pregnancy that she could not have somehow prevented this tragedy.

What are the types of pregnancy loss? In the case of a biochemical pregnancy, the “pregnancy hormone” (hCG) is detectable in the blood. In a biochemical pregnancy loss, the pregnancy has ceased to develop in the early weeks. A so-called “blighted ovum” occurs when the placental portion of the embryo develops, but not the fetus. Using the term “blighted ovum” is both sexist and inaccurate, as it blames the female (ovum), when technically, once fertilized, it isn’t an “ovum” any longer. “Miscarriage” is a more appropriate label.

And the case of an ectopic or tubal pregnancy, the embryo implants in a fallopian tube or extra-uterine site, necessitating removal, if possible, before the tube ruptures. An ectopic pregnancy can be life-threatening to the mother, and is virtually always fatal to the child. There are the rare instances of implantation on the intestines (abdominal pregnancy) and occasionally a baby can make it, but this is very risky and highly unusual.

Unfortunately, it is currently impossible to take an embryo from the tube and “re-implant” it into the uterus. Well-meaning people who suggest prayer and waiting upon God to “see if the pregnancy will ‘migrate’” are misguided. This is the equivalent to telling someone with crushing substernal chest pain to pray and wait for the pain to move. If cholesterol plaques clog your arteries causing a heart attack, hopefully you rush to the emergency room for angioplasty or bypass. An ectopic pregnancy is just as dangerous to a mother’s life, and close medical observation is required. In addition, the embryos don’t move from the tube to the uterus.

Although seventy-five percent of miscarriages occur before the end of the twelfth week, they can occur at any time during the gestation period. Some couples experience added grief because they’ve believed the misconception that “once you get past the third month, you’re home free.”

Why do we feel so terrible about it? Depending on personality and background, each person’s response differs. Men and women in general have different feelings about these losses as well, with women tending to feel more of a bond with the lost child. The intensity of pain depends on a number of factors, the most significant of which is the psychological investment in the pregnancy. Often the longer couples have been trying to conceive, the greater their sense of loss.

According to one psychologist, the wave of grief often crests between three and nine months after the loss, although some report that it takes between 18 months to two years for the scars to heal. And the healing process can be disrupted by other life difficulties.

Those who have experienced failed IVF cycles, failed adoptions and the loss of one or more children in a multiple pregnancy have identified many of the same feelings as those who have miscarried.

If you are called upon to support someone who has just lost a pregnancy, the key here is not to be the “answer person,” but to provide time, empathy, patience, informed care, compassion, kindness and the encouragement to talk without trying to find solutions. Ethics here require the appreciation for the sanctity of life—respect for the life lost, concern for the pain, and the need for healing through community.

Curing The Baby Blues

Finding Ethical Solutions for Infertile Couples

by William Cutrer, MD, and Sandra Glahn, ThM

They’re the frozen unchosen. Children on ice. Frozen babies, if you will. A couple engages in a custody battle over their unused frozen embryos. Meanwhile some researchers want to destroy “extra” embryos in hopes of curing diseases. And while some infertile women pray for their eggs to fertilize in IVF cycles, others give permission to have their “excess” embryos destroyed. Bring up the topic of “infertility,” and invariably someone will mention these sorts of ethical quagmires—pulled straight from the headlines.

In the process of creating a child together, why are couples often so willing to enter such a complex maze of moral dilemmas? Because, simply put, infertility is hard stuff. God’s first command to Adam and Eve related to conceiving children, and most couples dream about their union producing a child who is the product of their love. Wrapped up in childlessness, then, are unfulfilled longings and the death of precious dreams. Ever since the Fall, after which God told Eve he would multiply her pain in conception and childbirth, we see problems with human reproduction. Researchers have determined that the depression and anxiety infertile couples experience are equivalent to the pain suffered by patients suffering from terminal illness. Proverbs 30:16 hints at this when it tells us that a “barren womb” is among four things on earth that are “never satisfied.”

What exactly is infertility? Defined medically, it’s the inability to conceive or carry a child to term after one year of unprotected intercourse. It has many causes, but the idea that “infertile couples just need to relax and they’ll get pregnant” is a myth. In ninety-five percent of cases, there’s a diagnosable medical reason. Fertility problems are as common in men as in women, and the number of couples appears to be on the rise due in part to delayed childbearing, sexually transmitted diseases, and environmental factors.

What Can Couples Do About It?

Some argue that infertility is a matter of “God closing the womb” (e.g., Sarah, Hannah), thus insisting that faith alone should be sufficient. Others believe that, while God is able to open and close wombs, He has permitted limited insight into the complex functioning of the human body. (Few would accuse doctors of “meddling” when they treat diabetes with insulin, infection with antibiotics, or cancer with chemotherapy.) Recognizing that approximately sixty percent of couples pursuing treatment will go on to experience live birth, those in favor of medical treatment argue that therapy is appropriate as long as no scriptural principle is violated. Admittedly, scriptural principles are sometimes violated, as is evidenced by the uproar about researchers using stem cells from destroyed embryos, mostly obtained from fertility clinics. So for couples believing that some medical treatment can fall within the will of God, the next question is this: how far can or should we go with such intervention?

Medication – Based on the premise that drug therapies qualify as moral, many treatment options qualify as “fertility enhancing.” A simple course of antibiotics can be “fertility treatment” for the man with a prostate infection. Replacement hormone may be a “fertility drug” for a woman with low thyroid. Yet when we talk of fertility drugs, we usually mean specific ovulation-inducing medications. These hormones may bypass built-in protective mechanisms, resulting in the maturation of multiple eggs. Careful monitoring with ultrasound can help avoid multiple births and some ethical dilemmas.

Surgical intervention – Diagnostic surgery can uncover hidden causes of infertility, and corrective surgery often helps. Surgeons may, for example, correct fallopian tube blockage or endometriosis, which affects the uterine lining. In men, surgery can reverse vasectomies or repair structural damage and varicose veins in the testicles.

High Tech Options – Many Bible-believing Christians approve the use of artificial insemination, in vitro fertilization, and other high tech procedures, provided the egg and sperm come from the married partners and precautions are taken to honor life even at the one-celled stage. Couples using in vitro fertilization should limit the number of eggs fertilized to the number of babies they are willing to carry to term. By doing so they avoid having to later decide both about the destruction of “excess” embryos and about “selective reduction” in cases where the pregnancy results in six or seven babies. Some couples opt for freezing embryos; others have reservations about cryopreservation, feeling that it exposes the embryo to unnecessary risk and that it presumes on the couple’s future. At the very least, couples cryopreserving embryos should have a plan for carrying each one to term.

Adoption – Pharaoh’s daughter adopted Moses. A family member adopted Esther when her parents died. God calls all those who believe in Christ his children through adoption. Thus, the Bible draws a beautiful picture of the adoption relationship.

Of the many losses in infertility, adoption is the solution for only one—the loss of the ability to parent the next generation. Successful “embryo adoption” brings with it the addition of the pregnancy, birth, and nursing experiences not possible in traditional adoption arrangements. Yet the genetic family traits of husband and wife are not passed down. While not a great option in an ideal world, embryo adoption does provide a solution for couples who have chosen to have embryos cryopreserved but who want to avoid authorizing their destruction. Consider the couple who had eight embryos created during an IVF cycle. Doctors implanted three in the wife’s uterus and froze five. After she had triplets, the wife had emergency surgery to remove her uterus. That left this couple with three choices—to allow embryo destruction, find a surrogate, or connect with someone willing to “adopt” them.

Embryo adoption is relatively new—developed because of the more than 100,000 frozen embryos in the U.S. alone. One Christian embryo adoption program works like a full-service adoption agency connecting couples wanting to carry these embryos with couples who have “extras.” At the moment this costs about $6,000. However, some Internet services charge less than $75/month for these couples to advertise and connect with each other.

Most experts encourage couples who pursue infertility treatment to exhaust medical options before pursuing adoption—whether traditional or with frozen embryos—as going through infertility and adoption require working through separate sets of losses. This is why so many infertile couples find it aggravating when others tell them, “You can always adopt.”

Infertile couples usually grieve deeply the loss of a jointly created child. For them, adoption will never fill this void. However, once they reach the “resolution” stage of their infertility, other options look more appealing. Only then can adoption become a wonderful means of seeing their dreams and longings come to life.

Additional Question/Answer about Infertility:

Do most infertile couples seek such high-tech treatment?

No. Approximately five percent of infertile couples seek reproductive technologies as a means of resolving their fertility problems. The number of Christian couples pursuing these treatments is probably significantly lower than that. Probably most of these passively resign themselves to the “will of God,” often hesitating to seek even the simplest forms of treatment.

Is it wrong to pursue medical treatment for a fertility problem?

Not necessarily. Beginning with the premise that producing offspring is good and moral—clear from God’s command to the first couple to “be fruitful and multiply” (Genesis 1:22)—couples begin by asking if any medical intervention is moral. Some argue that infertility is a matter of “God closing the womb” (Sarah, Hannah, etc.) and they go on to insist that faith alone should be sufficient in all areas of life.

Others believe that, while God is able to open and close wombs, He has permitted limited insight into the complex functioning of the human body. Recognizing that approximately ninety-five percent of infertility cases stem from diagnosable medical conditions and that approximately sixty percent of couples pursuing treatment will go on to experience live birth, they argue that medical therapy is appropriate as long as no one violates scriptural principles. We would say that in the same way we would support using antibiotics for infections and chemotherapy for cancers, we use medical intervention to cure fertility problems. One biblical support for this would be that Paul told Timothy to take wine for his stomach’s sake (1 Tim. 5:23).

What can be done with fertility drugs?

Specific ovulation-inducing medications constitute what most call “fertility drugs.” These hormones bypass built-in protective mechanisms, resulting in the maturation of multiple eggs. Drug therapy for the male has been less encouraging. But in those men helped by drug therapy, we find no additional risk of multiple pregnancies, as the human egg normally allows only one sperm to penetrate.

For couples believing medical treatment can fall within the will of God, the next question is this: how far can or should we go with such intervention and still honor the Lord?

Join us in the next column as we explore this question.