New Life on Easter

It's Easter evening at 9 pm, and I am sitting on the Labor and Delivery Unit, awaiting the imminent delivery of a preterm infant. The mother is at 34 1/2 wks gestation (5 1/2 wks early), and has dilated to 7 centimenters, so it could be any time that she delivers. Or it could be all night until it happens. Or a few weeks. You never can tell.

She is far enough along in her pregnancy that we are not doing any aggressive interventions to try and stop her delivery, though we are not attempting to hurry things along either. 34-35 wks is a gray area. Prior to 34 wks, we would aggressively give her "tocolytics"--medicines to break her contractions--and give the mother steroids, which hasten fetal lung maturity. But at 34 wks, steroids are ineffective, and so little is gained by attempting to stop her contractions. (And anyways, most drugs that we use to stop contractions, when studied, are competely ineffective in preventing preterm delivery by more than a day or two.) By 36 wks, you can almost guarantee lung maturity in the absence of diabetes. But here we sit, in between, at 34 1/2 wks, expectantly managing her preterm labor, hoping that she may hold off for a few more days, but ready to deliver her in the next few hours.

Interestingly, Elizabeth and I had a relevent discussion last night, related to obstetrics and preterm birth and our religious convictions: when does the spirit enter the body of a newborn?

You would think that, having delivered somewhere around 250 babies, this would be something that I have frequently pondered. But actually no. With modern technology allowing us to look at life within the womb from early in pregnancy and throughout labor, some of the surprise--but not the wonder--seems to have vanished. A baby's emergence from the birth canal and its first "breath of life" has become just the next step of a journey, not a de novo incarnation of a previously soul-less organism. So last night's discussion challenged my beliefs.

The beauty of birth will always be there for me; the mother's final scream and the baby's first cry still bring me near tears. (Elizabeth will attest that, by all accounts, I am incapable of actually shedding true tears.) But it's the literal sweat, blood and tears (and numerous other bodily fluids--birthing has a sweet stench all its own), the exhaustion and triumph of the moment, that grip my heart, not an awareness of a spirit descending into a previously uninhabited body.

I believe, for a variety of ethical and religious reasons, that "life" begins at conception, at the creation of a new set of chromosomes harbored in a cell that has the capacity to become a complete human being. This nascent life, though not yet viable, has the full capacity to become so, and thus should be given its ethical dues.

I also believe that each of us human beings exists as a duality of spirit and substance, our eternal intelligence animating our flesh and bones. The spirit dwelling within the body constitutes a living "soul," created in the image of God. Prior to inhabiting our bodies, our spirits dwelt in His presence, sent to Earth to gain a body and to be tested and tried. Birth is then both a forgetting and a launch; all of our memories of premortal life are withdrawn, shrouded by a thin veil that then impels us to exercise faith on our journey back towards God.

If that is the case, then at what point in time does a spirit leave God's presence and enter into the fetus or infant? The Bible recounts how John the Baptist, out of recognition of the Son of God, "leaped" in the womb when Elizabeth approached the pregnant Mary, suggesting a intrauterine presence of John's (and Christ's) spirit. But then the Book of Mormon details how Christ's voice spoke to Nephi on the night before his birth: "On the morrow come I into the world," suggesting that his Spirit had not yet come into the womb. Contradictions abound: we do not recognize miscarried or stillborn fetuses as "children" on official church records, whereas we do acknowledge the life of a baby that takes one breath and then dies. This discrepancy constitutues a major ontological distinction, but is it truly a significant physiological one?

Regardless of how we recognize or legitimatize a birth, what is acutally happening at the moment? When does a viable fetus receive an intelligent spirit and become a living soul? Obviously I don't have the answer, only a supposition: that the birth of a soul is a nine month process, a vessel slowly docking and anchoring at a port over time. Defying Newtonion physics, this would qualify as a sort of wave-particle duality: the spirit at at once drifting in a harbor and simultaneously tethered to a dock, drawn daily closer to permanent anchor. A preterm baby, then, might be drifting languidly into port, only to be pulled roughly and unexpectedly into dock through the last few yards of water.

Or so it seems to me. But while trying to wring sense from these metaphysical mysteries, reality interrupted, and we safely delivered the 34 weeker an hour and a half ago. She weighed in at a whopping--and surprising-- 6 lbs 8 oz, vigorous and screaming. Just to be safe, we'll keep her in the intensive care nursery overnight to make sure she transitions well. It seems likely she will.

So whether her little spirit has been dwelling in her body for nine months or just ninety minutes, she looks a little shellshocked right now. She's a fighter, though. Since she has so recently been one of the two key participants in this whole birthing process, maybe I should ask her for the real answers to my deep questions. She probably would impertinently look at me and say, "What does it matter? I'm here now, aren't I?"

Yes. Here and hungry. Welcome home, little one. For now at least, that's what this place will be.

Happy Easter!