The Little Embryo That Couldn't
A couple of months ago, a friend asked me, “is it really so crazy to believe that life begins at conception?” I could have given him a number of different responses, because I know and believe many different things about this subject. At the time, I had in my mind a Slate article by William Saletan, in which he argued that the next logical extension of the pro-life crusade will be to put severe restrictions on IVF because of the problem of leftover embryos. (These embryos are human beings, the argument goes, and so they must not be destroyed when a woman has completed her family and does not need them anymore). This seemed like such a hysterical overreach, even accepting people’s sincere feelings against abortion, that I emphatically told my friend that an unimplanted embryo is a limited form of life with no future on its own, and to contend otherwise is lunacy. The loss (I would say “death,” but that language seems too loaded) of unimplanted embryos is a phenomenon that occurs quite often in nature – an egg is fertilized, but does not implant in the uterus, and is flushed from the body through what seems like a menstrual period. Estimates of the percentage of all pregnancies lost this way range from 30% to a whopping 75%. (I posted an article a couple of weeks ago written by a woman who had just experienced one).
IVF (in vitro fertilization) success rates help to demonstrate the dramatic number of fertilized ova that do not get much past their first few days of life. In IVF, a woman is given medications that stimulate her ovaries to produce several eggs at a time. Those eggs are placed in a petri dish with the partner’s (or a donor’s) sperm, and the embryos that result are grown for three days. Typically, two or three of the best, most viable-appearing embryos are transferred into the uterus at a time in the hope that one of them will implant and survive to become a fetus and then, hopefully, a newborn. Of these types of transfers, success rates average about 30-40%. Success rates are slightly higher when the embryos are grown for five days instead of the traditional three, because the additional 48 hours gives doctors a better idea of which embryos are more likely to be viable. In any case, the IVF process inevitably involves the creation of embryos that are defective and will not implant or survive – which mimics nature’s high failure rate at this same enterprise. Not all eggs are high-quality, and not all sperm are either. Nature discards that which has no chance to live.
Clearly, then, an embryo, no matter how much we wish that it will become a baby, is not anywhere close to a sure thing. How much sense, then, does it make to treat these many millions of embryos that stop developing or that never implant as human beings with rights equal to our own? To treat them as though their brief formless existence was as precious and valuable as the children already born? To ban emergency contraception, or for heaven’s sake, the birth control pill, because they may prevent a fertilized egg from implanting? In my view, none.
Even after the embryo does implant, the risk of miscarriage is reasonably high, probably about 30% in the earliest days and decreasing over time. The journey from potential life to actual life is a continuum that is fraught with danger. It’s undoubtedly easier, then, to just say that “life begins at conception” and be done with it. No critical thinking required. But that this is factually misleading suggests that basing public policy on it is equally misguided. Reproduction is a process, not a one-moment event. Things can and do go wrong at any point in that process. Now, the further along the process gets, the less likely it is that something will go wrong. But at the very least, it is beyond question to me that the disruption of the process of creation of new life is not identical, ethically, morally, or physically, to the termination of a life that already exists. That doesn’t mean that there are not moral and ethical issues to ponder with respect to a disruption of the process. But simply saying “abortion is murder” with no qualifications is flat wrong.
I know whereof I speak in all of this, as I am currently having a miscarriage. It has been interesting to hear the different ways in which people express their sympathy to me. (Although I have not told very many people, just my parents and a few close friends). One friend who had a miscarriage a few years ago said she knew how difficult it was to lose a wanted pregnancy. This seemed an eminently reasonable thing to say. But another friend (and a medical student, at that!) said that he was sorry to hear about my baby. And I just crinkled my eyebrows, nonplussed, because there was no baby. There was (is) an embryo that was probably chromosomally abnormal and that stopped developing very early on. The ultrasound woman told me this morning that she could see nothing other than a sac. (The medical term for this is “blighted ovum,” and it accounts for 50-60% of all first-trimester miscarriages – it means that the gestational sac continues to develop for a while after the embryo stops). The sac is just sitting there in my uterus, until my body realizes that it is time to expel it. But it is not a baby, and I actually find it kind of offensive and stupid for someone to say it is.
I mean, if ever I was going to become sentimental about embryos, it would be now, when I desperately want to start my family. Instead, I am annoyed by the sentimentality of others toward something that should be more sacred to me than to anyone else. I feel strange and judgmental about feeling this way, since there are women all over the Internet who miscarried before ten weeks talking about burying the tissue they pass, naming the embryos, grieving for months before starting to try again. Many of them had a blighted ovum too, meaning that there was no fetus at all. But I know what they are really grieving, and it isn’t the loss of a baby. It’s the loss of the excitement and happiness and plans they made when they thought they were pregnant. This is a loss, no doubt. But the difference between grieving for plans that don’t come to fruition and grieving for a human being is, it seems to me, an important one.
IVF (in vitro fertilization) success rates help to demonstrate the dramatic number of fertilized ova that do not get much past their first few days of life. In IVF, a woman is given medications that stimulate her ovaries to produce several eggs at a time. Those eggs are placed in a petri dish with the partner’s (or a donor’s) sperm, and the embryos that result are grown for three days. Typically, two or three of the best, most viable-appearing embryos are transferred into the uterus at a time in the hope that one of them will implant and survive to become a fetus and then, hopefully, a newborn. Of these types of transfers, success rates average about 30-40%. Success rates are slightly higher when the embryos are grown for five days instead of the traditional three, because the additional 48 hours gives doctors a better idea of which embryos are more likely to be viable. In any case, the IVF process inevitably involves the creation of embryos that are defective and will not implant or survive – which mimics nature’s high failure rate at this same enterprise. Not all eggs are high-quality, and not all sperm are either. Nature discards that which has no chance to live.
Clearly, then, an embryo, no matter how much we wish that it will become a baby, is not anywhere close to a sure thing. How much sense, then, does it make to treat these many millions of embryos that stop developing or that never implant as human beings with rights equal to our own? To treat them as though their brief formless existence was as precious and valuable as the children already born? To ban emergency contraception, or for heaven’s sake, the birth control pill, because they may prevent a fertilized egg from implanting? In my view, none.
Even after the embryo does implant, the risk of miscarriage is reasonably high, probably about 30% in the earliest days and decreasing over time. The journey from potential life to actual life is a continuum that is fraught with danger. It’s undoubtedly easier, then, to just say that “life begins at conception” and be done with it. No critical thinking required. But that this is factually misleading suggests that basing public policy on it is equally misguided. Reproduction is a process, not a one-moment event. Things can and do go wrong at any point in that process. Now, the further along the process gets, the less likely it is that something will go wrong. But at the very least, it is beyond question to me that the disruption of the process of creation of new life is not identical, ethically, morally, or physically, to the termination of a life that already exists. That doesn’t mean that there are not moral and ethical issues to ponder with respect to a disruption of the process. But simply saying “abortion is murder” with no qualifications is flat wrong.
I know whereof I speak in all of this, as I am currently having a miscarriage. It has been interesting to hear the different ways in which people express their sympathy to me. (Although I have not told very many people, just my parents and a few close friends). One friend who had a miscarriage a few years ago said she knew how difficult it was to lose a wanted pregnancy. This seemed an eminently reasonable thing to say. But another friend (and a medical student, at that!) said that he was sorry to hear about my baby. And I just crinkled my eyebrows, nonplussed, because there was no baby. There was (is) an embryo that was probably chromosomally abnormal and that stopped developing very early on. The ultrasound woman told me this morning that she could see nothing other than a sac. (The medical term for this is “blighted ovum,” and it accounts for 50-60% of all first-trimester miscarriages – it means that the gestational sac continues to develop for a while after the embryo stops). The sac is just sitting there in my uterus, until my body realizes that it is time to expel it. But it is not a baby, and I actually find it kind of offensive and stupid for someone to say it is.
I mean, if ever I was going to become sentimental about embryos, it would be now, when I desperately want to start my family. Instead, I am annoyed by the sentimentality of others toward something that should be more sacred to me than to anyone else. I feel strange and judgmental about feeling this way, since there are women all over the Internet who miscarried before ten weeks talking about burying the tissue they pass, naming the embryos, grieving for months before starting to try again. Many of them had a blighted ovum too, meaning that there was no fetus at all. But I know what they are really grieving, and it isn’t the loss of a baby. It’s the loss of the excitement and happiness and plans they made when they thought they were pregnant. This is a loss, no doubt. But the difference between grieving for plans that don’t come to fruition and grieving for a human being is, it seems to me, an important one.
posted by Sandi | 11:43 AM
6 Comments:
Sandi, I greatly appreciate your insight shared over your past three posts on this issue. The science of medicine is quite foreign to me, and I’ve been enlightened by your posts.
However, I can't help but feel there are portions of the abortion discussion that shouldn’t be overlooked -- issues outside of the "when-does-life-begin" debate.
My concerns are related directly to a dear friend. This friend is single and has had multiple sexual relationships. One long-term relationship ended in 2003 and an aborted pregnancy 4 months prior to the break-up was a significant factor. My friend was psychologically devastated, suffering from depression. Thankfully healing took place … another long term relationship came along. And too my deepest regret, 2 years later so did another pregnancy and then a second abortion.
IMHO, in this situation medicine doesn’t begin to address the central issue which led to 2 aborted pregnancies. And I have not heard proponents of the right to choose defend this use of abortion.
I hope you are soon blessed with a beautiful child. And I don't believe would-be mothers like you make up the market segment for abortion clinics.
But certainly abortion as a form of birth control is sad, sad commentary on the priorities of the sexually active couple. In my finite mind I can't imagine someone defending one's right to live this way.
I don't mean to cast stones at those with a past like my friend’s. I love my friend. But I find the actions indefensible.
As one that respects your opinion (particularly given its difference from my relatively uniform circle of friends) I would love to hear your thoughts.
Thanks for your openness, Sandi. Nothing like personal experience to confront the dismissive "you don't know what you're talking about" arguments.
As I've told you before, I wish you and your husband the best in your desire to have a baby.
Hi Dejon, without more details about why your friend chose to end her pregnancies, I'm not sure I can make any sense of her situation. If having an abortion was going to make her depressed, why did she do it? Were the relationships she was in not stable enough to become permanent? More importantly, how old was she at the time? Did she have access to birth control? (This isn't always conclusive -- all birth control methods have failure rates).
Also you sound a little judgmental about your friend's "multiple sexual relationships" -- I mean, I have had "multiple sexual relationships" too in the sense of having been with more than one person in my life. Details are important there too. Was she being coerced into having these relationships? Was she having them because she felt bad about herself and this was a misguided way of seeking love and attention? Were they one-night stands or did she date several people in a row and it didn't work out?
I can't figure out what "the central issue" you refer to is. My guess is that you mean unmarried sex. I was planning on addressing abortion further next week (I like the series thing, it works for me), particularly what I think people's concerns are about it. One of those is the "abortion as birth control" argument. Here is a preview: maybe I'm naive, but I don't think that most women who have abortions use it as birth control. From what I understand, it is a painful and invasive procedure that no one would choose unless they really felt they needed it. I'm sure that some people (perhaps your friend is one of them) are less responsible about birth control than they should be. And that some people (men and women) enter into sexual relationships that are not really in their best interest. My usual answer to the fact that some people make poor choices is that we should educate people to make better choices rather than to take choices away from everyone.
Sheepishly I admit at times I'm guilt of your accusation. I don't want to judge my friend, but too often my attitude descends to such depths. I strive to mature beyond this.
And here's where I'd love to spell out my articulate and irrefutable perspective on "the central issue." I can't. I don't have all the answers for my friend, and certainly can't give a pithy answer to solve it at the macro level. (But if I tried, legislation and politics would have no mention.)
And while I do not contend that the abortion decision stems solely from unmarried sex. I do suspect that an over-sexed society cultivates people that enter in to unhealthy sexual relationships and the abortion option is a temporary fix for their unplanned pregnancy, but does not address the underlying issues that led to the ill-timed conception, and in some cases the decision to abort compounds the problem. (I’m no psychologist so I can’t provide empirical data to support my last assertion. Do you consider me "way off?")
And I have to mention … In situations like these I find it very hard not to consider the likelihood that a healthy child would have been born.
But I'm learning here, and your patience with me is a blessing.
Thank you.
Dejon, no doubt about it, Americans have a troubled relationship with sexuality. (really most people do, but I know the most about where I live). This was only implicit in what you said, but I agree that the way our popular culture presents sex to young people is troubling. I am by no means a puritan or even a foe of premarital sex -- but unlike some on the left, I definitely acknowledge that sexuality is a powerful force that should not be taken lightly.
Unfortunately, I learned too much of that through personal experiences of which I am not necessarily proud. I wonder now how I could have learned this without having had those experiences (of course, I want to prevent my children from going through the same floundering, painful journey that I did). No doubt popular culture and peer culture informed how lightly I treated my early experiences. I wonder, though, whether notions of sin and shame are the answer. Judging from some of what I've read of "abstinence" education (egregious gender-role stereotypes and overstatements about sexual danger), I wonder whether it would have worked for me either.
I tend to think that we need a whole new way to think about what role sexuality should ideally play in our lives -- one that holds that sex is a positive part of human existence (the "sin" thing casts a pall over all of sexuality, I think, even when officially sanctioned by marriage); and one that promotes respect for each other and our bodies. Gender equality is a necessary part of this, in my view. It is inequality between men and women, I think, that has been the biggest culprit in poisoning sexuality in this culture (and probably other cultures too).
Okay, I'm writing next week's post, so I'll stop. I don't want to air your friend's laundry on a public website, so if you want to e-mail me separately and continue the conversation, please do.
Where I come from it would be appropriate for me to hear your comment above and give a throaty but loud "AMEN!"
Meaning I really couldn't agree more.
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