In the waning days of World War II, J. R. R. Tolkien published The Lay of Aotrou and Itron, a five-hundred-line medieval-style poem. “No child he had his house to cheer,” Tolkien writes of the aging Aotrou, “to fill his courts with laughter clear.” Aotrou’s anxiety about his “empty pride” and the dissolution of his lineage moves him to seek out a corrigan, a medieval witch, whose fertility potion gives him and Itron the heir they wanted. “Tis sweet at last the heart’s desire to meet,” Itron happily exclaims, “thus after waiting, after prayer, thus after hope and nigh despair.”

The desperation Tolkien depicts is familiar within scripture, as in the use of fertility-enhancing drugs. In Genesis, Rachel so intensely wants a child that she uses a surrogate. Not satisfied with that, she then trades access to Jacob for Leah’s mandrakes – the ancient Near East equivalent of fertility supplements. Similar stories abound: Sarah, Rebekah, and the Shunammite woman all faced the devastation of childlessness. And who can forget the tears of Hannah, that patron saint of childless women facing one more Mother’s Day at church?

While the prayers of these women to bear a child are ultimately answered, the story of Aotrou and Itron reads like a prophetic warning against taking human creation into our own hands at all costs. Nothing comes free from witches in medieval fairy tales, and Tolkien’s modern rendition is no different: the witch demands Aotrou leave Itron, and then takes his life when he will not comply.

In 1978, thirty-three years after Tolkien’s story was published, the first baby conceived using in vitro fertilization (IVF) would be born. While contraception was the first wave in reshaping how humans conceive of sex and childbirth, the success of in vitro fertilization was the second. For the first time, technology offered the power to meet our desires for biological children.

“Orchids” series by Katarzyna Mrożewska. Used by permission.

Since then, nearly ten million children have been born worldwide through IVF, each of them a blessing for which their parents have no doubt felt inestimable gratitude, each of them a beloved child of God. But the widespread use of IVF technology has come with its costs as well. The first is exacted from the other children created in the process: for every live birth, several other embryos – unique, nascent humans, as we all once were – have been brought into being. Some of these are implanted in the mother but naturally miscarry. Many are discarded in the lab as being of “poor quality.” Some are genetically screened for conditions that, by the logic of the screening, make them unworthy of life. Some (fewer than you might imagine, given the heated bioethics debates of twenty years ago) are donated to scientific research. And some – an estimated million in the United States alone – remain indefinitely on ice, their parents unable to decide what to do about them.

There are many other costs to IVF, of which the astonishing price tag is perhaps the least significant. Couples who pursue IVF will bear the burdens of doing so in their bodies: the regimen of hormonal treatments, autoerotic “pleasures” in sterile offices, and extractive surgeries all take their toll. It intensifies an already asymmetrical burden on women, by adding invasive procedures to the process; it imposes unknown risks on children, who are transferred and stored while in an exquisitely vulnerable condition at the origins of their life; in screening and discarding nascent human beings with the “wrong” genetic profile, it perniciously qualifies the value of lives based on their characteristics and reaffirms a conditional attitude toward human dignity that is by no means confined to the IVF laboratory.

But what is all of this against the powerful desire for a child? Against this imperative, few objections survive; as the desire becomes a demand, anything must be done to meet it.

In the United Kingdom, soon after the first IVF baby was born, fertility doctors began to speak of a “right” to have a child. This social transformation has dramatically reconfigured what it means to be infertile.

In recent years, a movement to establish “fertility equality” for nontraditional couples has grown. At bottom, the movement redefines “infertility” as a social fact, rather than a medical reality. Anyone who is unable to conceive, for whatever reason, now counts as “infertile” – including those who are single or in a same-sex relationship. By appealing to the “right to have a child,” the fertility-equality movement can justify surrogacy relationships and other nontraditional means of bringing humans into this world. It will likely succeed, given the West’s astonishing laxity about procreative norms. The United Kingdom, Canada, France, Israel, and other countries provide state funding for IVF, and were it not for the United States’ hopelessly complex healthcare system, it would not be far behind.

At the same time, the success of IVF has meant that other therapeutic interventions are being neglected by the fertility industry. Childless couples today find themselves in a medical environment that hurtles them impatiently toward IVF, which has the joint advantages of both being relatively successful and highly lucrative (though it is not nearly so successful as many people think). Meanwhile, Fertility and Sterility, the journal of the American Society for Reproductive Medicine, published a number of essays in 2019 naming the crisis of declining skills and diminishing education for therapeutic interventions and surgeries besides IVF. Couples wrestling with involuntary childlessness who are unwilling to embrace IVF face a medical complex that not only regards their concerns as unintelligible, but increasingly lacks the skill and interest to help them investigate the underlying sources of infertility without skipping straight toward artificial reproductive technologies. The first-line approach to unexplained infertility by many clinics is often intrauterine insemination (IUI). This older procedure does not result in “extra” embryos or genetic screening. Yet it still involves introducing third parties into the process of procreation, creating a formal division between the act of intercourse and the conception of a child. As a result, many Christian ethicists regard IUI as dubious. Either way, the financial incentives and relative success rates of IVF mean many couples are urged to pursue it regardless of whether alternate means might succeed.

It is among the many ironies that the same society that pushes IVF toward the end of childbearing years does much to discourage having children till that point. While some young people might willfully delay marriage and childbirth, the vast majority have been unintentionally swept along with an economic and social environment that has been built on denying their importance. Meanwhile, declining birth rates around the globe have revived pro-natalist sentiments in the United States and elsewhere. As the sterile world that P. D. James imagined in Children of Men becomes more like reality (already, Japan has turned to using dolls to simulate the presence of children), a layer of social as well as personal urgency enters the question of whether or how to have a child.

Christians are not immune from these mixed messages. In certain circles, there is a stigma on childless couples who have apparently disobeyed the putative “command” to procreate in Genesis 1:28. For a great many people, the burden of childlessness is a cross not of their own making. Those who prate about how young people are turning away from children are often the same people who filled those young people with upper-middle-class expectations, and demanded they get the college degrees to meet them, adding physical and financial obstacles to family formation. It is not surprising that a generation of Protestant Christians who had no patience for the celibacy of Jesus in their theology of marriage now have no accounting for the (biological) childlessness of Jesus in their theories of procreation. Meanwhile, many churches have been silent about IVF while our society has trapped a million embryos in ice to await Judgment Day; the Southern Baptist Convention, for example, has said nothing since IVF was introduced.

For Christians, the idea that there is a “right” to children is, theoretically, foreign. We are far more likely to think that children are one of God’s good gifts, and that the complex of medicine is simply one new way God has given us to receive them. Yet we are more susceptible to the logic of rights than we realize, even if we do not use the language. When we face the cross of childlessness, we might not invoke our “rights” in our prayers. But we often embody them within our actions. Our claim to children is more felt than articulated – but it is no less real for its tacit expression.

Children are an unmitigated blessing from the Lord. Yet Tolkien’s tale is a stark reminder that the gifts of God can be loved in the wrong ways. The consolation childless couples need lies elsewhere, away from the industrialization of fertility and the “rights” it tempts us to claim. How has our vision of children and procreation been distorted, and how it can be repaired?

Good and Gracious Gifts – Gone Wrong

The tragedy of childlessness is real, and unspeakably deep. Childlessness means gaps in the common life of friendship with other parents, whose all-consuming kid activities are a reminder of what we are missing out on. It means confronting loneliness in old age and wondering who will bury us if we outlive our siblings. More than those, though, it means the absence of a lineage, of descendants who carry on the name we were given and that we forged through our character and life. The one with children stands proud “at the city gates,” Psalm 127 says, because children form the reputation of their parents as no one else can. The command to honor parents is tied to living long on the earth, which secures a name for both the parent and the child: in this sense, children are an “inheritance from the Lord” (Ps. 127:3). Begetting a child is an assertion, in deed if not in word, that it is good to be our selves, together with the one we love, and that we need not be ashamed of such goodness. To face infertility soberly and honestly is to squarely address the question of the value of our own existence and life.

Theologians have sometimes met these frustrations with blunt appeals to the gospel, which in their reading more or less demands that childless couples get over it. Karl Barth offers the glib (even if true) word that childless couples “must set their hope on God and therefore be comforted and cheerful.” More recently, theologian Michael Banner’s antipathy toward the unmet longing for children prompts him to argue that moral theology should “deny the existence of (and repudiate) the desire for the child of one’s own,” and “deny the tragedy of childlessness which that child is intended to relieve.” Unlike Barth’s position, Banner’s view has the misfortune of being both callous and false. The goods of nature are real goods, and we cannot so quickly move past our sorrow for not receiving them.

While the tragedy of childlessness is real, though, it is of a peculiar sort. It is not the tragedy of being denied what we are owed, of not receiving our due. We have no more a “right” to conceive a human being than we have a right to marry one. The way a relationship begins shapes its character, and framing the parent-child relationship through the language of “rights” distorts it from the outset. The nature of parental love is sacrificial: to give gratuitously and to endure the long, joyful, and sad series of goodbyes as the child enters the mature freedom of adulthood. To consider children an entitlement introduces a possessiveness into the relationship that is antithetical to such a love and inimical to both parties’ flourishing. Through the deep struggle to set aside these unfulfilled desires and trust the kindness of God, childless couples (paradoxically) learn to cultivate the very form of sacrificial love they long to share.

It is better to think of children as a gift. The paradox of procreating is that it involves so many limits on our agency – that there is so much beyond our control. It is plausible to think that all we can do is try to procreate, as the success of any particular act of intercourse in generating life is highly contingent: so much luck and so many inefficiencies are involved in forming human life that one might reasonably doubt the intelligence of the process’s designer.

The advent of artificial reproductive technologies might seem to correct this design flaw. But in doing so, IVF suggests that childlessness is a disease. If IVF is a “therapeutic” intervention on par with dialysis machines or other medical treatments, then there is something wrong with the couple who has not conceived. Many infertile couples already feel “broken.” Medicalizing the creation of a child inherently reinforces that perception, making childlessness even more of a burden than it was before.

Instead, in relinquishing control, a couple may find that the luck and contingencies involved in bringing life into the world also bind them together: to attempt conception requires, after all, the frequent and successive uniting of a couple in love. Theologian William May once wrote that sex must be “intended to be open to the gift of life,” which is an odd formulation. After all, it is rare to think we intend to be open to a gift. We generally think we intend what we can bring about ourselves. What child, after all, “intends to be open” to receiving a gift at Christmas? Yet the vulnerability within the process of generating human life puts sharp limits on what we can do in bringing new life into the world. We can be the occasion for God’s action in generating a life who bears the image of God – but we cannot compel him to do so.

Such an approach allows for genuine grief when such a gift is not given. The blessing of the Lord precedes, accompanies, and surrounds Genesis 1:28’s exhortation to be “fruitful and multiply.” Whether command or something else (and I think it is not a command), the generativity of a people is a mark of divine favor upon them. It is a fine thing to seek blessings from the hand of God, and an occasion for sorrow when we are not given them. Yet that grief is intrinsically qualified by the limits on our agency, and the claims we can make in light of them: because we cannot bring about a child, we must release ourselves into the hand of God.

Childlessness is not a pathology in need of a remedy, but rather a disclosure of the deepest truth about human life: that it comes from God. In the unfulfilled desire for children, couples come face-to-face with the fundamental core of human existence, the sheer givenness of our life behind which we simply cannot go and for which we must simply be grateful – that we live and move and have our being only as the gift of God. Such is the cross and calling of childless couples.

The Household and the Cross

Every Christian couple who uses IVF has their reasons. Finding the grief of infertility intolerable and the hope of IVF irresistible is more than understandable. It takes either masochism or heroic strength to oppose the temptations to satisfy the longing for children by making life within the laboratory. These parents are as much victims of the lordless powers as willing participants in their regime. In a world where getting what you want remains the only principle, it seems especially unjust to tell the childless that they must live with unfulfilled desires. No one else is, after all.

If we look beyond the industrialization of fertility, though, we will find that we are all implicated in the impulse to escape the limits of our flesh of which artificial reproduction is only the outer edge. This issue merely makes the refusal to honor our bodies more transparent.

Western society’s widespread desensitization to the body has made it increasingly indifferent toward other, more violent forms of manipulating nature. What began with efforts to help infertile couples has culminated in the wildly unregulated use of surrogates, an exploitative practice that threatens to sever the link between birth and parenthood. Stranger forms of making life lie on the horizon, too, as gametogenesis will enable us to make human beings out of stem cells from any combination of humans, and artificial wombs promise to free women from the burden of gestation altogether. This seamless, anti-life garment of “control” extends to the end of life as well: we increasingly pursue medical treatment to the uttermost in order to forestall death, on the one hand, while turning toward the euphemistically named “medical aid in dying” on the other. The reshaping of our society’s imagination on matters of life and death seems to know no limits.

The first step to forming Christian imaginations in the realm of sex and marriage is to expand their horizons in a different direction. The gospel offers an account of the human family that is less simple and more inclusive than the odes to the blessing of procreation may suggest.

Even the Old Testament qualifies the value of a biological lineage in palpable and sometimes shocking ways. Hannah’s song after birthing and releasing Samuel not only offers hope to the childless but issues judgment on those with children: “The barren has borne seven, but she who has many children is forlorn” (1 Sam. 2:5). That song is echoed in Psalm 113:9: God “gives the barren woman a home, making her the joyous mother of children.” “Sing, O barren one, who did not bear,” the Lord says in Isaiah 54:1, “Break forth into singing and cry aloud, you who have not been in labor! For the children of the desolate one will be more than the children of her who is married.”

The desolation of childlessness has its home on the cross, and its hope in the resurrection. The childlessness of Jesus remains the great qualifier and challenge to any pro-natalism, as his life opens up the possibility of a kinship that transcends (without destroying) the value of procreative bonds. While Mary is the biological mother of Jesus, Joseph (who some sources suggest was an adopted son himself) willingly takes the role of his earthly father. Then, on the cross, Christ reconfigures his household by giving his disciple John filial responsibilities to Mary and offering Mary maternal privileges over John. These endorsements of “fictive kinship” pervade the Gospels.

The vision of the New Testament must be embodied, though, through the retrieval of the Christian household. To speak of the household means looking beyond the “nuclear family” – a stunted, insular vision that limits the dimensions of family life and our solidarity with others outside our homes. As a “place of mutual and timely belonging,” in Brent Waters’s words, the household is a gathering place for a wide variety of social relationships in which the joys of marriage radiate outward in a form that is adverbial – through parental relations, rather than parenthood. And it is a place where care and support can be given in ways not bounded by biology, but by the responsibilities we accrue to one another within the providential care of God’s kindness. Whoever does the will of God is Christ’s mother and brother and sister (Mark 3:35). In the same manner, we may be father and child and uncle to all those whom God calls us to love.

No book has modeled this vision so well as C. S. Lewis’s That Hideous Strength, in which the Director’s house at St. Anne’s on the Hill becomes a refuge for the intentionally childless Jane and the involuntarily childless Dimbles. Jane’s troubled marriage and determination to not have a child – “One had one’s own life to live,” she thinks to herself – collide with the Dimbles’ generous love, which is parental without being smothering, and which bears fruit for the kingdom through their obedience.

While Cecil Dimble had been Jane’s tutor before her marriage, Mrs. Dimble “had been a kind of universal aunt to all the girls of her year.” Their house had been a type of salon, yet of all Dr. Dimble’s students, his wife had felt for Jane “that kind of affection which a humorous, easy natured and childless woman sometimes feels for a girl whom she thinks pretty and slightly absurd.” Mrs. Dimble feels the sorrow at the empty rooms in her house, yet embodies maternal virtues toward Jane all the same. The childless Dimbles had the luxury of a ready supply of young people to regularly fill their home, which not all couples do. Yet they embody the expansiveness of love that is necessary to overcome our tacit or explicit demands to meet our “right” to have a child. Indeed, the whole household at St. Anne’s is a picture of the fruitfulness of chastity – in marriage that is open to children, whether or not God gives them, and in a singleness that is faithful in celibacy. Through encountering this chaste love, Jane eventually becomes willing to bear children.

The form of this world is passing away, Paul writes, enjoining those who “have wives to live as though they had none, and those who mourn [to live] as though they were not mourning, and those who rejoice as though they were not rejoicing.” (1 Cor. 7:29–31). Paul’s exhortation incorporates Hannah’s inversion of the sorrow of barrenness. The declaration of the gospel in the realm of procreation not only offers hope to the childless, but places a great qualifier over the joy of the fruitful: baptism is our entry into the kingdom of God, not the blessing of fertility.

A world that rejects God will reject creation. Yet the paradox is that we must look beyond creation itself if we wish to renew its authority and goodness within our communities. Life in the kingdom of God both confirms and disturbs our love of creation. To paraphrase Lewis, those who focus on the family rather than the kingdom will eventually have neither – but those who look to the kingdom shall have family given to them as well. We announce the gospel in the realm of sex and procreation only when our exhortations to marry and procreate honor the fact that the children who bear our name are “not the good things of the eternal Jerusalem,” but are the “good things that belong to the land of the dying” – as Augustine once wrote.

The abundance of St. Anne’s on the Hill is born out of the Christian tragedy of childlessness, which confirms the goods of creation by looking toward what they point to – a life of participating in the works of charity toward all those whom God gives to us to love. The endlessness of love never fails, though our hopes and dreams for our lives in this world sometimes might. God’s good gifts sometimes come in strange and severe forms, yet each of them is ordered toward the perfection of our joy in the gift of our lives to God and each other. Within the economy of God’s love, the barren will someday wear their crowns of triumph at the city gates. They, too, will no longer be ashamed.