- The Trauma in Being Human -

Where is God's Blessing for the Infertile Couple?

by Martin Baldwin

martin@toptracks.info

August 2005

 

Having children has long been seen as a blessing from God.  So are those without children outside God's pleasure?  Rain like God's love, falls on the just and unjust Jesus observes, and we know that some people have children when they would rather not, or should not.  So we can't seriously treat childlessness as an act of God.  Christians face not only the trauma of infertility but also the trauma of ethical decision making as they assess recent technological solutions for infertile couples.  Where the heart of their belief lies and whether they are able to trust and have faith in a God who loves and knows best determines the speed of the journey through this harrowing time.

 

Trauma is not regarded as a pleasant or positive thing.  Deriving from the Greek, meaning to wound, it is perhaps better defined as a 'psychic injury'.[1]  Similes of trauma include, agony, anguish, disturbance, ordeal, pain, suffering, and torture.[2]  To clarify further, trauma is regarded as a disturbingly persistent memory that may be either repressed or unresolved.[3]

 

Humans[4] experience trauma as the result of seen and unseen events.  A terrorist attack on the other side of the world causes trauma not from being there, but in identification that it could have happened where we are.  Somehow we relate to events that we are not related to, and then to greater and lesser degrees.  People in Israel or Iraq suffer from such constant and extreme trauma from frequent suicide bombers that they get desensitised, and trauma becomes part of who they are, part of their daily lives. 

 

In New Zealand the last significant earthquake or volcanic eruption has reduced over time the trauma faced by New Zealanders of this very real threat.  'Human Trauma Big Item in Flood Cost' states the Otago Daily Times in 2002.[5]  What flood we now ask?  In reality, New Zealand with its isolated location basks in a relatively trauma free zone, whatever trauma occurs, quickly exits short term memory.  Our greatest trauma is perhaps coming second in sports events, especially rugby, as most can remember the anguish and pain of a significant loss, to England, Australia, or Auckland!   These though are public or collectively felt traumas.

 

This document studies a trauma on an individual or personal level, one that is cross cultural, intercontinental, world wide and affects up to 15% of the world's heterosexual couples.  This trauma is infertility, the pain suffered through inability to have children of your own.[6]

 

 

Infertility as Trauma

Infertility embraces miscarriage[7], still birth[8], as well as inability to conceive.  The classical definition is the inability to achieve pregnancy within one year of procreation efforts (six months if the woman is over 35) or inability to carry through to a live birth.[9]

 

Most people take the ability to reproduce for granted, but this isn't as straight forward for 15% of couples in the world, but as low as 8% in the western world.[10]  The rate of infertility in New Zealand is high, at least 15%.[11]  These people face tremendous pain and searching, as they question why they don't have the necessary ability to conform to a societal norm, having children. 

 

Although both individuals in a relationship suffer, it is a trauma that is significantly greater for a female to battle as 'femininity has traditionally been based on the bearing and rearing of children.'[12]  Men are affirmed by job success, sporting achievements and social status.[13]  A woman's ability to reproduce is tied in with their sexual identity and therefore their self image.[14]  From preschool ages girls play with dolls, imagining them as their first babies[15] before graduating to baby sitting duties.  As one woman notes, when the reality of her time to realise this hope and dream arrived at the age of 26 'all other goals in my life faded into obscurity.  Having a baby was paramount.'[16]

 

So to discover that this goal is not as straight forward as expected, is devastating to say the least.  The pain and trauma of infertility is often underestimated, and it is one of the most emotionally destructive conditions there is.[17]   It is not difficult to find examples of the pain of infertility:

'For a long time I was very angry and wondered

what I did in this life to deserve such pain'[18]

 

'I was starting to relate better to death than life'[19]

 

She said to Jacob

“Give me children, or I shall die!”[20]

 

'At Christmas I felt like the only child in a large family

to whom the parents had forgotten to give gifts'[21]

 

'Nine years of trying to have a child of our own was like

 having to drink bitter waters from a poisoned well month after month'[22]

 

'when a friend told me she was pregnant I congratulated her

and then went home and cried'[23]

 

 

'When I was most depressed about infertility, I experienced a pervasive sense

 of personal failure.  I felt like an evolutionary outcast!'[24]

I had a 'constant feeling of loss'[25]

 

'I feel now that being hopeful will only bring more pain'[26]

 

'I wasn't suicidal, but I did feel there was nothing worth living for any more'[27]

 

The results from a study of 1000 infertile people show that one in five contemplated suicide while waiting for infertility treatment and more than nine out of ten reported feelings of depression, isolation, and frustration.[28]  Other common feelings are incompleteness, disappointment, emptiness, anger, jealousy.[29] 

 

The level of misunderstanding from others is perhaps the hardest of all to face.  Most of our society assumes that conception and pregnancy are matters of choice, and under personal control.[30]  But it's far from that simple.  The best way for those not affected to relate to infertility is to see it as a form of death.[31]  Everyone can relate to losing loved ones, for infertile couples, the grieving is not from losing a loved one, but a grief[32] for losing something they've never had.[33]

Several scales [34] attempt to classify the grief, but none fully appreciate the continual sense of loss from not having children.  Unlike other forms of grief where over a period of time the grief is overcome, infertility trauma is like a roller coaster, and takes years to settle.  In an effort to portray this see figure 1 Grief Continuum. 

 

Grief Continuum

Figure 1 The Grief Continuum showing the three stages that infertile couples travel through.

 

In this model are three main stages couples facing infertility go through, the agonising and most traumatic first stage where they struggle to come to terms with what they had taken for granted, each month facing a repeating pattern of highs and lows, hope after each ovulation that you may have conceived, followed by despair once your period arrives.[35]  This stage can last over ten years and ends when reality sets in, that there is nothing you can do, that you have to move on to survive.  'To give up cherished hopes and dreams especially when they are about ordinary human activities that the rest of the world achieves effortlessly, is a painful process.'[36]

 

The second stage usually takes less time to work through, as the trauma is dealt with and reduces, leaving the final stage when all hope of pregnancy is gone.  Please note, that although the trauma is low, at no time does it go completely.  The blimp during this stage reflects that at unexpected times the pain returns.  Such as in the true story of a childless woman in her 70's who thought she had gotten over infertility but realised she hadn't when her friends began having grandchildren.  'When they brought out the photos and the knitting I felt like an outcast.'[37] 

 Infertility Today

Infertility is usually assumed to be the fault of the woman.[38]  But recent studies have shown that this is not correct.  40% of infertility cases are to do with male factors, 40% female, 15% is due to both, and 5% is the frustrating unknown factor where everything appears in order, but it just doesn't work.[39]  How many women have felt guilt or been unnecessarily made to feel guilty from this false assumption?

 

The biological clock is a major issue.  Women have only until menopause to conceive, but in reality, after the age of 27, chances of conception fall increasingly steeply.[40]  Men also have a biological clock but the timing is different.  They also have decreasing chances of conception after the age of 30.  Both men and women are most fertile in their 20's,[41] by 35 years of age both are only half as likely to conceive as at 25.[42]

 

Therefore most couples facing the pain of infertility are in their 30's but there are other contributing factors and biological clock issues are not the only reasons.  Today most couples delay the starting of a family until a level of financial, marital and emotional stability has been reached.[43]  In 1982 80% of the births in this country were by women under 30.  In 2002 this had dropped to 50%.  Also many career oriented women have found alternatives to children to fill their early lives.[44]  And with marriage being preferred later in life as well, the age of people beginning to have children is older than ever.  This suggests that the incidence of infertility is rising, and therefore is likely to become an area of trauma for a significantly greater percentage of couples.

 

While looking at the solutions to infertility it is appropriate to examine its causes.  In women these include: heredity, diet, climate, environmental factors, anatomical, physiological or psychological abnormalities,[45] also ovulatory dysfunction, abortion, smoking, and coffee.[46]   The single greatest cause accounting for between 25-35% of cases in women is blocked or damaged fallopian tubes.[47]  Sexually transmitted diseases (STD's) are what typically cause this. 

 

There has been little research on the male side,[48], which is surprising considering that 40% of infertility cases are associated with male factors.  It is commonly thought that the problems are oligospermia (low sperm count), asoospermia (no sperm at all) or sperm that lack motility, but it is fairly likely that what you eat, how much exercise you do, illnesses and accidents you have had, exposure to chemicals, smoking, alcohol and drug abuse and possibly STD's are factors.[49] 

 

 

Solutions

Infertility has traditionally been regarded as bad luck, a curse, or simply God's will,[50] with generally little you could do about it.  There have always been human endeavours to overcome it.  In biblical times, a wife could be divorced for not producing male offspring, or a slave girl could be supplied to the husband to overcome the wife's inability to produce a child for her master.[51]  This practice is reflected in Genesis 16:1-4 where barren Sarah gives her slave girl Hagar to Abraham to bear them a son.  It is interesting that God did not honour this human solution, but stepped in to provide a child for Sarah.

 

The culture in Old Testament times demanded a male child for each household.  Sons gave prestige in the community, managed the family affairs, perpetuated the family line, helped keep parents in their old age, arranged for proper burials, and therefore playing an essential role in society.[52]  This put tremendous pressure on couples to produce, and various less ethical means were used.  A particularly sordid passage tells of Lot's two daughters getting him drunk two nights running and sleeping with him to preserve with sons their family line.  Incidentally, these boys, Moab and Ben-Ammi became enemies of Abraham's descendants. 

 

If a man died without leaving a son, a single brother of the man, or next of kin, as in the case of Ruth, was responsible for continuing the family and family name of the dead man.  The first born son would be regarded as the dead man's.

 

Best selling author Bryce Courtney writes the incredibly traumatic tale based on fact in Jessica where the favoured barren daughter steals her 'Cinderella' sister's baby.  This tear jerking Australian scenario from less than 100 years ago is hopefully an exception but goes to show the desperation and lengths that some people will go to have a child.

 

This was further outlined in an hour long programme recently where traditional Maori methods were being used by couples in the United States to overcome their infertility.  They endured physically brutal treatment as 'Papa Joe' released them physically, emotionally and spiritually.[53]  They were prepared to endure this pursuit to overcome their pain.

 

While adoption has traditionally been the solution for many infertile couples[54], it does not cure infertility, it resolves childlessness.[55]  And adoption is no longer a realistic option in New Zealand as most single, pregnant women, previously the main suppliers of adoptive babies are now able to bring up their children thanks to the 'Domestic Purposes Benefit' and more tolerant community attitudes to single parents.[56]  In 2003 there were a total of only 81 'normal'[57] adoptions in New Zealand. 

 

Today there is an array of technological interventions (Assisted Reproductive Treatments, ART's) available.  The best known treatment is In Vitro Fertilisation (IVF)[58].  Other common treatments include GIFT[59], ZIFT(aka PROST)[60] AIH[61], AID[62], TEST[63], DIP[64]. 

 

Surrogacy, the modern version of adoption, one woman carrying a baby for another as assisted reproduction is considered to be a good option and also a way to prevent the passing on of genetic diseases.[65]  There are other more experimental and less ethical procedures such as PGD[66] and cloning available in more liberal countries such as Argentina. 

 

Modern biotechnology offers a variety of solutions for the infertile couple.  The possibility of overcoming this trauma is exciting for those who have the means to access it.

 

 

In Vitro Fertilisation

IVF is far from a straight forward and simple procedure.[67]  For several months a woman is required to inject herself with large doses of hormones that can cause incredible bloating, nausea, vomiting, hair loss and mood swings.[68]  And then there is the fertilisation stage where eggs have to be harvested, fertilised and implanted a procedure that is far from pleasant for the woman involved.  This process is awkward, embarrassing and quite painful.[69]

 

However, the rewards though are high, even if the success rate is not.  One cycle of IVF has only 27% chance of live birth, slightly higher than for natural conception (22%), but the odds increase[70] if you are able to continue the physical, mental and fiscal punishment.  Louise Dickson (published 2001 in NZ) and her husband endured seven attempts at conceiving a child through IVF that cost $90 000, a huge amount of damage to her health and a lot of heartache, as none of the cycles were successful.[71]  Around 450 IVF children are born in NZ each year.[72] 

 

 

Ethical

It is important to remember that ART's have been created from a demand created from ordinary people desperate to have a child, not developed by doctors and scientists wanting to play God.[73]  Nonetheless, a multi million dollar industry has developed to overcome infertility.  This industry is reliant on this condition continuing, and therefore has done little to address the causes, as outlined above.

 

Just as there are many factors and variables in the causes of infertility, there is a wide range of treatments available some that are relatively inexpensive.  Fisch suggests that better diagnosis and appropriate treatment would save potentially millions of dollars.  However many couples are not offered alternative treatments, and are quickly headed in the expensive and more traumatic IVF direction as this brings greater profits to the industry.[74] 

 

Furthermore, with the prevalence of STD's in our sexually liberated culture, if were able to radically modify lifestyle and sexual behaviour, the incidence of infertility would be significantly reduced.[75]  'It would be hypocritical, to say the least, to advocate ART's to relieve infertility and increase population growth when at the same time we live a lifestyle that is conducive to the development of infertility.'[76]

 

Some people have a problem with having more embryos fertilised than will actually be used, as these embryos are the beginning of humans.  Spare embryos can be frozen for later use, costing the couple in additional storage fees, or simply discarded.  The issue here is whether these embryos are human and whether we are killing small people.

 

New Zealand’s National Ethics Committee has recently ratified creating a child through surrogacy.[77]  Wyatt argues strongly that creating a child through donation or surrogacy breaks the link between making love and making babies.[78]  What could result is not a love child but a 'strange and hidden hybrid'.[79]  The issues for the child to come to terms with later in life as they seek to determine who their real parents are could create new and significant trauma for all involved.  Stott wonders whose baby’s these are anyway, the doctor's, donor's, or God's?[80]

 

Surrogacy and donation of embryos also allows lesbian and homosexual couples to have children.  With the passing of the Civil Unions Bill in New Zealand, this is no longer a legal issue, and should perhaps be expected.

 

While humans are created with freewill, there are limits as the tree of knowledge in the Garden of Eden clearly shows[81].  Humanity is not allowed to do as it pleases.  'God creates the limits beyond which his creation cannot transgress.  This is re-emphasised in Job 38:8-11, man and nature have God set limits.  Some technological interventions available to humanity today to overcome infertility could broach these boundaries.  Humanity must be very careful with what they do.  Our freedom is limited by a 'hidden moral order' that we must live by or face disaster.[82]

 

Cloning is the future, and who knows where that will lead.  We are not free to improve on the original human design.  We have to ask whether new technology fulfils the artist’s original intention.  'If we lose the concept that human beings are designed by God, we strike at the heart of the biblical understanding of what it means to be human.' [83]

 

It is easy and understandable for some people to overlook these and other serious ethical issues in their desperation for a child.

 

 

Biblical

Within the Bible are at least eight specific incidents[84] of infertility, and a raft of proof texts that are not particularly helpful to those who are facing this trauma.  Take for example Psalm 127:3, 'Sons are a heritage from the Lord, children a reward from Him.'  Are the infertile couple supposed to take from this that infertility is a punishment?  Certainly not, we say, but these difficult and often unhelpful verses are still there and create problems when suffering from this trauma.

 

 

Creation (Good)[85]

We need to grasp the full meaning of creation to understand what we have fallen from.[86] God's plan for humanity was 'very good'.[87]  Infertility but more importantly trauma at Creation, has to have been absent, a non issue.  The issue though was relationship.  'We can assume that before falling into sin, human beings are created to live in a perfect harmonious state of relation with the Creator, knowing his love and loving him in response, worshipping and enjoying him in total dependence.'[88]  All that was needed was provided.  Relationships with others and God was to be seamless.  It seems His intention was for a race of people to develop that could enjoy His fellowship and love.  And over the ages believers have become that race.

 

It is easy to get side tracked into thinking that Creation was only about more people.  God's command in Genesis 1:28 that the couple go out and multiply is understandable in a fresh new world where the need for population increase was required.  But in today's context, the world's current population may compel us to examine seriously whether producing more offspring is still a necessity.[89]  What has often been seen as a command to procreate, should be seen as a blessing and promise, not a command and duty.[90]  The specific purpose for marriage is therefore not procreation but companionship. Genesis 2:18 says that it is not good for a man to be alone, so God made a helper for him.  This is powerfully significant for the infertile couple.  Having children is then not to be seen as a vital activity as far as God is concerned.

 

The utopia of Eden didn't last, there seems to have been created in humans a natural ability to do wrong much as is noted in Romans 'for all have sinned and fall short of the glory of God'.[91]  It doesn't seem to have taken that long for people to begin trusting in themselves and not their Creator. 

 

 

The Fall (Bad)

The breaking of God's rule and the establishing of sin broke the seamless relationship with God.  This sin should be seen as 'a ghastly declaration of independence by a dependant creature against his creator'.[92]  As the now corrupted image of God, human beings move from a state in interdependence to one of independence and autonomy.  The beauty of creation is lost.  Evil became 'an ingrained pervasive reality.'[93]

God was not prepared to sit by and let humans get away with sin.  Adam and Eve and all subsequent humanity discover that sin has consequences.  Giving birth is directly affected, as is conceiving, for as God condemns the snake, cursing it and the soil, He then turns to the woman, but shows restraint, not cursing her or mankind.[94] 

 

Walton's paraphrase of Genesis 3:16a,

             “I will greatly increase the anguish[95] you will experience in the birth process,

          from the anxiety surrounding conception to the strenuous work of giving birth.”[96]

 

The consequences of sin are to establish trauma in conception and possibly infertility.  The first part of this verse is to do with the anxiety a woman will face from conception to birth, worrying about whether she will be able to conceive, worrying about pregnancy, about the baby in the womb, and worry surrounding the birth process. 

 

It is possible that as the rainbow reminds us about God's goodness, the pain of infertility is to remind us about human wretchedness, and 'that sin and disobedience do not go unchecked and unchallenged.'[97]  It initially seems a harsh thing to do, but then God shows that he takes sin seriously enough to allow His son to die on the cross to save us.  How dare we complain about a little bit of suffering through infertility?  What a small price to pay!

 

With sin, humans also cease to relate to creation responsibly.  They begin to use it to create idols to take the place of God.  This begins with the Tower of Babel, and continues with the creation of the 'golden calf' in the desert, to providing a visible representation for Israelite worship.  For some people the quest for children becomes a 'golden calf', their god.  Questions should be asked about whether the child is an artefact, 'a product of human planning and ingenuity for the parent's use' rather than a blessing from God.[98]  The story of Rachel’s infertility in the Bible reminds us not to let our quest of a child be like this.  Rachel craved having a child, yet even when she had one, she wasn’t satisfied, she wanted more.  In the end that which was more important to her took her life, as she died giving birth to her second son, Benjamin.  The lesson for us is to keep God as our first love.[99]

 

The writer of Ecclesiastes reminds us that going after all the things of the world does not bring happiness or fulfilment.  He bemoans, that he may as well have been chasing the wind!  Life without God, in sin, is hopeless.

 

 

Redemption (New)

Some time after the writing of Ecclesiastes a new era was born, the time of Jesus.  His life and resurrection provides new hope for the future.  Relationship with Him also offers comfort and love.  He says,

 

“Come to me, all you that are weary and carrying heavy burdens,

and I will give you rest...you will find rest for your souls.”[100]

 

For those who grieve, Jesus comments in the beatitudes,

 

“Blessed are those who mourn,

for they will be comforted.”[101]

 

For the very private grief that is infertility, Jesus can be the ever present comfort in this difficult time.  Although He was known as a miracle worker, faith in Jesus, or good deeds, will not necessarily bring reward for wants.  Our primary focus Jesus reminds us must be for God, loving Him with all our soul, mind and strength.[102] This applies especially to infertile couples where the all consuming desire for a child can cause a damaging shift in focus.  Before infertile couples venture into the use of ART’s they need to be sure of their motives.  For others, reality needs to be faced that children need not be a part in everyone’s future.

'In the sphere of the New Testament message there is no necessity, no general command to continue the human race as such and therefore to procreate children.'[103]  'Parenthood is now only to be understood as a free and in some sense optional gift of the goodness of God.'[104]  It is not to be seen as a bad thing to be without children.  Childless couples must set their hope on God, 'for the Child who alone matters has been born for them too.'[105]    Childlessness can be seen as provision of freedom to engage in other tasks and cares and joys.  'To bring up children is a beautiful and promising thing, but the end and purpose of human life cannot and must not be sought in this...since the meaning of this activity is only earthly and temporal.'[106] 

 

Sometimes the hard decisions have to be made, saying no to medical progress.  Sometimes there is a need to have trust and courage in declining what modern technology makes possible.  In the biblical worldview, suffering can have purpose.[107]  This is avoided at all costs because of impatience, and the need for instant answers.  But perhaps it is a period that can draw couples closer to God.  When in the midst of suffering we ask ‘How long?’ rather than 'Who is God in the midst of this?'  Such patience does not mean waiting until things change, but learning to wait because of who God is even when the situation doesn't change.  Such a change of focus enables us to ask better questions and to search for different answers.[108]  The answers to these is where we must begin: Is God good?  Will I trust Him?[109] 

 

The world sees the cross as foolishness, weakness, humiliation, defeat, and absurdity.  The church though sees the cross through lens of the resurrection, seeing God's wisdom, power, glory, victory and purpose, a means of salvation to a new community.[110]

 

 

Perfect

The Garden of Eden gives a glimpse of what the renewed earth will look like.  Jesus will return, raising the dead, judging the world, regenerating the universe and bringing God's kingdom to its perfection.  'From it all pain, decay, sin, sorrow and death will be banished, and in it God will be glorified forever'.[111]  Trauma is finished with.

 

Relationship will be completely restored, to be as God intended it.  The redeemed of God will live in resurrected bodies, perhaps in some new way of life that transcends sexual relationships as we have now.[112]  Jesus suggests this in Luke 20:34, we will neither marry nor be given in marriage but be like angels in heaven.  So that eliminates with pain, infertility. 

 

So we should not hold onto life here on earth, but live in faith and hope for the future, for the renewed[113] earth.  It is this hope that must sustain us through our suffering.[114]  This is not to say that hope will take away our pain, but it can provide a way through it.

 

And this hope we have in the future must shape our mission in the present.[115]

 

 

Missiological

Mission, simply being salt and light to the world, showing practical love while sharing the message of Jesus. 

 

Where could infertility possibly fit into mission?  Summing all the adjectives related to fertility challenges, possibly the most applicable is, lonely.[116]  What implication does this have for Christians?

 

After Jesus stated what the greatest commandment was, he continued saying the next most important was to love your neighbour.[117]  We are called to have empathy with those who are hurting, not offer trite advice, weeping with those who are weeping, rejoicing with those who rejoice.[118]  Simply being there is what’s called for.  And this should not be done in the quest for another convert, but in simple obedience to Jesus command, and an outworking of faith.  This is what God expects of His church.

 

Infertile people need others who have silent listening ears, people who acknowledge that their hurt is understandable.  They need the warmth of touch, acceptance of honest feelings, need to hear that their mourning is justified.  They need the prayers of friends, and spontaneous acts of kindness.  Overall they need your patience.[119]

 

Childless Christians may have a significant ministry opportunity for being able to talk ‘with someone else who has been through the trauma and grief is important in coping with what is a loss of part of yourself.'[120]

 

The Bible is also a book that offers help and hope, and can play a useful part if it is used appropriately.  This book mentions eight instances of infertility.  At first glance they seem irrelevant to us, but within each narrative is a hidden message that is as applicable now, as then. 

 

For example, in the case of Abraham and Sarah, God had clearly told Abraham that his descendants would be as numerous as the stars.[121]  They just had to trust and wait.  Infertility though pulls at such powerful forces in our souls that this is easier said than done.[122]  Their impatient use of Hagar caused short and long term problems.  Our message is to have trust and faith in God, that nothing is too hard for him.  If He knew having a child was the very best thing for us, He would cause us to conceive.[123]

 

The story of Isaac and Rebekah reminds us that sometimes we don't receive from God what we desire because we haven't asked Him.[124]  We have to keep our focus on the Lord and remember to bring Him into the loop, by praying.

Hannah provides an example for us to emulate.  She shows the pain of ridicule that is so easy to identify with.  But we see in her a woman who continued to trust God through her trauma.[125] 

 

If these stories of hope are too difficult, the lament Psalms, especially 77 show us that we are not alone in our suffering.  These Psalms confirm that God expects us to cry out to Him in frustration and pain, that we should not suppress our feelings or be embarrassed about our anger.  God is waiting to listen and comfort us. 

 

Churches seem to lack an ability to deal with fertility issues.  While most pastors and ministry leaders are sensitive and caring, most 'are simply unaware of the struggles, the heartache, and the significant pain caused by infertility.'[126]  Within each church, every Sunday it is likely that there is at least one hurting family longing for a child.[127]  The tragedy is that unless the couple are strong in their faith, the insensitivity of the Christian community often pushes them away from church altogether.[128] 

 

Children are a blessing.  Churches need to be aware that many cannot take such a gift for granted.  They need to be careful not to elevate parenthood to the point where childless couples feel cursed because they have not been so blessed.[129]

 

The church as the community of believers should be a haven of love and acceptance, inclusive of all.  A church should be a place where the infertile feel supported.  When this is clearly the case those in the wider community will feel comfortable coming into and sharing in the love and support that exists. 

 

There are various times during the year, Christmas, Mothers and Fathers Days, when children and having children are highlighted in Sunday church programmes.  These are difficult times for childless couples and churches need to plan carefully so as to not marginalise those without children.  And if the commercially oriented Mothers and Fathers days do have to be recognised, acknowledging all women or men on their day irrespective of children is a more loving and inclusive treatment of all.[130]

 

The Christian community should not need reminding of the need to look after the poor, lowly, sick, lame, widows.  Those suffering from infertility certainly fit into this category, and are people the church should be caring for.

 

 

Conclusion

So where is the blessing for infertile couples?  There is no one answer.  While everyone is made in the image of God, every person and each couple are unique.  Each couple must seek God's unique blessing for them and their individual lives, through personal relationship with Him, by keeping their focus continually on Him, and seeking to love Him and others. 

 

Only God knows the reasons for any couple’s infertility.  He doesn't want to cause us pain, but He sure is there to help us through it.  You will still feel the loss at Christmas, and Mothers' Day celebrations, and when people ask how many children you have, but you have in Jesus a friend who understands, who has been through trauma, who will be there for you.[131] 

 

The pain is real, and no one can truly appreciate the pain another is in, and we mustn't presume to do so. Those with children will never know the trauma that infertile couples face.  It doesn't seem fair.  Yet couples without children will never have to face the trauma of losing a child, which also isn't fair. 

 

Infertility steals your focus.  We need to lift our eyes to see other and perhaps more obvious fields.  The primary aim of marriage is not to be an institution for bringing up children.  Barth is encouraging as he suggests studying the possibilities that you have without children.  He seems to be suggesting looking outside the square as an opportunity to do something significant for the surrounding world.  There has to be a trust that as we have a big generous and loving God, He knows what is best for us.  Sure the pain has to be worked through, but children are not to be seen as the reason for life. 

 

The two greatest commands, to love the Lord your God with all your heart mind and soul, and to love your neighbour, remind us that our focus is to be on a personal relationship with a loving God, and loving others, rather than on fulfilling our own wants and dreams.  We need to trust that God has a plan for our lives and work toward fulfilling it.

 

Dickson says, teaching provided an outlet, a way of channelling her gift of dealing with children into something truly positive.  'Being surrounded by such great little people gave me so much satisfaction that not having my own children seems less and less of an issue.'[132]  ‘I had to change to survive.  I still have sad times, I still wonder occasionally what life would have been like if I had had my own family.  Teaching is stressful and no substitute for motherhood.  But it is an extremely rewarding alternative.’

 

‘I want to encourage others in my position not to lock themselves away.  Not to shut out the people who love them or turn away from other children.  Where people have reached out to others they have gained some control over their lives again.’[133]  Your life may not be the same as your best friend's, your sister's or your cousin's but it is no less important and finding a purpose in life and pursing your ambition is a way to ease the pain.[134] 

 

Finally, our time in this fallen age is nothing compared with eternity on the new earth.  It is this we must look to, not by endeavouring to get there early, but trusting that the best is yet to come, and accepting that hard times are inevitable in the present age.  Somehow we have to continually hold on to the big picture.  If Christians can demonstrate how to break though the trauma that is infertility with a living and loving God into a bright and positive future then what a witness this is to the 10-15% of New Zealand couples in facing this.

 

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Bibliography

 

Alexander,  Desmond T. et al New Dictionary of Biblical Theology. Leicester : IVP, 2000.

 

Archer, Michelle. Miracle Babies. in New Zealand Woman's Weekly  11 June 2001 pp26-28.

 

Bartholomew, Craig G. & Goheen, Michael W. The Drama of Scripture. Grand Rapids : Baker Academic, 2004.

 

Benner, David G. & Hill, Peter C. Encyclopedia of Psychology and Counseling. Grand Rapids : Baker Books, 1999.

 

Brenner, Athalya. (ed)  A Femminist Companion to Genesis. Sheffield : Sheffield Academic, 1997.

 

Brown, Lesley. (ed) The New Shorter Oxford English Dictionary. Oxford : Oxford University Press, 1993.

 

Carsen, D.A. The Gagging of God. Grand Rapids : Zondervan, 1996.

 

Chapman, Robert L. Rogets International Thesaurus. New York : Harper Collins, 1992.

 

Clare, Jacqueline. Still Not Pregnant? in More April 1987 pp157-158.

 

Collins Shorter English Thesaurus. Glasgow : Harper Collins, 1993.

 

Courtney, Caroline. Infertility – is it all in your mind? in Next July 1998 pp56-62.

 

Currid, John D. Genesis. Darlington : Evangelical Press, 2003.

 

Dawn, Marva J. Joy in Our Weakness. Grand Rapids : Eerdmans, 2002.

 

Dickson, Louise. Life's Lessons. in Next July 2001 pp114-116.

 

Downie, Sue. Nine Ways to Make a Baby Without Making Love in More September 1988 pp118-127.

 

Dye, Stuart. New Hope for Childless Couples in The New Zealand Herald 9.8.05 A1.

 

The Most Useful Books

 

Fisch, Harry. The Male Biological Clock. New York : Free Press, 2005.

 

Glahn, Sandra L. & Cutrer, William R. The Infertility Companion. Grand Rapids : Zondervan, 2004.

 

Hamilton, Victor P. The Book of Genesis Ch 1-17. Grand Rapids : Eerdmans, 1990.

 

Hampson, Amanda. Battles with the Baby Gods Infertility Stories of Hope. Sydney : Doubleday, 1997.

 

Hui, Edwin C. At the Beginning of Life. Inter Varsity Press : 2002.

 

Kilners, John F. & Cunningham, Paige C. & Hager, David W. (ed's) The Reproductive Revolution. Grand Rapids : Eerdmans, 2000.

 

Labett, Tess. The Waiting Game. in Next December 2001 pp80-82.

 

Leadbetter, Anna. A Private Grief. in More Nov 1987 pp192-196.

 

Lyman, Stanford M. The Seven Deadly Sins. New York : St Martins Press, 1978.

 

Morley, Barbara. Grieving for What Has Never Been. in Contact 120 1996 pp22-25.

 

Neuberg, Roger. Infertility, Your Questions Answered. in New Zealand Woman's Weekly : 9 March 1992 pp36-8.

 

No Ordinary Joe. Inside New Zealand TV3 : 12.5.05 produced by Kiwa Film and Television.

 

Olsen, Ted. Hannah's Sisters. in Christianity Today 46 (3) March 11 2002 pp20.

 

Peters, Ted. Playing God. New York : Routledge, 1997.

 

Phare, Jane. Infertility Breeds Grief. in NZ Herald  24.7.96  2:3.

 

Rae, Scott B. & Cox, Paul M. Bio Ethics A Christian Approach in a Pluralistic Age. Grand Rapids : Eerdmans, 1999.

 

Saake, Jennifer. Hannah's Hope. Colorado Springs : NavPress, 2005.

 

Statistics New Zealand New Zealand Official Year Book 2004. Albany : David Bateman, 2004.

 

Stimming, Mary T. Childless in December Endless Advent. in The Christian Century 117(34) Dec 6 2000 pp1273-1275.

 

Stott, John. New Issues Facing Christians Today. London : Marshall Pickering, 1999.

 

Volf, Miroslav. The Gift of Infertility. in The Christian Century 122(12) June 14 2005 pp33.

 

Vos, Howard F. New Illustrated Bible Manners and Customs. Nashville : Thomas Nelson, 1999.

 

Wakefield, Rowan. Every Month I'd Cry & Cry. in New Zealand Woman's Weekly Sept 5 1994 pp34-5.

 

Walton, John H. The NIV Application Commentary – Genesis. Grand Rapids : Zondervan, 2001.

 

Wenham, Gordon J. World Biblical Commentary Vol 1 Genesis 1-15. Nashville : Thomas Nelson, 1987.

 

Worthington, Everett J Jr. Counselling for Unplanned Pregnancy and Infertility. Waco : Word Books, 1987.

 

Wyatt, John. : Matters of Life and Death. Leicester : InterVarsity Press, 1998.

 

 

 

www.stats.govt.nz

 

http://www.infertilitynetworkuk.com/article.php?articleType=magazine 20.7.05

 

http://www.montclair.edu/pages/psychservices/griefscale.html

 

http://wps.ablongman.com/ab_marriage_family/0,6256,473451-,00.html#

Perinatal Grief Scale (PGS)

http://www.gotquestions.org/infertility.html  (5-7-05)

 

http://www.gotquestions.org/birth-control.html (5.7.05)

 

http://www.biblegateway.com/passage/?search=Psalm%20127:3-5;&version=46;65;45;9;51;  (7.7.05)

 



[1]Brown  pp3376   A far more serious disorder than stress or internal frustration.

[2]Collins  pp692

[3]Brown  pp3376

[4]Trauma is a very human condition.  Plants suffer from stress through drought for example, but can't be said to suffer trauma.  Animals have an innate ability to recognise danger, such as when a dog cowers from an abusive owner, so this memory could be regarded as trauma.

[5]Otago Daily Times 22/4/02 pp23

[6]The animal and plant world are also affected by infertility.  Some plants are sterile, they cannot multiply without seed.  Farm animals such as sheep are pregnancy tested, ewes are scanned for single multiple and dry pregnancies. Is it possible that the 'drys' suffer from their state of infertility?

[7]Death of a baby prior to 20 weeks gestation.  Saake pp219

[8]The death of a baby in its mother's womb after 20 weeks gestational age and up to the moment of delivery.  Saake pp220

[9]Kilner pp8  This is not only for the first pregnancy, as infertility can occur for subsequent attempts.

[10]Downie pp119

[11]Phare reports roughly 15% in 1996 article, Wakefield pp34 in 1994 states 1 in 6 couples, 17%

[12]Leadbetter pp193

[13]Leadbetter pp193

[14]Leadbetter pp193

[15]Dickson pp114 

[16]Labett pp80

[17]Leadbetter pp193

[18]Hampson pp215

[19]Hampson pp212

[20]Genesis 30:1 NRSV

[21]Volf pp33

[22]Volf pp33

[23]Leadbetter pp194

[24]Stimming pp1273

[25]Leadbetter pp194

[26]Clare pp157

[27]Wakefield  pp34

[28]Wyatt pp75

[29]Leadbetter pp193

[30]Stimming pp1274

[31]Stimming pp1275

[32]Clare pp157  An infertile person goes through stages of grief like a person who is dying or overcoming a loss.  Brown pp1143 notes grief as mental anguish or sorrow caused by bereavement, bitter regret or remorse.  This is linked to the understanding of trauma (pp1265), a state or condition that results from a repressed or unresolved  psychic injury, the result of an emotional shock.

[33]Morley article title

[34]Benner pp520 provides this five stage one: denial and isolation, anger, bargaining, depression, acceptance

[35]Leadbetter pp194

[36]Leadbetter pp195

[37]Leadbetter pp194

[38]Fisch pp3

[39]Kilner pp8

[40]Glahn pp24

[41]Fisch pp2 and Leadbetter pp195

[42]Courtney pp60 and Fisch pp2

[43]Leadbetter pp195  Statistics reveal that in the last twenty years there has been a dramatic change in New Zealand society.  In 1982 80% of the births in this country were by women under 30.  In 2002 this had dropped to 50% (Stats NZ website).  This trend suggests that in 2005 more women over 30 will be having babies. 

[44]An interesting aside to this is that poorer and less educated women, who begin families earlier when they are more fertile, suffer less.  It seems that infertility could largely be a disease of the educated.

[45]Hui pp165-6

[46]Hui pp 166-7

[47]Hui pp166

[48]Hui pp167

[49]Fisch pp13

[50]Downie pp119

[51]Vos pp17   In Greece babies were sometimes sold to childless women who did not want to lose their husbands. 

[52]Vos pp39

[53]Inside New Zealand, TV3 broadcast 12.5.05

[54] The myth that if you adopt you will get pregnant is another cruel misconception that infertile couples must face.  The facts are that less than 5% of infertile couples who do adopt produce a biological child, make that 95% of infertile couples who adopt do NOT produce a biological child (Courtney pp60).

[55]Wakefield pp35

[56]Leadbetter pp195

[57]While I hesitate to be misleading, there were several hundred adoptions in total (639) but these included inter family transfers and imported children so can hardly be included in the sense of normal traditional adoptions.  It is also worth noting that the total number of adoptions has halved in the last ten years.  2004 Year Book pp128

[58] In Vitro Fertilisation, literally 'in glass fertilisation', pioneered by scientist Robert Edwards and gynaecologist Patrick Steptoe with the first live birth Louise Brown in July 1978 in England.  Downie pp120

[59]Gamete Intra Fallopian Transfer, places separated egg and semen directly into Fallopian tubes, an ethical advantage.  Developed by Prof Ricardo Asch at the University of Texas, August 1984.  Downie pp120

[60]Zygote Intro Fallopian Transfer, a method somewhere between IVF and GIFT, developed in Western Australia by Dr John Yovich.  First live birth March 1987.

[61]Artificial Insemination of Husband's semen, used as early as 1790 in London. Downie pp120

[62]Artificial Insemination of Donor semen, first recorded case in 1890  in US.  Downie pp120

[63]Tubal Embryo Stage Transfer, developed by Yovich, first baby born September 1987

[64]Pouch of Douglas.  A variation of POST and could be a cheap alternative to GIFT

[65]Downie pp120

[66] Pre Implantation Genetic Diagnosis, where embryos are selected for certain characteristics. (Bio Ethics course)

[67]Fisch pp129-131 outlines five things that people must consider before attempting IVF, it:

is expensive (in New Zealand $7-9000 a time, in the United States, $12 000 a cycle)

is emotionally draining

is logistically cumbersome

is relatively demanding of the woman and not always comfortable

it requires a substantial commitment of time, effort, money, and emotional energy.

[68]Dickson pp116  Tess Labett reports that she had to inject herself most days for seven weeks.

[69]Leadbetter pp194

[70]For two cycles -47% success rate, three – 61%, four – 72%  (Fisch pp129)  The figures vary from clinic to clinic, Fertility Associates in New Zealand claim 43% for women under 35 years of age.

[71]Dickson pp116

[72]Dye in NZ Herald ppA1

[73]Wyatt pp76

[74]Fisch pp88 Each year around six million American men and women realise they have a fertility problem (Fisch pp10). In 1994 it is estimated that there were 150 000 IVF births world wide, and by 2005 it is expected that there will be 500 000 IVF births in United States alone making this a massive industry.  Couples in the United States spend between $44-200 000 on each fertility attempt, contributing to reproductive specialists being among the highest earning doctors in the US (Wyatt pp77).

[75]Hui pp173

[76]Hui pp173

[77]Dye reporting in NZ Herald 9.8.05 ppA1.  Any surrogacy in New Zealand is scrutinised rigorously and must be approved by the National Ethics Committee.  There are around a dozen applications a year at this stage (Prof Jones).

[78]Wyatt pp91

[79]Wyatt pp92

[80]Stott pp366

[81]Genesis 2:17 'but you must not eat from the tree of knowledge...

[82]Wyatt pp62

[83]Wyatt pp50

[84]Passage           parents                         child

Genesis11:30      Sarah & Abraham           Isaac

Genesis 25:21     Rebekah & Isaac             Jacob

Genesis 29:31     Rachel & Jacob              Joseph

Judges 13:2-7     wife of Manoah              Samson

1 Samuel 1        Hannah & Elkanah          Samuel

2 Samuel 6:23    Michal & David 

2 Kings 4:8-17   Shummanite woman        son that Elisha prayed for

Luke 1:7            Elizabeth & Zechariah      John

[85]The next four sections use Stott's fourfold scheme of biblical history (Stott pp34).

[86]Wyatt pp49

[87]Genesis 1:31

[88]Hui pp145

[89]Hui pp172

[90]Magnuson in Alexander pp405

[91]Romans 3:23 NIV

[92]Carsen pp220

[93]Stott pp35

[94]Wenham pp80-1 & Currid pp132 & Hamilton pp200, infertility is NOT to be seen as a curse.

[95]It is worth noting that the use of the word anguish, or more commonly 'pain' first used in this verse is only used two other times (Genesis 3:17 and 5:29) in the Old Testament primarily to express grief and worry, not physical pain.  As we have already seen, grief and worry are very real characteristics infertile couples face.  Further to the point, 'pains in childbearing' is also a hendiadys, a joining of two nouns, and helps clarify again that this is something like 'conception anxiety' (Walton pp227).  The 'pain' used in the second line is used elsewhere to refer to strenuous work, and is therefore an appropriate description of giving birth.  (Walton pp227)

[96]Walton pp227

[97]Hamilton pp201

[98]Wyatt pp91

[99]Glahn pp80

[100]Matthew 11:28-30 NRSV

[101]Matthew 5:4 NRSV

[102] Mark 12:29-30

[103]Barth pp266

[104]Barth pp266

[105]Barth pp267

[106]Barth pp267

[107]Wyatt pp66

[108]Dawn pp143

[109]Glahn pp84

[110]Bartholomew & Goheen pp163-4

[111]Stott pp40

[112]Goheen pp212

[113]Footnote 1 on pp231 of Goheen suggests that as the Greek word for new that is used in both 2 Peter 3:13 and Revelation 21:1 is kainos and not neos, that the new earth and heaven will be new in nature and quality but not brand new.  It doesn't make sense for a brand new earth to be formed, as God was very pleased with His work at Creation, to create something brand new would be both pointless and suggests some sort of failure.

[114]Dawn pp12

[115]Bartholomew & Goheen pp206

[116]Saake pp138

[117] Mark 12:31

[118]Rob Harley on Radio Rhema

[119]Glahn pp66-7

[120]Leadbetter pp196

[121]Genesis 15:5

[122]Glahn pp78

[123]Glahn pp78

[124]Glahn pp79

[125]Glahn pp83

[126]Saake pp137

[127]Saake pp137

[128]Saake pp137

[129]Saake pp170

[130] 1 Timothy 5:1-2 do nothing out of favouritism, but honour all men as men together, and all women as women.

[131] Crucifixion was not a pleasant way to die.  To say Jesus was worried about what lay before him is an understatement; he was traumatised thinking about it to the extent he sweated blood (Luke 22:44).

[132]Dickson pp116

[133]Labett pp82

[134]Dickson pp116