The Liminal Nature of Human Embryos, and How That Nature Complicates Reproductive Decisions

The Liminal Nature of Human Embryos, and How That Nature Complicates Reproductive Decisions November 30, 2012

As the one-year anniversary of my book publication approaches in January, I’m devoting Fridays from now until the end of the year to revisiting the book’s major themes. Each Friday, I’ll post an excerpt from No Easy Choice: A Story of Disability, Parenthood, and Suffering in an Age of Advanced Reproduction. This week, I’m featuring a section on how our culture tends to approach human embryos as “either/or,” rather than as liminal, that is, as dwelling in between two states of being.

Politically charged pro-life/pro-choice debates have made it difficult to contemplate embryonic life because these debates insist on absolutes. Either embryos are the same as babies, or they are merely bunches of cells subject to their parents’ choices. I think most people, when pressed, would say that neither is quite true. Embryos occupy an in-between place. They are liminal; they serve as a doorway or threshold between one state of being (individual sperm and eggs that only have the potential for life until they join with the other) and another (the definitive, transforming presence of a newborn child). The threshold is essential for connecting those two states of being; it cannot be lightly discarded any more than a house can be built without doors. But it’s also more a passage to something vital than a destination in itself.

The liminal nature of embryos and the importance of naming and considering their in-between nature more fully are apparent in two phenomena: Cultural responses to miscarriage, and how parents perceive their unborn children, whether they are embryos in a laboratory freezer or images on an ultrasound screen.

In her memoir Waiting for Daisy, Peggy Orenstein details her experience with infertility and several miscarriages, describing the liminal nature of embryos and miscarriage this way: “What I’d experienced had not been a full life, nor was it a full death, but it was a real loss.” On a trip to Japan shortly after one miscarriage, she realized that other cultures are not as unwilling or unable to name the loss of embryonic life as our culture is, observing that “there is no word in English for a miscarried or aborted fetus. How better to bury a topic than to make it quite literally unspeakable?” Japanese people, in contrast, have a word for miscarried or aborted fetuses—mizuko, “which is usually translated to ‘water child.’ Historically, Japanese Buddhists believed that existence flowed into being slowly, like liquid. . . . A mizuko lay somewhere along the continuum, in that liminal space between life and death but belonging to neither.”

Orenstein took advantage of a semipublic Japanese ritual called mizuko kuyo, in which mothers grieving the loss of miscarriage or abortion leave trinkets (caps, flowers, baby toys) on small statues of infants placed in Buddhist temples. Mizuko kuyo is a ritual of apology (to the unborn child who did not have a chance at life) and remembrance. Orenstein left her trinkets and said her good-byes. She left the temple while still grieving but grateful for the ritual that allowed her to name her loss. Even Christians who reject the specific Buddhist beliefs that inform mizuko kuyo might learn something from Japanese culture’s willingness to recognize and name the liminal nature of embryonic life.

Taking part in mizuko kuyo revealed to Orenstein the insufficiency of American pro-life/pro-choice rhetoric to capture the complicated relationship between parents-to-be and their unborn children. As a pro-choice advocate, Orenstein believes that “social personhood may be distinct from biological and legal personhood,” but admitted that

the zing of connection between me and my embryo felt startlingly real, and at direct odds with everything I believe about when life begins. Nor have those beliefs—a complicated calculus of science, politics and ethics—changed. I tell myself that this wasn’t a person. It wasn’t a child. At the same time, I can’t deny that it was something. How can I mourn what I don’t believe existed? The debate over abortion has become so polarized that exploring such contradictions feels too risky. In the political discussion, there has been no vocabulary of nuance.

The New York Times editor Bill Keller experienced a similar disconnect between his pro-choice rhetoric and his experience as a father when his son was prenatally diagnosed with significant abnormalities:

The technology that informs you [that] your future baby is mysteriously endangered also makes him real, a boy-like creature swimming in utero. . . . Yes, I know how shamelessly the anti-abortion lobby has exploited this illusion to give tadpole-sized fetuses the poster appeal of full-grown infants. But no amount of reasoning about the status of this creature can quite counteract the portrait that begins to form in your heart, with the poetry of the first heartbeats.

Through their family’s losses, these authors recognize that our debates over abortion, embryos, and reproductive technology are sorely lacking in recognition of the hard-to-pin-down, emotional realities of conception, pregnancy, pregnancy loss, and birth.

One might think that parents would find it easier to define their relationship with IVF-conceived embryos that never made it out of their Petri dishes, rather than embryos that were the subject of excited phone calls announcing a pregnancy or fetuses whose tiny toes were visible on ultrasound. But studies show that even with embryos left over from IVF cycles, parents struggle with reconciling practical concerns with their emotional responses.

A 2005 study found that 72 percent of couples interviewed who had gone through IVF treatment had not made and were not in the process of making decisions about what to do with their leftover embryos. That study cites an earlier study revealing that more than 80 percent of couples who had planned to donate their embryos for research or to other couples changed their minds. In the 2005 study, “several couples commented that contemplating the fate of their embryos was harder than their decision to go forward with the donor oocyte [and IVF] procedure itself.”

The study found that “the factor that contributes most significantly to the difficulty of the disposition decision is the complex nature of the couples’ conceptualization of their embryos.” Couples saw their embryos in a variety of ways: as biological material, as living entities, and as “virtual children,” whose interests must be considered. Some were uncomfortable with donating to another couple because they would lose control over their genetically related children, for whom they felt responsible. Some couples “incorporated [the embryos] into their family structure by referring to them as siblings of their living children. This view complicated the consideration of donating embryos as it gave rise to concerns about the possibility of their living child inadvertently meeting and starting a relationship with a child conceived from a donated embryo.” Couples saw embryos as a “genetic or psychological insurance policy and considered the possibility that their embryos might provide some medical benefit to their living children at some future time,” or might be “potential replacements for their living children should they be lost through illness or accident.” Embryos also became “symbols of the infertility that had dominated their lives for so many years.” Some wanted to use their embryos up to have more children, and for some, the unused embryos fed an ongoing desire for more children even when that was impractical.

Parents’ complex relationships with their embryos, whether they exist in laboratories or the womb, defy simplistic pro-life/pro-choice arguments that define embryos either as equal to fully developed children or as mere biological matter.

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