The Theological Problem of the “Choosy Womb”, Part 1: An Honest Look at Spontaneous Abortion

What, precisely, is lost?

It was the fall of ‘99, and I was a freshman at a Christian liberal arts college overlooking the Hudson. The evangelical subculture I was steeped in was unquestioningly pro-life. One morning my favorite professor spoke to the entire student body in chapel, engaging us in a thought experiment.

Had we considered the implications of our belief that personhood begins at conception? he asked. Did we know how many embryos are miscarried every day, most unbeknownst to their mothers? And if these countless billions are innocent human souls made in God’s image, shouldn’t we expect they will be in heaven? And that means heaven is mostly populated by “people” who never lived beyond a few days or weeks in the womb? That embryo souls outnumber believing Christians by an astounding rate? That most of the redeemed never had a face, never had arms or legs, never had a brain, never took a breath, never read the Scriptures because they never had eyes, never heard of Jesus because they never had ears, and were never baptized because they never saw the light of day? What do we think of that kind of heaven? What kind of afterlife can you have if you slipped away from this life before anyone even knew you were here? How should we orient ourselves to the sheer magnitude of this continuous, invisible loss? What, precisely, is lost?

He didn’t say those exact words. I’m filling in the gaps in my memory with subsequent thoughts I’ve had along the lines he started. But his gist was a pin hovering uncomfortably close to my pro-life balloon. He wasn’t providing an answer: he was pointing out a theological problem. It wasn’t a question about heaven’s seating capacity but about what constitutes a “redeemable” person: how much of a “you” must you be to be part of the people of God?

At eighteen, my heart was a smooth, unbroken surface. The provocation my professor threw out couldn’t find purchase in a life like mine, without rough patches or cracks caused by suffering. His questions slid right off of me, and I promptly forgot about them. Within a decade, if I remembered that moment at all, it was with a wry shake of my head: There can’t be more embryo souls in heaven than conscious Christians with a testimony. And aren’t we all just magically thirtysomething in heaven anyway? Our bodies develop and change continuously in this life as we age—do our souls “age” along with us or are they static and complete from the get-go? My thoughts quickly spiraled off into speculation without moral stakes.

But the questions came back to me twenty-six years, two and a half decades of marriage, and four children later, on a day when my devotional reading of a parable coincided with tedious yard work that placed biological facts about seeds squarely in front of my face. I finally had ears to hear. My heart had been textured with painful experiences; I knew now how to sit with unanswered questions. The problem of the fragility, liminality, and sheer quantity of “wasted” embryonic human beginnings began to bother me. Instead of allowing myself to forget or to speculate, I dug in.

A sower went out to sow

In the parable of the sower, Christ invokes an agricultural metaphor stemming from the experience of people living off the land.

A sower went out to sow. And as he sowed, some seeds fell along the path, and the birds came and devoured them. Other seeds fell on rocky ground, where they did not have much soil, and immediately they sprang up, since they had no depth of soil, but when the sun rose they were scorched. And since they had no root, they withered away. Other seeds fell among thorns, and the thorns grew up and choked them. Other seeds fell on good soil and produced grain, some a hundredfold, some sixty, some thirty. He who has ears, let him hear.” (Matt. 13:3-9)

The disciples asked Christ for an explanation: it’s a call to prepare the soil of our hearts to receive the seed (the word) of God and bear the fruit of faith and obedience. The metaphysical meaning may have been lost on the original audience, but everyone grasped the material conditions that rooted the symbol in reality. Christ’s message depends on the difference between seed/sprout and harvested grain, and on the dangers (birds, thorns, rocks, scorching heat) that fill the space in between. We’re presented with a series of bottlenecks: only a small subset of seeds make it through to fulfillment, and there are degrees of fulfillment. The parable is rooted in a biological world that contains the possibility for success, partial fulfillment, and failure.

I’d heard this parable a thousand times, but I always imagined myself as one of the soils, never as one of the seeds. Until that day.

I have mixed feelings about seeds. There’s an extravagantly fecund “sower” in my backyard: a towering sweetgum tree which scatters its spiky pods by the thousands each year, making barefoot treks in the backyard a dangerous proposition. Every year my sons and I gather them up and dispose of them. Every year the tree tries again. Occasionally we discover a random seedling sprouting in an inconvenient place, under the side of the hen house, or mere inches from the finished stone patio.

I read aloud Peter Wohlleben’s book The Hidden Life of Trees to my boys last year, and was stunned by what he calls “the tree lottery.” He doesn’t mention the rates for sweetgums, but a poplar (which produces over 54 million seeds in its lifetime) will end up producing only one descendent that reaches maturity. If you’re a plant seed, the odds are never in your favor. The overabundance of fertility—the exorbitant number of living lottery tickets—is the flip side of nature’s saturation with contingency, failure, and death. In a letter to J.D. Hooker, Charles Darwin mused, “What a book a devil’s chaplain might write on the clumsy, wasteful, blundering, low, and horribly cruel work of nature!” No kidding.

Trees are not the only organisms whose seeds and sprouts die for the sake of that rare lucky one which survives. Out of one thousand sea turtle hatchlings, one reaches adulthood. Common frogs have a 1-2% survival rate for their offspring. Baboons have early miscarriage rates of 60%. High rates of loss are not a glitch in the system, but a feature of how complex organisms reproduce. Such loss is baked into the process of bringing new life into the world.

It’s a high risk, high reward world

There was a time when I placed every instance of nature’s awfulness into the bucket labelled “the Fall.” Futile work? The Fall. Pain in childbirth? The Fall. Broken bones, cancer cells, earthquakes, tsunamis, carnivores, and mosquitoes? The Fall. Each and every moment of pain, suffering, failure, and death had a single source. It was a relief to me back then that assigning blame was so simple. But then one of my dearest friends was diagnosed with late-stage cancer. As she faced her death, I got the distinct sense that the abstract doctrinal propositions about God’s sovereignty we’d absorbed in church together couldn’t help her do this embodied thing we call “dying”—not as something that merely happens to you but as the performance of virtue in the face of unavoidable suffering.

Watching her grope for something more, for something else to help her know how to die, undermined my religious idealism and my sense of security. This was my first true experience of radical contingency. What comforted my friend wasn’t God’s control over a pre-written script of her life, but the idea of an open future, where she might not recover, but she just might. “The ending hasn’t been written yet for me,” she would tell her young children. She vastly preferred this hope to “The Plan.” It felt better to live in a world of uncertainty than to believe that God had hand-picked her worst nightmare and wrapped it in a bow just for her.

I came to trust her intuition. We live in a world in which safety is not guaranteed for beings who are dust and who will return to dust (Gen. 3:19). “Life and hope are both modes of striving,” writes theologian John Haught, “they are risky ventures. They have the quality of a wager. For wherever there is striving, there is the possibility of failure as well as success. . . . Since living beings can fail, they are susceptible to tragedy as well as triumph” (55).

I realized with a shock—somewhere in the middle of my dog-eared pile of books on evolution and Christian theology I accumulated after my friend died—that “nature red in tooth and claw” wasn’t caused by human sin.

I realized with a shock—somewhere in the middle of my dog-eared pile of books on evolution and Christian theology I accumulated after my friend died—that “nature red in tooth and claw” wasn’t caused by human sin. The losses inherent in nature long preceded the existence of homo sapiens and in a frankly troubling way fashioned us into what we are. In an evolutionary paradigm, suffering is not our fault: it’s our (proverbial) mother. Christopher Southgate writes in his book The Groaning of Creation: God, Evolution, and the Problem of Evil, that “Darwin’s scheme both extended the narrative of creaturely suffering over vast spans of geological time, and embedded that suffering within the process by which value arose” (10). The values we love and the disvalues we despise are intermingled in a world of freedom in which God makes things to make themselves. The world was only free from death when it was free from life, writes Bethany Sollereder. “The complexity, interrelatedness, and beauty of life are directly related to the ever-present violence, death, and extinction of numberless creatures” (4).

That is a bitter pill to swallow. It still sticks in my throat sometimes.

The consensus of the Christian theologians in my library is that while it may be costly for God to create developmentally and gradually through contingency (rather than making a “finished product” with a finger snap), it’s the only way to generate creatures with the capacity for divine communion, capable of freely offered worship and freely given love. There is no love without freedom, no freedom without risk, and no risk without the possibility of failure. I recognize that not all Christians agree about how to reconcile God’s creative activity with evolutionary processes, but even setting aside the possibilities of uncountable deaths in eons past, new lives today continue to mature only in the context of many more deaths in the seed and sprout stages.

A very disturbing “everyday phenomenon”

My willingness to sit with the questions my professor raised grew out of the pain of failure: the failure of my friend’s immune system; the failure of so many of the sower’s seeds; the failure of the tree in my backyard; the failures that formed the backdrop for the success of homo sapiens. His questions felt newly relevant to me. How should we orient ourselves to the sheer magnitude of the continuous, invisible loss of embryonic human life? What, precisely, is lost?

Vast amounts of “seeds” are wasted in human procreation: roughly 733 billion sperm are spilled by the average married man over his lifetime (chatGPT did the math). As fetuses in their mothers’ wombs, females start with 6-7 million eggs: this drops to 1-2 million at birth, then 300,000 by puberty, and continues to decline over the reproductive years until there are fewer than 1,000 eggs remaining at the onset of menopause. This drastic culling of eggs for quality is called atresia. Gametes aren’t people, so this isn’t controversial to point out. But this should resituate us as part of nature’s lottery, since each individual is the combination of just one lucky sperm and one lucky egg meeting in just the right way at just the right time.

Wasted seeds don’t tend to bother us now, but many are troubled by the waste of fertilized “seedlings” (especially expectant parents and Christians). It turns out that natural early embryo loss—“spontaneous abortion” in medical terms—is just as likely an outcome as a live birth in humans. The odds of an embryo’s loss and a baby’s birth are roughly equal—a coin toss. Forty to sixty percent of human conceptions are naturally and spontaneously aborted by the woman’s own body, often before implantation, and sometimes occurring so early in the pregnancy that she never even knew she conceived. Perhaps her period is a few days late or just a bit heavier than usual. Perhaps she notices no difference at all.

Some early miscarriages are related to aneuploidy (chromosomal defects triggering between 50–90% of miscarriages, depending on whom you ask). But the rest of these spontaneous abortions occur for other reasons, some of which may be treatable, like hormone deficiencies, diabetes, autoimmune disorders, intrauterine adhesions, ovarian dysfunction, maternal smoking and alcohol use, and nutritional deficiencies.

Older gametes (in both sexes) often lead to genetic abnormalities that end in miscarriage. The risk of spontaneous abortion increases noticeably with maternal age: women over 35 create more embryo loss than younger women do. Exposure to environmental toxins also increases aneuploidy which can lead to early miscarriage. IVF receives negative attention for its abysmal success rates (only 2.3% of embryos created through IVF in the U.S. result in a live birth), but this doesn’t erase the fact that natural conception through sex also (always) generates striking rates of embryo loss. Many Christians view artificial methods of contraception like the Pill and IUDs as abortifacients because they degrade the uterine lining, leading to a spontaneous abortion in the event that conception occurs while using the method. But even natural methods of family planning can contribute to spontaneous abortion: if intercourse is timed to take place just after a woman’s fertile window ends, this increases the likelihood of accidentally conceiving at the ovulated egg’s “expiration date,” creating a less genetically healthy, more perishable embryo. Given that an older woman trying repeatedly to conceive generates more lost embryos than a young woman who procures just one abortion, should pro-lifers discourage conception attempts after age 35, just as they discourage IVF because of the terrible rates of embryo loss? How should we morally evaluate or rank the various choices we make that lead to embryo death?

There are innumerable reasons why a human zygote never becomes “developmentally competent.” Spontaneous abortions happen all the time—in young women and in older women, in healthy women and in unhealthy women, in those trying to get pregnant and in those trying to prevent pregnancy, in women who use artificial methods of contraception which accidentally fail and in those who use natural methods, in those who conceive through IVF and in those who conceive the good old-fashioned way. Sometimes the pro-life movement paints the subset of women who procure abortions (one in four American women by the age of 45), along with those who use IVF (roughly one in 200), the Pill (one in nine), or long-acting reversible contraception like IUDs and implants (one in ten) as the only ones responsible for embryo loss, as if these women were uniquely guilty for “destroying” nascent human life. This is a false picture. Any and every sexually active woman is physically responsible for the creation and destruction of embryos—regardless of her feelings, desires, intentions, and awareness. There is no getting around the prodigality of nature in human reproduction. The only way to prevent all embryo loss would be to stop trying to reproduce (by any means) and to stop having sex. Period. (This is not my recommendation).

The average mother of three children can be expected to have had about five spontaneous abortions or “occult losses” which occur so early they don’t register on pregnancy tests. Since most publicly reported miscarriage rates (about 20% in the first trimester) are of clinically confirmed pregnancies after this initial “coin toss,” the miscarriage rate appears much lower than it actually is, when in truth, “spontaneous abortion is an everyday phenomenon.” Ignorance of the real rates of miscarriage causes conceptions to appear more like guaranteed children than precarious beginnings which commonly come to nought. Many women cross their fingers, hold their breath, and hold their tongues—hesitant to announce a pregnancy until the twelfth week. But even this hesitancy doesn’t come close to reconciling us with the unfavorable odds that modern medicine can’t fix because nothing is technically broken.

While the rates of child mortality under age five used to be similarly terrible, they proved amenable to improvements in sanitation, nutrition, and vaccination, making precarity a solvable problem rather than a defining feature of childhood. In the case of most early miscarriages, however, our bodies are working exactly as they are supposed to. Embryo precarity reflects the lottery. Nature rolls the dice every time we have sex.

According to evolutionary geneticist Deena Emera in her book A Brief History of the Female Body: An Evolutionary Look at How and Why the Female Form Came to Be, every woman’s body has a mechanism that decides which pregnancies to continue and which to abort: the sensitive endometrium either welcomes or rejects zygotes based on its assessment of quality. This process occurs within us unconsciously, even in healthy young women. This is different from the way a disorder causes miscarriages that are preventable and treatable. What I’m discussing is a feature, not a bug, of human procreation. In a paper titled, “Maternal Selection of Human Embryos in Early Gestation: Insights from Recurrent Miscarriage,” scientists refer to this phenomenon as a “robust maternal implantation checkpoint.” It’s something our bodies do on purpose and it contributes to the overall success of our species. To wish it away is to wish humanity away.

Our religious intuitions on the sanctity of life are difficult to square with the “clumsy, wasteful, blundering, low, and horribly cruel” lottery of sexual reproduction in an evolving world—that of the parable of the sower. Many seeds are scattered but never fertilize. Many seeds fertilize and immediately spring up, but then wither away without ever taking root. Natural selection operates on humans and inside every woman’s body in a manner that is an affront to our sense of life’s sacredness and the preciousness of each individual (to the degree that we believe a person is present at conception). We develop gradually throughout pregnancy in a delicate biological process of negotiation with our mothers, whom we cannot exist without. Not every negotiation is successful, but every person you know today is the result of a successful negotiation. Both the embryo’s precariousness and the maternal body’s discrimination and selection lie at the heart of pregnancy’s proper functioning.

What our bodies do, we do

What should we make of this fact that, regardless of our intentions, our bodies regularly conceive embryos and then cull them? That every fertilized egg receives either a thumbs up or a thumbs down from the discriminating endometrium, and that we are designed to be this way? That this is normal, inevitable, even good? That our unconscious bodies are only “pro-life” sometimes because they are “pro-choice” all of the time? We are all survivors of selection for quality by our mothers’ wombs. This, too, is a bitter pill to swallow.

In a paper entitled “The Scourge: Moral Implications of Natural Embryo Loss,” Toby Ord of the University of Oxford writes that 226 million embryos die from spontaneous abortion each year. This is 30 times the number of people who die from cancer annually (7.6 million). He also notes that World War II killed 60 million people over 6 years: spontaneous abortions kill over 3 times that number every single year. According to the WHO, 73 million induced abortions occur worldwide each year, which is only a third of the amount of spontaneous abortions. The natural process of human reproduction is the biggest killer of all.

Christian theology puts a premium on intention: we are less culpable for things outside our control and more culpable for actions we consciously choose. But traditional Christianity also insists we are hylomorphic—we are mind-body unities, not mere meat suits driven by a mind or spirit (the evergreen error of Cartesian dualism). As philosopher and psychiatrist Iain McGilchrist puts it, “spirit and body are not distinct, or opposed, but discernibly different aspects of the same being” (1211). If we are truly unified, then at some level we must take responsibility for those things our bodies do unconsciously and teleologically, and admit that if our body does them, we have done them—especially if those processes are aspects of our nature functioning properly. Otherwise we set up a false dichotomy between the body and the self and remove our moral culpability from the natural order.

My point is that spontaneous abortion is a purposeful, well-designed, pro-natal process: it’s a good part of female human nature in the service of motherhood over the course of a woman’s whole life. It’s not evidence of something breaking down and “going awry.” So while it’s true that no woman consciously chooses spontaneous abortion, it is also true that her body aborts some embryos on purpose (not by accident, mistake, or illness).

Procreation and loss are inextricably intertwined in nature—and we are a part of nature. We can’t reasonably place spontaneous abortion into the bucket called the Fall.

Procreation and loss are inextricably intertwined in nature—and we are a part of nature. We can’t reasonably place spontaneous abortion into the bucket called the Fall. If we do, then all of human procreation goes in there too, because the success and the failure are a package deal. It’s impossible to be purely “pro-life” in the physical sense. You don’t have that kind of body. Even extreme admit-no-exceptions pro-lifers have choosy wombs. Anyone willing to welcome new life will get her hands “dirty” at those ineradicable checkpoints. There is a tragic hue to being human and to extending our family tree that neither scientific achievements nor religious idealism can expunge.

In her article “Let the Body Testify,” Leah Libresco Sargeant writes that, “Our bodies are a brute fact,” and that we ought to value “the givenness of our bodies as they are” because “every body is a testimony: we are made in God’s image. . . . A woman’s body, accordingly, does not need to be rewritten—women must be seen and loved as women.” She is making the case for the dignity of dependence, but her words are just as true for that other unpleasant-looking aspect of the female body: its choosiness. We do ourselves no favors by rewriting the prevalence and meaning of spontaneous abortion out of the story of women’s bodies because we find that “brute fact” troubling. Calling it “natural” and moving on without further thought is to dismiss the problem rather than to let it get under your skin.

Christians have been keen to defend the deeper meaning of our sexed bodies in the face of the LGBTQ movement’s ever-expanding drop-down list of genders. We do this because we believe the body “speaks” and says something true about who we are. But that means that spontaneous abortions are just as meaningful a signal as is the fact that breasts are made for nursing and nurturing. The response of the endometrium to a misbegotten embryo has to be allowed to define motherhood as much as gestation itself does because it is purposeful. It’s true that women’s bodies are designed to be welcoming “homes” for growing humans: it’s equally true that we are physically designed to be picky about who we let grow there and when. The oscillation of our ovulatory cycles between fertility and infertility, the onset of menarche and its cessation at menopause, the selectivity of our endometriums—all convey seasons of “yes” and of “no.” If the body speaks, it speaks of both hospitality and boundaries, of generosity tempered by limits. It would be odd indeed if this key feature of our healthy bodies’ functioning—our choosiness—had no analogue within our conscious minds. This doesn’t mean that chosen abortion is morally justified, but it is an argument that the property of “choosiness” is ineradicable in women. Hence the need for the cultivation of virtue to properly train our conscious choosiness.

Like my professor before me, I am not offering a solution or trying to provide comfort: I am pointing out a problem that I have not yet heard Christians take seriously in mainstream, non-academic discussions, because miscarriage is generally tossed into the Fall bucket and evolution is denied or ignored. The responses I’ve seen are either pastoral (designed to comfort miscarrying women) or political (designed to draw a hard bright line between spontaneous and early induced abortion as if these first-trimester phenomena had nothing whatsoever in common). The Catholic theologian Karl Rahner wondered back in the 1960s, “Will [today’s moral theologian] be able to accept that 50 percent of all ‘human beings’—real human beings with ‘immortal’ souls and an eternal destiny—will never get beyond this first stage of human existence?”

There are facts about the female body that ought to be a thorn in the side of the fetal-rights-focused pro-life movement because these facts reveal biological motherhood to be a choosy, ambivalent enterprise from the very get-go.

There are facts about the female body that ought to be a thorn in the side of the fetal-rights-focused pro-life movement because these facts reveal biological motherhood to be a choosy, ambivalent enterprise from the very get-go. If you believe that a person (a soul) is present from the moment of conception, then you’re stuck with some unsavory options: either the Fall has so wiggled its way into our wombs that every single woman is cursed to kill many of her own offspring against her will, or all women are natural born killers whose bodies couldn’t care less. In this worldview with embryonic souls (which feels more like Greek tragedy than Christianity to me), women are either uniquely screwed over or uniquely depraved.

Could there be another way to frame the meaning of early embryos? A way that honors how they genuinely differ from the unborn that are further along—the ones who’ve safely passed through the bottlenecks, the ones who’ve made their presence known with flutters and kicks, the ones who are no longer precarious but have proven themselves tenacious? My professor’s question about embryos prompted me to look for a different paradigm that will allow me to not throw the female body under the bus. Perhaps it’s motivated reasoning, but I can’t shake the intuition that my evolved, embodied female nature is still somehow “very good,” and neither inherently cruel nor hopelessly cursed.

To Be Continued: I will explore an alternative paradigm for understanding pregnancy (and what it morally requires of us) in Part 2 of this article.

Image Credit: The Artist’s Garden at Eragny, Camille Pissarro (1898)