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The Womb and Reproductive Technologies: Telos and Integrity

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Classical and theological discourse has always held a unique and deeply significant respect for the womb.  Indeed, the womb is the place where the human person first experiences communion with another, where it is nourished and grows under the care of maternal union, where the developing person is most vulnerable and depends upon another in all things. 

Resulting from many years of special reverence awarded the womb, a norm has formed in Catholic morality with the implication that there exists a regard for the womb which bears a unique significance within the theology of the body.  This norm surrounding the womb has yet to be fully articulated in Church teaching however.  The absence of which, can be understood when looking to the Church’s early understanding of human embryology.  St. Thomas Aquinas in the thirteenth century thought that human life began only from the man’s sperm, his “seed.”  The woman’s participation in conception was thought to be passive.  She offered the place and the nourishment of her blood for the development of the man’s seed.  It was not until 1827 that the woman’s physical contribution to conception was realized with the discovery of the ovum.  It is interesting to note however that the woman’s “seed” is mentioned much earlier, in Genesis 3:15.

This most spiritual and indeed special reverence for the womb has come to bear on arguments surrounding reproductive technologies, such as adoption of frozen embryos, early gestational therapies, ectopic (tubal- out of the uterus) pregnancies, etc…; Arguments, it must be noted, that arise most commonly from an understanding of sexual marital ethics and not from an understanding of the womb organ – its telos (end for which it is exists) and integrity (the good it serves).  This is not to concede to an ideological dualism that would separate a woman’s personal being from that of her organ – uterus, implying it is something not of her.  On the contrary, but that early understandings of human embryology might lead one to believe that the womb warrants treatment as a corporal spiritual entity autonomously from the mother, such as belongs to the embryo.  The womb is of the woman’s body and therefore is of her person; her body and soul are one reality (corpora et spiritu unum).  Moreover, it must also remain to be recognized that the womb of the woman’s body exists not for the physical integrity of her corporal good, but for that of another, the embryo or fetus.  It is in fact unique though it is and remains within personal presence of the woman.  It is of her.

An Ontological look at the Womb

Materially speaking, the womb is an organ of the female body referred to as the uterus.   As we know, the uterus is part of the reproductive system yet outside of the generative capacity of the system itself.  In other words, the womb itself does not participate in the formal material conception of a human being, but is the place where a new life grows and develops. St. Thomas was correct in his understanding of the womb’s role in embryonic development though not regarding conception and when  and how life begins.

The womb by design does not serve the physical integrity of the woman, such as the kidney or liver, but exists to serve another, actually drawing from, to a small degree, the physical good of the woman – demanding her gift of self.

Without a fuller understanding of the womb, will we be able to answer the questions of the future involving issues such as (1) wombs in organ donation and (2) the gestation of embryos in artificial wombs-machines?  In delving into these questions of the future, we contribute significantly to present debates, such as early embryonic transplants to save the life of the fetus.  Are artificial wombs intrinsically wrong?  Would it be immoral to remove the unborn child from a mother’s womb and place it in an artificial uterus to save its life?  Or, would it be immoral to transfer an unborn child into the uterus of another woman to save its life? 

The womb and reproductive technologies 

In November of 2006 the review board for New York’s Downtown Hospital granted approval for Dr. Giuseppe Del Priore to perform the United State’s first uterus transplant in a human.  But there are yet to be found any publications to claim a successful transfer.  The first known attempt was performed in Saudi Arabia in 2000 and was removed after 99 days due to clotting of the blood, even after two successful menstrual cycles.  Upon hearing of the NY board’s approval, barren women were lining up to volunteer to receive a new uterus in hopes of obtaining the ability to gestate the conceptions achieved in their marital unions.   The problem with uteral illnesses, is not necessarily the lack of conception, but that the womb becomes inhospitable to the embryo, causing a failed attachment and the resultant death of the embryo. Given that medicine has sought a non-conventional therapy in the form of transplants.   We must ask, “Is it ethical?”

The Church teaches that “Ethically, not all organs can be donated. The brain and the gonads may not be transplanted because they ensure the personal and procreative identity respectively. These are organs which embody the characteristic uniqueness of the person, which medicine is bound to protect.” (Pontifical Council for Pastoral Assistance, Charter for Health Care Workers, 1995, no. 88).   

With a uteral transplant, a woman’s uterus leaves her body and enters the body of another woman for the sake of offering gestation to the lives the recipient and her husband conceive (homologously).  The uterus is biologically foreign to the recipient, as with all organ donation, and is part of the reproductive system though not generative – it does not contribute to the conception of a new human being nor does it comprise personal or procreative identity.  In formulating an ethical regard for transferring a heterologous (foreign) uterus into the body of another woman, will we need to include considerations of marital ethics or sexual ethics surrounding an organ of the reproductive system?   

The child gestating in the heterologous womb within its biological mother is not foreign to the mother or the father, nor is it generated without their participation.  It also seems reasonable to say that the intromission of the uterus, though again part of the reproductive system, is not a sexual act in any fashion nor does it engage sexual organs. It is a medical intromission, as can be argued, that provides an actual good for both the fulfillment of the marriage and the gestation of their children.  The woman’s becoming pregnant after such a transfer remains to be established as a result of the natural marital union.   The gestation of the couple’s progeny however, comes about through the gift of another – an organ – though remains personal to the mother and to her body.   One might find the physical assistance or contribution of another woman for the nurturing of early human life similar to that of wet nursing. 

To conclude, the womb is an organ to be ethically regarded separate from the ovaries or testis which bear relation to generational identity and to procreational ethics.  The womb bears no generational identity and, I pose for further ethical inquiry, may be permissible for transplant in order to save another – to gestate and nurture a human life. 

A shorter version of this article first appeared in the November, 2010, issue of Legatus Magazine. [1]