Near the end of Reproduction and Responsibility, the 2004 report of the President’s Council on Bioethics, comes a call to safeguard women and pregnancy. “In an effort to express our society’s profound regard for human pregnancy and pregnant women,” the council urges Congress to prohibit procedures exploiting female reproductive capacities.
The concern for pregnancy is well founded, if seldom expressed. What is striking about ongoing public discussions of stem cells, cloning, assisted-reproductive technologies, and the like, is how infrequently pregnancy and maternity are mentioned. In the media, pregnancy is more likely to be downplayed or caricatured than regarded seriously.
Not that we don’t take babymaking seriously. Reports of high-tech reproduction appear frequently in the news, the regular cast of characters including frozen embryos, postmenopausal women, surrogates, lawyers, and doctors. What these stories confirm for extraordinary cases is now familiar in more ordinary ones: Having babies is a project that we undertake with doctors. The implication is that the doctor or the treatment are responsible for fetal flourishing, and gestation is a stage to be passed through on the way to getting the baby out. Meanwhile, bedazzled by DNA, pop culture gives the leading role to genes, the new package of forty-six that hurtles the zygote into full-fledged humanity. Along the way, gravid women become comparatively insignificant, bystanders in babymaking.
What we need is an evaluation that makes sense of both biology and experience. Poor thinking about childbearing obscures important aspects of what it means to be human. Technology has changed childbearing, not only for women employing cutting-edge medical techniques but also for “routine” pregnancies. But modern science is finally limited in its ability to tell us the meaning of our life in it. Leon Kass, former chair of the bioethics council, has called for a biology “that does full justice to the meaning of our peculiarly human union of soul and body in which low neediness and divine-seeking aspiration are concretely joined.” Philosophical sources, premodern and current, can contribute to this, as can religious voices. The Christian tradition offers insights and a vocabulary that may help us grasp what we are doing in bearing children and how deeply it matters.
There are conflicting Christian opinions on childbearing. But a good place to begin is with the idea of procreation. It is an archaic-sounding word, and though sometimes made to stand in as a synonym for “reproduction,” there are crucial differences between the two. Reproduction depends on industrial and mechanical metaphors, making copies of the human species. In contrast, procreation roots sexuality and childbearing deeply within two relations: that of the man and woman, and that between the couple and God. In the first, the sexual embrace of husband and wife opens them to receive a child. In the second, procreation places human intimacy in the context of a divine work, with husband and wife as co-workers alongside God in the creation of a unique human soul.
While procreation implicitly defines the whole process from conception to birth, most often the word is used particularly for the parents’ physical union. Given the profundity and physical character of pregnancy, though, a woman’s continuing efforts to nurture a fetus should also be described as a moral act, her cooperation with God in bringing forth life. Indeed, the woman is particularly burdened and particularly honored in the process. She is the first to witness the creation of the new human being, never before introduced to the created order but present in her. “God creates the soul of the new child in her body,” Alice von Hildebrand writes of this maternal privilege. “This implies a direct ‘contact’ between Him and the mother-to-be, a contact in which the father plays no role whatever.”
In centuries past babies were thought to arise from male “seed” and then be shaped by bodily humors and planetary arrangements, with mothers largely passive in the process. Some premodern ideas may strike us as peculiar, but at least they approached procreation in a philosophical way, mindful that biology necessarily carried implications about men, women, heredity, and divine purpose. Scientific language today tells us much more precisely what happens when DNA from sperm and egg unite—but without obvious connections to relationships human or divine. We have known for some time that women provide half the genetic material of a new baby, and that they also give it the environment, nutriment, and nurturance necessary for life. After thousands of years of assuming generation and the child’s soul to be primarily a male accomplishment, the discovery that mothers contribute both seed and matter might have inspired fresh consideration of maternity. Instead, we have passed from the ancient description of babies as essentially man-made to considering them as basically self-made. Theologians discern where God may still be found in the process—maybe ensoulment comes at the joining of chromosomes, maybe with the primitive streak—but what mothers do seems to matter only when things go wrong.
The transformation of our embryology has immense implications for human experience, but a reductive scientism should not have the first and last words in describing human life. A sperm-meets-egg-makes-cluster-of-cells narrative is inadequate to explain our origins: not false, only not sufficient. As Pope John Paul II emphasized in his 1994 Letter to Families, “Man’s coming into being does not conform to the laws of biology alone, but also, and directly, to God’s creative will, which is concerned with the genealogy of the sons and daughters of human families.” Our aim should not be to reclaim folk beliefs about how babies are made, but given the biological and clinical frameworks of maternity today, return to philosophy and theology to help describe the import of what we are doing.
The knowledge (and self-knowledge) imparted by medicine alters the way women view and live pregnancy. Even before that knowledge informs action, it is morally significant. Human gestation resembles the same process in other mammals except for this distinction: We are very much aware of it and we, in some measure, understand what is happening. Carrying a baby is a conscious act.
A mother learns that her actions provide critical assistance to the baby’s development. For all that we talk about babies as products of their genes, prenatal care presupposes that what happens to a fetus in utero has significant effect. Pregnant women are cautioned not to smoke, drink alcohol, eat mercury-tainted fish or pesticide-laden produce, empty cat litter, or perm their hair. On the positive side, they are admonished to exercise, eat healthily, monitor physical symptoms, report for regular doctor visits. Care in observing these directives should not be viewed merely as following doctors’ orders, a form of social control, as some feminists contend. Instead, prenatal prescriptions are better seen as practical steps whereby a woman can put together what she recognizes scientifically with the desire to nurture and assist the child she carries.
What medicine reveals about the mechanics of gestation, rather than stressing woman’s passivity, instead allows us to see pregnancy as a moral act. “Feeling fine, just tired,” a mother-to-be might politely answer when asked how she is doing. Just tired: bone-tired, spent as though having performed a strenuous task. A mother is doing something strenuous, not “making” a baby directly, like hammering out a shape in a forge, but growing tissue, crafting a placenta, carrying weight.
Pregnancy is not just waiting but real work. Exactly what kind of work is it? Terms offered by the market are not much help: It is not evaluated like salaried tasks, and phrases like “maternity leave” construe the event as though it were vacation or hiatus from meaningful employment. We might better avail ourselves of theological categories to help make sense of women’s labor in this phase of procreation: Hospitality describes the mother as welcoming a needy guest, self-denial honors the pains and costs of that nurture, and stewardship observes the boundaries of her agency in respecting Providence.
Scripture and the early Church enjoined hospitality as a duty, and St. Benedict commended it in his Rule. Believers were to extend kindness, such as the acts of charity itemized in Matthew 25, to strangers as though to the Lord himself: “I was a stranger and you invited me in.” An expectant mother welcomes and serves a child as a stranger. Ultrasound pictures notwithstanding, the fetus is a person she does not yet know but whom she is uniquely qualified to help. Doctors may not encourage “eating for two”any more, but an expectant woman comes to live as two. Her whole being is stretched to accommodate another person. Her body, clothing, time, rest, and food are shared, and the most intimate areas of life reflect the presence of another person. Consider those notorious food cravings. Women develop aversions to edibles formerly counted as favorites, or desires for things normally detested, or for great quantities or in strange combinations—as in the venerable jokes about pickles and ice cream. These cravings point to something fundamental about pregnancy. Wanting something you usually do not like attests to this: You are not yourself. At least, you are not only yourself. You are acting on behalf of someone else, wittingly and unwittingly.
Consumption theorists have argued that women come to know the baby-to-be by buying things for it. When anthropologists Daniel Miller and Alison J. Clarke studied London women in their preparations for birth, Clarke concluded that “the putting together of nurseries, the receiving and deciphering of infant-related gifts, and the competencies and social relations implemented in the everyday consumption of baby-related goods simultaneously makes babies and mothers.” A casual glance at parenting magazines and layette departments might ratify that conclusion. There are myriad items one is said to “need” for a baby. By purchasing things for a yet-unborn child, the argument goes, a woman constructs herself as a mother and the fetus as a social being.
These theories are on to something but miss the mark. A mother may be swept in by the marketing of maternity and place great (if misplaced) value on nursery decor and the newborn wardrobe. However misdirected that attention is when focused solely on buying, it is not coextensive with a desire for acquisition. Rather, assembling crib, diapers, clothes, car seat, is an act of charity to someone who, having nothing, will need these things. Buying for baby reflects an effort to do good for another.
Pregnancy is a primary community, an exhibit to onlookers as well as to mothers of interdependence, charity, and life together. It qualifies our assumptions of autonomy, the liberal romance with individuality and self-sufficiency. None of us at the beginning is autonomous, and the continuation of the species depends on the partial sacrifice of autonomy that women make in childbearing. Learning to extend oneself on behalf of the child in utero (and observing women who provide this aid and comfort) nurtures community within and beyond the family.
The self-denial of these nine months invites comparisons to Lent. Uniting discipline and charity, a mother who swears off liquor, tobacco, and sweets aims not at personal health, as in a diet, but at the child’s well-being. Pregnancy is a time, to borrow John Winthrop’s definition of Christian charity, to abridge ourselves of superfluities to provide for another’s necessities. A mother practices this self-abasement in what she bears as well as in what she forsakes. For every woman willing to praise and cherish pregnancy, there are half a dozen who profess to hate it. There is reason for this. Pregnancy can feel lousy. It is true that pregnancy is not a disease, as women’s-health advocates for decades have urged obstetricians to acknowledge, but it can feel like one. For most women in prosperous, medically advanced societies, maternity complaints are relatively minor. But childbearing also can trigger long-term debilities or disfigurements. And there is always the possibility that pregnancy could kill you.
Carrying a child means (sometimes quite literally) giving your life for the child. More generally it means suffering, often on a small scale and occasionally a large one, as the body does the work of growing a child. This is true not just of labor, whose pain and peril has not been eliminated altogether by modern medicine, but of the whole nine months. Choosing to embrace the gravity, even danger, of the undertaking makes maternity much more than a stint as a patient or a baby-store consumer.
Finally, pregnancy is an exercise in stewardship. If hospitality and self-denial illuminate how much a woman does in pregnancy, stewardship acknowledges the limits of her doing. Though the term can be applied variously, Biblical stewardship means taking care of something that is not one’s own, caring for what is entrusted by Providence. Seeing children as gifts discourages our efforts at over-determination. Maternity is not manufacture. A woman carrying a child is not making a baby in the sense that she can control the outcome. She is working together with God in the creation of a new human life, of which she, at end, is not the author. Part of the danger of the screening methods that have become increasingly common in reproductive medicine is their encouragement of a “quality-control” sensibility. A mother’s task is to care for, nurture, and protect the life she carries to the extent that she can.
The limits of our stewardship responsibility also can be a source of solace. Maternity guidebooks and advertising are rife with prompts to anxiety and guilt, warning that the slightest maternal misstep or oversight could destroy or handicap a wanted child. Pregnancy should not be burdened in this way. As Martin Luther wrote about women who suffered miscarriage, “One ought not to frighten or sadden such mothers by harsh words, because it was not due to their carelessness or neglect that the birth of the child went off badly.” However scrupulous a mother may be, a child may be miscarried, have grave problems, or be stillborn. Knowing that ultimately we do not make a child alive can draw us away from the guilt and despair of such situations.
Stewardship returns us to the need to view pregnancy not as the project of a woman and her doctor, but as a couple’s collaboration with God. In that collaboration the woman visibly holds together unitive and procreative love, physically linking eros to the child it engendered; pregnancy’s symptoms are both delayed consequences of intimacy and advance signals of another person’s coming to be.
A mother’s tasks, reflections, and abstentions, from conception through birth, comprise her part of that procreative work. When we think this way about pregnancy, we begin to appreciate it more fully. We admire the way God has arranged the connection of mother and child, the moral good that women in this state are situated to undertake.
At a time when biotechnology explores ways to enhance, produce, and destroy embryos, it may seem unnecessary to focus on ordinary pregnancy. But it is in this ordinary process, in practicing habits of nurture and hope on behalf of another, that virtue is developed. It is through doing well with the day-to-day care of new life that we grow more prepared to meet extraordinary situations when they come. Reproductive technologies already abound at conception and delivery but as yet leave the span in between largely free. Pregnancy is an area in which we may still admit technology into our lives rather than the other way around. We should admit it in a way that honors the special work we undertake with the Creator.
Agnes R. Howard is adjunct professor of English and History at Gordon College in Wenham, Massachusetts.