Birth Is Not the Finish Line

As the battle over abortion intensifies once again, lawmakers should listen to Americans’ moral intuitions about when personhood begins.

A human embryo on the third day of development after an in-vitro-fertilization treatment
Jim Dyson / Getty

Somewhere inside my fertility clinic’s laboratory, in a tank of liquid nitrogen, there are several vials with my name on them. The vials contain five embryos, frozen at the blastocyst stage since early 2013, when they were created from a single round of in vitro fertilization, or IVF, using my eggs and my husband’s sperm. I have never seen the vials, but my husband and I pay a storage fee—currently $45 a month—to keep them preserved. In the six-plus years we’ve had them in storage, we’ve paid more than $3,000 to the third-party company in charge of billing, administration, and what the company calls “disposition”: that is, what happens to the embryos when they are no longer part of our family-building plan.

A human blastocyst is an embryo 0.1 to 0.2 millimeters in diameter, round like a soccer ball. It consists of about 100 cells, divided into an inner mass, which could become a fetus, and an outer shell, which could become a placenta. IVF patients whose cycles produce a number of embryos are often advised to allow them to reach the blastocyst stage, when doctors can determine which embryo has the best chance of implantation and development, before transferring or freezing them. Even at this stage, the chances are not great—about half of blastocyst transfers will fail to implant, or will result in a chemical pregnancy or miscarriage.

During my IVF cycle, I kept a small black notebook with me during phone calls and meetings with our doctor and embryologist. I recorded the number, quality, and stage of development of our embryos in my most careful handwriting, and I taped four-leaf clovers, found on my daily river walks, in the pages that followed. Up to that point, those embryos were my most costly and meaningful investment. They were precious to me, because they represented what my husband and I believed was our best chance of building our family. We were extremely lucky—from the initial group of embryos, our two daughters were born: Beatrice, in 2013; and Harriet, in 2018. They are the great joys of our life.

I think of the remaining five embryos often these days because we are at the “disposition” stage—our family is complete—and also because the question of embryonic personhood has made its way again into the courts. The “heartbeat” laws outlawing abortion after six weeks’ gestation in Ohio, Georgia, and other states were intended to provoke litigation. In a recent Supreme Court opinion, Justice Clarence Thomas evoked the eugenics movement and described the fetus as an “unborn child.” As others have noted, Thomas’s opinion signals receptivity to the ultimate test, and potential undoing, of Roe v. Wade, a ruling grounded in a woman’s right to privacy. If fetuses, or even embryos, are given the status of persons, her privacy won’t matter. All abortion and possibly some forms of birth control could then be deemed unconstitutional.

Most Americans agree that women should have at least some access to abortion; we also agree that a cryopreserved blastocyst is not the same as a child. These moral judgments are meaningful. As the anti-abortion movement poses the question of fetal personhood, deciding what to do with our embryos has been instructive to me in thinking it through. Leaving those vials in the freezer would be unthinkable if a 0.1-millimeter embryo, or a pea-size fetus, was truly a child. Instinctively, though, we know otherwise.

The choices my husband and I have are as follows: donate our embryos to another couple or individual, donate them to medical research, thaw them and discard them, or continue paying for their storage indefinitely.

Because we know, from years of trying, how hard overcoming infertility can be, donating them might make sense; surely this would give someone else the same joy that we experienced. If we donate them to research, perhaps we could contribute, in some small way, to the cure for a debilitating disease. Or we could ask the clinic to thaw the embryos and dispose of the remains (though we’d be wasting the opportunity for science to benefit from embryonic stem cells). For me, the only option that is completely off the table is what we are doing now—continuing to store them, at $45 a month.

While writing this essay, I tried to find the black notebook that had once been so precious to me—the one in which I had listed our embryos and their stages of development, and in which I had taped a photo of the blastocyst that developed into my older daughter. I looked on my desk, in my dresser, and on the several bookshelves where I thought it could be. I didn’t find the notebook, but I did find many signs of my actual children: a song written by Beatrice, which I typed up at Christmas; books by Sandra Boynton and Arnold Lobel; some costume jewelry and paper fans; a canister of glitter, which I am always trying to hide from Beatrice; and the many crystals, rocks, and geodes that Beatrice is always trying to hide from Harriet. I realized that, for me, the embryos are not special, or meaningful, or worth protecting or preserving now that they are not part of my family plan.

Abortion opponents commonly treat birth as the finish line, the point at which they can stop worrying about the welfare of a child and her mother (in North Carolina, where I live, the same politicians oppose Medicaid expansion, for example). But most parents, especially mothers, know that the finish line does not exist. My children, their friends, and every person walking or crawling on this planet have vast and often unaccounted-for needs that stretch far into the future. They need to breathe clean air and drink uncontaminated water. They need education and health care and healthy food. They need to be kept safe from gun violence. They need protection from the floods and hurricanes and tornadoes and fires that are terrifyingly more common and severe thanks to global warming. One day, they will need reproductive health care.

Forty-five dollars a month is not much—I pay more each month toward my phone bill, and to drive and park my car at work. But $45 would also buy books for a classroom library, compost bins for a community garden, or supplies for an after-school theater program. It could contribute to someone’s health care, including their reproductive health care. In the end, I would much rather take care of the people who are here now—the needy, beautiful humans who already surround us.