The technologies available to people who want to have a baby but struggle to conceive naturally are many and growing, such as medications, intrauterine insemination (IUI), in vitro fertilization (IVF), donated eggs and sperm, surrogacy and genetic screening of embryos.
Reproductive technology raises many questions -- medical, emotional, financial and moral -- that can be particularly vexing for people who want to make decisions in line with their religious faith. Based on my own experience with reproductive technology, and conversations with others, here are five recommendations for people of faith who are considering using reproductive technology.
1. Be clear about your hopes, desires and goals.
People considering reproductive technology have a straightforward goal: To have a healthy baby. But given the many choices available to today's aspiring parents, it's helpful to dig a bit deeper: What motivates your desire for a child? Do you see parenthood as a vocation (a "calling")? How important to you is the experience of pregnancy and childbirth? Or that there be a genetic link between parents and child?
Once you walk through the doors of a fertility clinic, you will face pressure to avail yourself of any and all treatments to achieve pregnancy. It is vital that you enter those doors with a solid sense of why you want to have a baby, and how your faith informs that desire, so that you can evaluate your many options for building a family.
2. Consider moral questions.
Moral questions around reproductive technology encompass, but go far beyond, traditional concerns raised in abortion debates about embryonic life and reproductive choice. For example, what are the implications of our being able to control certain aspects of procreation (such as screening embryos)? Does fertility medicine tempt us to view children not as gifts, but as products manufactured to parental specifications? The market orientation of fertility medicine raises questions about stewardship of resources, and the potential exploitation of patients desperate to have a baby, gamete donors, surrogates and the children themselves.
The news media tend to alternately gloss over or sensationalize such questions. Clinicians, committed to their discipline and focused on achieving pregnancies, are unlikely to raise moral concerns with patients. But moral concerns remain (in fact, as reproductive technology grows in scope and capability, they are multiplying), and are highly relevant for people of faith.
3. Take your time.
Pursuing technological reproduction is like stepping onto a treadmill; once you get on board and get going, it can be hard to step off. Protestant Christian bioethicist Gilbert Meilaender has observed that, "[Reproductive] technology carries its own momentum which, if not irresistible, is nevertheless very powerful."
Such momentum comes hand in hand with a clinical focus on achieving pregnancies. Patients can also be eager to move ahead quickly, particularly if they have been "trying" for a long time or are older. Nevertheless, taking time to talk through decisions with your partner, family, friends, religious advisors and/or counselors, as well as to pray, do your own research, and ask your medical providers plenty of questions, will ultimately help you take control of your decisions, rather than being hustled along from one step to the next.
4. Ponder decisions before you have to make them.
Pursuing reproductive technologies requires dozens of concrete decisions: How will you decide if and when to jump from lower-tech interventions (medications, intrauterine insemination) to higher-tech interventions (such as IVF)? What will you do with embryos left over from IVF? Do you want to limit the number of eggs your clinic fertilizes to prevent having many leftover embryos? How will you decide when to stop treatments if they don't succeed?
No doubt there will be surprises along the way, and you may change your mind. But as much as possible, think about the decisions you'll make before you have to make them.
5. Seek help ... but know that you might not find it.
Pursuing parenthood despite barriers to natural conception is a draining, difficult process. You'll need support, and lots of it. Seek out people with whom you can share your anxieties, frustrations and grief, as well as talk through decisions -- friends, family, a trusted counselor or pastor.
However, be aware that many people are ill-equipped to help with decision-making. While some faith traditions (such as the Roman Catholic Church) offer clear guidance on reproductive technology, others offer only inconsistent, incomplete resources. Many people, including well-meaning and well-educated clergy, don't even know enough about what reproductive technology can (and can't) do, much less the daunting questions it raises.
In addition, reproductive dilemmas tend to draw out the most unhelpful clichés from family and friends: "If it's God's will, you'll have a child." "Just relax and you'll get pregnant." "Why don't you just adopt?" (While adoption is a wonderful choice, this question, with its implication that adoption is a simple remedy for those struggling to conceive, is misguided.)
Seek out safe places in which to talk about your struggles and decisions, ask for prayers, and receive tangible support such as rides or meals. But if people aren't helping, or are making things worse, don't hesitate to look elsewhere for help.
Reproductive decisions are some of the most emotional and complex decisions we can make. Reproductive technologies offer hope to aspiring parents, while raising many difficult questions. These questions touch on core religious concerns about human purpose, dignity, suffering, love and worth. Religious faith also offers the promise of comfort, additional resources and supportive communities within which people can make these most intimate, life-changing and ethically fraught choices.
Ellen Painter Dollar is the author of 'No Easy Choice: A Story of Disability, Parenthood, and Faith in an Age of Advanced Reproduction' (Westminster John Knox). She blogs about faith, family, disability and ethics at Patheos. Visit her website at www.ellenpainterdollar.com.
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