“‘I’m the only mother,’ I’d correct people brightly, again and again. ‘Actually, there is no biological mother,’ I’d sometimes add, in a tone that I hoped suggested Isn’t this interesting rather than You are an insensitive fool. ‘You see, both the donor and the carrier contributed biologically to each child, so the term cannot encompass this situation.’”

That is the response Melanie Thernstrom provided when people asked who the mother of her “twiblings” was. Thernstrom told the story of her IVF and surrogacy experience in a recent issue of the New York Times Magazine.[1]

Like many women today, Thernstrom suffered from infertility that prevented her from being able to conceive children naturally. After five unsuccessful rounds of in-vitro fertilization (IVF) treatments, she and her husband began looking for other alternatives to have children. What they settled on was IVF with donor eggs and the resulting embryos to be carried by surrogates. To make their situation even more complicated, they wanted to have twins, so they had an embryo implanted in two different surrogates at the same time. Roughly nine months later, two babies were born—twins delivered by two different women five days apart. Since that idea of twins is so difficult to grasp, Thernstrom calls her children “twiblings.”

Before evaluating Thernstrom’s situation from an ethical standpoint, I first want to acknowledge that infertility is a devastating condition for many couples. It is not my point to cast stones at those who cannot conceive for that situation is the result of the fall; rather, I want to evaluate one particular aspect of Thernstrom’s specific scenario that should raise eyebrows.

The medical technology available for reproduction is almost the stuff of a science-fiction novel—babies created in a lab from donated material, carried in the womb of another woman and reared by yet others. While these technologies seem to be recent innovations, the most common procedures have been around for a while. Intrauterine insemination (IUI, also known as artificial insemination) was first used on humans in 1785 by British physician John Hunter. In-vitro fertilization (IVF) produced its first birth in July 1978. Surrogacy, in various forms, has been in practice at least since the days of Abram and Sarai, but its modern form has grown in popularity with the development of IVF.

Thernstrom and her husband participated in IVF with the use of donor eggs. Donors don’t have to be a part of the picture for IVF, but they are often used for either sperm or eggs when the couple seeking the IVF has weak or unusable reproductive materials. The use of donor eggs is most common in women over 40 years old because their own eggs tend to be weaker and less likely to implant if fertilized.

The issue I want to raise regarding this situation is one that Thernstrom mentioned in the article. It is the question of moral concern regarding the introduction of outside parties into a marriage for the sake of having children.

Thernstrom relates the story like this:

“I once felt a prick of an unpleasant emotion. It was the week the Fairy Goddonor came to Portland for the egg retrieval. Over tapas one night, I watched her and Michael laughing and suddenly felt unhappy. I poured myself more wine, but instead of dispelling the feelings, it made me feel more alone. ‘You were quiet at dinner,’ Michael said as we got into the car. He turned to look at me. ‘Are you not feeling well?’ ‘Is it weird that you’re having babies with her instead of me?’ ‘I’m not having babies with her. I’m having babies with Melissa and Fie [the surrogates].’ The conversation dissolved into laughter. That was the thing about our conception: there were too many players to be jealous of any one.”

So does Thernstrom’s “prick of an unpleasant emotion” actually point to something more egregious? Could there be a bigger problem underneath the surface?

Here’s the deal. From a biblical standpoint, procreation is only properly carried out within the confines of marriage (Gen 1:28; 4:1; Heb 13:4). In Genesis 16, we see the closest example of the scenario portrayed in the article. In this passage, we see how Sarai gave her maid Hagar to Abram so they could have a child. This would be the ancient form of donor eggs and surrogacy—just without the IVF. I don’t think anyone would doubt that the relationship between Abram and Hagar was adulterous even though Sarai was the one who initiated it.

So that begs the question of whether or not egg or sperm donation for IVF is adultery. Thernstrom admits that she had a moment of “unpleasant emotion.” Could that have been her conscience saying this isn’t right?

Every semester, I pose this same question to my students: Is IVF or IUI with donor(s) adultery? Each class struggles through the answer to that question. The general consensus is that it is difficult to define the situation as adultery in the literal sense of the word because there is no physical relationship between the donor and the spouse. However, my classes generally feel uncomfortable with the idea.

I agree with my classes on the level that adultery cannot be proven in the literal sense because IVF and IUI with donors do not meet a technical definition of adultery. However, has technology provided another means by which an adulterous relationship can be undertaken? Before social networking sites, few people talked about emotional adultery, but now an intimate relationship expressed over social sites and conversations that never produces a physical relationship is generally accepted as emotional adultery. Could it be that the technological advances in reproductive medicine have created another category of reproductive adultery? While the definition is hard to pin down, I believe that the elements are present for such a category. For this reason, I believe it to be the wise choice to avoid the introduction of donor sperm or eggs into the reproductive process.

The Associated Press released an article over the weekend about a proposed provision in the new healthcare legislation that passed through Congress. Part of the healthcare overhaul was a proposal to provide preventative care to patients at no cost. According to the article, “A panel of experts advising the government meets in November to begin considering what kind of preventative care for women should be covered at no cost to the patient.” The question before the panel is whether or not various contraceptive methods should be included as “preventative care.”

There are a couple of ethical issues at play in the work of the panel and the government in general. I will not deal with all of them, but some of them include: 1) Is it the government’s role to provide free healthcare? 2) What is the definition of preventative medicine? 3) Is contraception preventative medicine? 4) Do certain types of contraception violate matters of conscience for which taxpayers should be exempt?

I will not deal with the first two questions, but I want to address the final two. Dr. David Grimes, an OB-GYN and professor at the University of North Carolina, is quoted in the article stating,

“There is clear and incontrovertible evidence that family planning saves lives and improves health. Contraception rivals immunization in dollars saved for every dollar invested. Spacing out children allows for optimal pregnancies and optimal child rearing. Contraception is a prototype of preventative medicine.”

The questions to ask Dr. Grimes are: 1) What is improved health? 2) How do you define “optimal pregnancies”? 3) What is “optimal child rearing”? My guess is that he would define improved health as avoiding any medical condition that is viewed as undesirable in the eyes of the patient. He would probably say that optimal pregnancies are only those that are carefully planned and spaced at previously determined intervals. Finally, his definition of optimal child rearing probably has something to do with caring only for children that are the result of planned pregnancies and not being burdened by too many children.

I certainly do not desire to go back to the Middle Ages for my medical technology, but viewing pregnancy as a medical condition against which you can “immunize” is medieval at best. We are talking about the creation of life, human beings, babies, not the measles. Contraception is a bigger issue than merely the prevention of a medical condition.

In Psalm 127:3-5, Solomon writes, “Behold, children are a gift of the Lord, the fruit of the womb is a reward. Like arrows in the hand of a warrior, so are the children of one’s youth. How blessed is the man whose quiver is full of them; they will not be ashamed when they speak with their enemies in the gate.”

We need to evaluate our own motives and perspectives on the use of contraceptives so that we are in keeping with God’s desires. If we view children as a burden or another line item on the expense chart, we are not in keeping with God’s perspective on children. God is very clear—children are a blessing.

When looking at the various types of contraceptives that are being considered as a free service, we must consider how they function. The article notes that this initiative “would remove a cost barrier that may be keeping women away from more reliable long-acting birth control.” This more expensive form of birth control includes intrauterine devices (IUDs) which function, in part, to change the endometrial lining of the uterus to prevent a fertilized egg from implanting in the uterus.[i] In addition, some forms of the IUD depend on copper wires to prevent fertilization or implantation. Thus, a woman is placing copper in her uterus for up to ten years at a time, running the risk of developing other medical problems as a result of the IUD.

Another form of birth control that will create controversy regarding this proposed initiative is the so-called “morning after pill.” This is a pill that can be taken within a few days of sexual activity to prevent a fertilized egg from implanting in the uterus. This method of birth control has generated much controversy through the years and many states have made allowances for pharmacists who have conscientious objections to dispensing these pills.

In both the case of the morning after pill and IUDs, the question comes to when life begins. If you believe that life begins at conception (as I do), then these methods of birth control are of serious concern. If you believe that life begins at some other point, I would challenge you to try to specify at what point after conception life actually begins. Does it begin at birth? What about viability in the womb (which seems to get earlier and earlier with progressing medical technology)? What about brain activity, motion, etc? The clearest point at which a change of state occurs and something new exists is conception. And if new life begins at conception, then these methods of birth control raise serious ethical concerns.

At the end of the day, we may not have any say in what the healthcare reform looks like, but we need to express our beliefs to our elected officials and inform them that we have a problem. Unfortunately, the article states that aside from Catholics, “most other religious conservatives have stayed out of the debate.” May we not repeat our folly from the abortion debate of the 1960’s and 1970’s. Let’s make our voice heard and protect life.