Bradley and Elaine were married in their late 20s and enjoyed three happy years as a couple before they decided they would like to start a family. They embarked enthusiastically on this enterprise, thanking God for their love for each other and the opportunity to share that love with new little lives. Six months went by, with no success. They had heard that it could take a while to fall pregnant, but six months seemed too long. Elaine asked her doctor about it and received some suggestions about how to improve their chances.
_They tried this for six more months. Still nothing. After that, they lost interest a little, and found that talking about sex made them both feel angry. Bradley wondered whether in fact he wanted to be a father, and threw himself into longer hours at work instead. As a result, they didn't make much of an effort with each other for another six months or so.
_Two years after their decision to start a family, Bradley and Elaine were starting to wonder whether God was keen on the idea. How would they know what their lack of ‘success’ meant? They prayed, and talked, and decided that it was time to look at medical intervention. They were advised to try IVF. They did; it was expensive. Nothing happened. Most of their friends were onto their second child now, and Bradley and Elaine's marriage was fraying at the edges. Church didn't help—all those Sunday School programs and family picnics—so they started attending less regularly.
_One Sunday afternoon, Bradley got a call from his pastor: he hadn't seen them for a while; was everything all right? Holding back tears of anger and embarrassment, Bradley started to explain …
_Infertility is a crisis in the life of many Christian people that receives very little attention. It is often an unspoken grief that afflicts at least some couples in every congregation. It is an issue not just for those couples unable to conceive (primary infertility). Those who have had a previous pregnancy, which may or may not have resulted in the birth of a child, but who seem unable now to conceive again (secondary infertility), can find it almost as painful as never having conceived.
_In Australia, infertility rates are between 12-15 per cent of couples and on the rise, although the increased incidence may well be explained by the increased willingness of the population to come forward for investigation.1 Research suggests that about a third of fertility problems can be traced to the would-be mother, about a third to the father and the remaining third to some combination.2 Studies in the UK reveal that approximately 1 in 10 couples fail to conceive after a year, and of these, about 50 per cent may never conceive. This means that in almost every congregation, there will be several couples who are presently struggling, or who have in the past struggled with this heartbreaking situation.
_While technology offers some hope through IVF programs and improved fertility drugs, medical science is still unable to solve all the problems. Ironically, sometimes the technology now available contributes to the pain experienced by many couples. Going on such a program can lead to a roller-coaster ride of emotions. There is no guarantee of success. The technology offers much, but may not deliver quickly, or ever, and the hopes of the couple are once again dashed.
_Couples must weigh up the cost of the various IVF programs—both financial and emotional—against the obvious benefits and joys of having a family. Hard ethical choices often have to be made about how far to go with the programs on offer, and when to stop the procedures and say enough is enough. This is made more complex as both husband and wife are involved, and often have different levels of desire and commitment to having children.3
_Many of the fertility programs present very complex ethical issues that can be difficult for Christians to think through. What should be our guiding principles as Christian people in making decisions about these forms of technology? How do we use the Bible in seeking to do what is right? This article cannot deal with the technical issues, nor the complex ethical decisions an infertile couple may face (see box at the end for recommended references on these issues). Instead, here we focus first on the pastoral implications as I have experienced them, before looking to the Scriptures.
_Infertility raises important pastoral issues for Christian couples and those who pastor them through this difficult experience. Infertility is a form of grief, but it is a complex one. It is made more complex by:
_Like all forms of grief, various strong emotions are raised by infertility. Infertility strikes at some core issues for individuals and couples. It can be a crisis of identity for individuals. What does it mean to be a woman and a wife, and not be a mother? What does it mean for a man not to be able to have children? Is his ‘masculinity’ in question? If our ‘self-worth’ and sense of fulfilment in life are tied to having a child, clearly infertility will strike us hard.
_It often strikes at the core of a marriage as well. What happens to our notion of being a ‘family’ if it is just the two of us without children? What happens to our sexual relationship now that we are on a program that tells us when to have sex? Far from being fun or spontaneous or romantic, sex can become a dissatisfying, task-oriented, timetabled activity and a subject of open discussion with various specialists.
_For some of us, children represent our link to the future; infertility raises questions therefore about our mortality, about our future (who will care for me in old age?), and so about the whole purpose and direction of our lives.
_For Christians, it obviously raises issues for our faith. If children are a blessing from the Lord (Psalm 128), then what is God saying to us? Why us? What have we done wrong? It can seem so unfair. An unmarried teenager has her second unwanted child, and we are a loving, committed couple who cannot have any! We can feel God has denied us something that is so good and that we want so much. Many people grow up expecting one day to have children, and consider it either as routine or almost as their ‘right’. The absence of children becomes a major challenge to our expectations.
_In an age that prides itself on being in control and solving all our own problems, this can be an area of life that is outside our control. For some successful, achievement-oriented people, this can be very disturbing. Infertility can be a powerful challenge both to the ‘self-made man’ syndrome and to a self-righteousness that says that good people deserve God's blessing. Of course, not all infertile couples struggle with such feelings, but it can be surprising what deep-seated beliefs and emotions will rise to the surface under pressure.
_Added to this for most infertile couples are the constant reminders of their childlessness. Birth announcements, Christmas, Mother's Day, Father's Day and family get-togethers are repetitive reminders of one's own situation, and can at first be very upsetting, and after that, very wearing. The media, too, sends out mixed messages about children. Sometimes parenting is depicted as less important than career ambition and recreational pursuits. Yet at other points, children are highly esteemed, and those without them can seem less than human. Supermodels can talk about the fulfilment of motherhood, and imply that it is the ‘next step’ in the journey to becoming the perfect woman.
_The pressures on the infertile couple come from many directions. Those who have children are often not aware of all these pressures, and may unwittingly cause all sorts of difficulties and sadness for their friends. We may need to make more effort in our churches to bring some of these issues to light in order to serve each other better.
_There is not room here to deal in detail with the ethical issues arising from infertility programs. However, we can briefly turn to God's word and examine what it says under three headings: God's view of children; responses to childlessness; and the family in gospel perspective.
_When we turn to the Scriptures, we see a very positive attitude towards children and parenting. From Genesis 1 onwards, there is an expectation, even a command, to be fruitful and multiply and fill the earth, as part of the mandate given to mankind. There is an expectation that from a marriage union will come children, for God desires godly offspring (Mal 2:15). Children are a blessing from the Lord (Ps 127:3, 128:3-4). They are given by God and ought not be considered a right, but rather a gracious blessing and gift, for God is the one who opens and closes the womb (Gen 30:1-2, 25:21).
_The Bible is full of stories of women who were infertile and who experienced the pain of childlessness. Look at Sarah (Gen 11:30, 18:11), or Rebekah (Gen 25:21), or Rachel (Gen 29:31, 30:1, 30:22) and how distressed she became at the taunts of her rival, or Samson's mother (Judg 13:2), or Hannah (1 Sam 1:1-20) or Elizabeth (Luke 1:7, 24, 36-37). In each of these cases, the woman was eventually able to conceive and give birth, for nothing is impossible with God (Luke 1:37, Gen 18:14). With these women, God's plan for them involved initial inability to bear a child.
_The example of Hannah is particularly instructive as we see her patient trust in God and her prayerfulness in the face of such sadness and ‘bitterness of soul’. Her prayer is not a ‘deal’ with God to somehow force his hand; it is a genuine prayer and offer to God. Her song later reveals that she understands fully the complete sovereignty of God, who is the great reverser of fortunes. Other childless women in the Bible reveal exactly the opposite, as we see bitterness and anger take hold of them. For example, Rachel and Leah exhibit a failure to understand God and his plans and promises (Gen 29:11ff).
_Infertility is not particularly a modern problem but, like all of life for a Christian, it is an issue that challenges our faith in God. God will answer the prayers of his people, but we must be willing to accept his answer in the light of his sovereign will and his love for his people. God will remain faithful to us, but his faithfulness may look different to our own desires.
_The Bible reminds us that real satisfaction comes not from having a child but from being a child. To know that you are a child of God is of far greater worth than being a parent. Isaiah 54:1 (cf. Gal 4:27) teaches us that because of the work of God through his servant king, the Lord Jesus, there will be a time of joy and singing, even for the barren woman, for God will raise up a great family with many descendants, of which the childless person can be a part. Similarly, in Mark 10:29-30, Jesus directs the disciples' attention towards the new family of brothers, sisters and children that the believer gains in this life, and especially in the next. These ought to outweigh the losses we experience in this life.
_The Christian family is of greater eternal importance than our earthly ones which, while bringing to many of us joy and a sense of fulfilment, bring to others heartache, pain and sadness. Throughout the Bible we are reminded that the future glories that are ours as children of God are far greater than anything this life has to offer, and far outweigh the sufferings we must endure for a little while in this life (Rom 8:18ff; 1 Pet 1:3-7)5. Is it possible, then, for our churches to be a ‘foretaste of heaven’ where the humanly impossible can happen—the single person doesn't feel lonely and the childless couple rejoices in the children who surround them? This may be a goal for us to work towards.
_As in all the troubles of this life, it is to the gospel and the God of all comfort that we must turn and find hope, looking always to see how God is both strengthening our faith and training us so we can be of comfort and help to others (2 Cor 1:3-11; 1 Peter 1:6-9).
_This leads to the question “How can those brothers and sisters who are facing infertility best be cared for by their Christian friends?”
_The ethical and theological issues involved with each procedure can be quite different. Recommended further reading on the subject is available at www.hannah.org and the Center for Bioethics and Human Dignity in USA at www.bioethix.org. Also see ‘Bioethical Issues’ in kategoria #11, 1998, pp. 11-24.
_1 Dr Martyn Stafford-Bell, ‘How to Treat Infertility’, Australian Doctor (Oct 1998), II
_2 CN Atton, ‘The Pastors Opportunities’, Exp Time 100 (1989) 448.
_3 In Australia, recently, a debate has been raging over whether unmarried mothers and lesbian couples ought to have access to fertility programs.
_4 These points are made in a helpful article by Nancy Gieseler, ‘Pastoral Care for Infertile Couples’, The Journal of Pastoral Care, Winter 1994, Vol. 48, No.4 p. 355-360.
_5 Interestingly, such thinking leads Paul to say in 1 Corinthians 7 that although marriage is clearly good and given by God for our well being, the urgency of the times and the hope that we have in Christ will lead, at least, some people to say singleness is better. Does this help the childless couple see their situation more positively, for the sake of the gospel, just as it might help the single person to view their situation as an opportunity rather than a burden to endure?
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