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BY John Burger
Special ministries offer guidance in line with Church teaching
NEW YORK—After three years of marriage, Ann and Jim C. began to wonder if they would ever be able to have a baby. The New York City couple became so concerned about their child-lessness that they consulted their doctor, who referred them to a fertility specialist. Tests revealed that Jim had a low sperm count, and the specialist indicated that Ann's chance of getting pregnant in the usual way was practically nil.
She felt empty and frustrated, but for three more years the couple tried several options to address the problem. Jim had a surgical procedure known as varicocelectomy to correct blockage of semen, injections of a male hormone to stimulate sperm production, and surgery to alleviate tubal blockage. When nothing worked, the specialist suggested in vitro fertilization.
Although Ann, who did not want her real name used for this article, was a practicing Catholic, she admitted she was tempted by the idea. She badly wanted a child, and at 40, she felt time running out.
She and her husband eventually realized though, that throughout all their efforts with medicine, they “didn't really petition God.”
Ann then asked herself, “Who are we really going to trust, God or science?”
Trust in God is the quality she encourages others in her situation to develop. She meets infertile couples regularly under the auspices of the St. Elizabeth's Hope Ministry in New York, which was started by another woman who suffered from childlessness. Apostolates such as St. Elizabeth's developed out of real-life needs and the wish of Catholic couples to do what is right in the eyes of the Giver of Life.
Apostolates such as St. Elizabeth's developed out of real-life needs of Catholic couples.
Often barraged by an array of technical options in baby-making, many Catholic couples are subject to confusion. Many do not know what is right and wrong in assisted reproduction.
“St. Elizabeth's is a teaching ministry to help people protect their bodies and their souls,” explained founder L.A. Doyle, an obstetrics and gynecology nurse. Many fertility techniques are not only contrary to Church teaching, she said, but can be damaging physically and emotionally.
Twice a year, couples meet at a convent of the Sisters of Life in the Bronx, a community of nuns founded by John Cardinal O'Connor to pray for and promote a sense of the sanctity of life. Speakers discuss the problem from both spiritual and medical perspectives. Some offer resources and information on adoption and natural family planning. Couples are then invited to attend bimonthly holy hours.
Infertility has been on the rise in recent years because of delayed marriage and childbearing, the long-term effects of venereal diseases, and the use of the pill, the intrauterine device, and other contraceptives. Childless couples are boosting a $2 billion a year industry that markets everything from fertility drugs to “custom embryos” made by selectively matching donor egg and sperm to enhance the intelligence and good looks of the resulting child.
What's more, human cloning is appearing to be more and more a possibility. The recent successful cloning of mice in Hawaii seemed to confirm the breakthrough made last year by Scottish researchers. Dolly the sheep was the world's first clone of an adult mammal, an advance that put man a step closer to human cloning.
Advances in the technology have encouraged a mentality that “if it can be done, it should be done,” said Dr. Kevin Reilly, director of the department of obstetrics and gynecology at Our Lady of Mercy Medical Center in Bronx, N.Y. A significant number of couples will try just about anything to have a baby, believing they have a “right” to a child, he said.
But looking at a child in any way other than as a gift from God reduces him to the status of a product or commodity, many Catholic thinkers point out.
Catholic teaching states that the child is not “an object to which one has a right, nor can he be considered as an object of ownership: rather, a child is a gift, ‘the supreme gift’ and the most gratuitous gift of marriage, and is a living testimony of the mutual giving of his parents. For this reason, the child has the right, as already mentioned, to be the fruit of the specific act of the conjugal love of his parents; and he also has the right to be respected as a person from the moment of his conception” (Donum Vitae, 7).
The St. Elizabeth's Hope Ministry — named for the mother of St. John the Baptist, who was thought to be sterile but conceived in her old age — was founded in the summer of 1996 after Doyle said she was “horrified” hearing the news that some 3,000 frozen embryos created in Great Britain by in vitro fertilization were scheduled to be thawed and destroyed because they had reached their five-year storage limit.
Doyle realized that couples often receive bad advice from fertility specialists, support groups, and the media, and need not only knowledge of what techniques are moral, but support in prayer.
“In this ministry, we go to God as Creator,” she explained. “We have couples pray together because it's a couples problem.”
After four miscarriages in six years of marriage, Doyle began to feel that doctors were putting a Band-Aid on her problem rather than going to its root. She too was about to agree to a specialist's advice — in her case to use a drug that stimulates egg production.
“He wanted to give me the same drug [Iowa septuptlet mother] Bobbi McCaughey was taking,” she told the Register. “But he said that if there was a multiple pregnancy, he would recommend a ‘fetal reduction.’This is the man who was supposed to help me have children, and he was willing to destroy them. I never went back.”
McCaughey's doctor recommended aborting some of the unborn babies so the others would have a better chance of surviving. She and her husband, devout, pro-life Baptists, declined, saying they would trust in God. All seven children, born last November, are still doing well.
The Church has not condemned the use of such drugs, but couples employing medication such as Pergonal or Metrodin “would have to be well advised,” in the words of Msgr. William Smith, professor of moral theology at St. Joseph's Seminary in the Archdiocese of New York. He said that if the doctor can determine via sonogram that the medication has produced more than three ripe eggs, it would be better for the couple to refrain from intercourse until the next cycle.
“We are designed to be born one at a time,” he said. “The womb is not constructed for overcrowding.” Having so many fetuses increases the chance for premature birth, with its concomitant problems of low birthweight, underdeveloped lungs and skin, and the possibility of birth defects.
Donum Vitae (Gift of Life), the 1987 Vatican document that formally condemned in vitro fertilization (IVF) and other artificial techniques, explained that it is wrong to generate human life outside the marital act.
“These procedures are contrary to the human dignity proper to the embryo, and at the same time they are contrary to the right of every person to be conceived and to be born within marriage and from marriage” (Donum Vitae, 5).
Techniques that help intercourse achieve its objective of procreation but do not substitute for it are morally licit. But IVF, artificial insemination, surrogate parenting, and techniques that involve the freezing or donation of sperm or eggs entail the dissociation of husband and wife by the intrusion of a person other than the couple.
“The freezing of embryos, even when carried out in order to preserve the life of an embryo-cryopreservation-constitutes an offense against the respect due to human beings by exposing them to grave risks of death or harm to their physical integrity, and depriving them, at least temporarily, of maternal shelter and gestation, thus placing them in a situation in which further offenses and manipulation are possible” (Donum Vitae, 6).
Also immoral are techniques involving only the married couple but that dissociate the sexual (unitive) act from the procreative act.
That includes artificial insemination, even when the husband's own sperm is used.
Father Russell Smith, theological consultant for the Diocese of Richmond, Va., sees Donum Vitae as building upon a 1949 address of Pope Pius XII to an organization of Catholic physicians.
“What he said still holds true,” Father Smith told the Register. “Medicine is not a matter of being artificial or natural. But if one spouse becomes unnecessary in the reproductive process, it is not a worthy way of bringing forth life.”
What options are open to a faithful Catholic couple?
“Most Catholic hospitals have fertility clinics,” said Father David Liptak, cofounder of the John Paul II Bioethics Center at Holy Apostles Seminary in Cromwell, Conn. “This would be the first instance of inquiry.”
Procedures that assist but do not replace the conjugal act would include surgical treatments for tubal blockage, reversal of tubal ligations, and medical or surgical treatment of endometriosis, where tissue that is normally confined to the lining of the uterus is growing outside that area, such as in the ovaries.
There are also procedures that, because they are relatively new and subject to further study, the Holy See has not yet determined to be moral or immoral and can be considered “an open question, pastorally,” said Father Smith. Some Catholic hospitals offer Gamete Intra-Fallopian Transfer (GIFT), for example, which extracts an ovum, places it near sperm cells in a catheter and then inserts both into the uterus. Conception follows in vivo — in a woman's body.
There is debate among medical ethicists concerning GIFT, which was developed in 1988, when Donum Vitae was issued. Critics say that everything that intervenes in the conjugal act is so invasive that it renders the husband virtually unnecessary. But Peter Cataldo, director of research at the National Catholic Bioethics Center (formerly the Pope John Center for Medical Ethics) in Boston, said that a modified form of GIFT can be used as long as masturbation is not involved. Semen may be collected during the conjugal act by using a special perfo-rated sheath (not a condom) that allows for a quantity of semen to pass into the woman before it self-seals, collecting the remainder. The device has a chemical composition that is not hostile to sperm.
“If fertilization occurs, it would be as a result of the conjugal act,” Cataldo said.
Added Father Smith, “Assisted insemination is as medical and technical as other things but it doesn't replace the conjugal act. Neither spouse is made unnecessary.”
There are also a number of “lowtech” solutions that Catholics may try, including natural family planning (NFP), which is normally used for spacing births for serious reasons.
Many cases of childlessness are due to “bad timing,” missing the fertile time in the woman's cycle, said Nona Aguilar, author of The New No-Pill, No-Risk Birth Control, a book about NFP (MacMillan, 1986). Couples have a 27% chance of conceiving a child once they isolate the day in which the wife is ovulating.
Marilyn Shannon, author of Fertility, Cycles, and Nutrition (Couple to Couple League, 1996), believes that obtaining enough vitamins and other nutritional elements is crucial to fertility. She said Americans are not receiving enough essential fatty acids because of the country's low-fat craze, for example. She cites instances where taking flax oil, which contains those acids, has made a difference.
“We recommend couples to try all of this low-tech stuff for six to nine months,” said Shannon. “Then, if they still don't get pregnant, we recommend that they seek ethical, prudent medical care.”
For those for whom nothing seems to work, Donum Vitae offers consolations. It calls infertile couples to find in sterility “an opportunity for sharing in a particular way in the Lord's cross, the source of spiritual fruitfulness.” It suggests finding “other important services to the life of the human person,” for example, adoption, various forms of educational work, and assistance to other families and to the poor or handicapped children.
Dioceses around the country have adoption services, as does Catholic Charities USA. Ann and Jim were offered a nine-month-old girl with “special needs,” and were unsure about what to do. They were still praying for a baby of their own as well.
“We wanted a guarantee that everything would be perfect but realized that any way you have a child there are risks and that she would need a lot of love,” Ann said. When the couple brought the child home, they “just fell in love” with her. She could not sit upright, was very frail and underweight, did not like to eat and did not make eye contact.
But by her first birthday, the girl was “scooting around” in a walker. “The more she was loved, the more she responded, and now, at age three she's making eye contact.”
Stories abound of couples who adopt and then find themselves expecting one of their own, and six months after adopting, Ann became pregnant. She wasn't sure how to explain it, except as the answer to their prayers, since Jim's last test showed his blockage had come back and his sperm count still low.
Ann said she feels her life is “full” and looks back at how God's plan has worked itself out in her life.
“I thank God now because if I had conceived naturally from the beginning, I'd never have my adopted daughter. And I couldn't imagine life without her.”
St. Elizabeth's Hope Ministry may be contacted at 914-526-3905; the National Catholic Bioethics Center may be contacted at 617-787-1900. For information about local instruction in NFP, couples may call their diocese or the Couple to Couple League, 513-471-2000.
John Burger writes from New York.
EXCERPT: CULTURE OF LIFE