When Does Life Begin? A Physician’s View

Excerpt from The Christian and Abortion: A Nonnegotiable Stance

When during the course of a pregnancy does human life begin? Is it immediately after birth?

At the point at which the baby could survive outside the womb? At the onset of movement? At implantation? At conception? All of these landmarks during the course of a pregnancy have been proposed.

The Bible has some very clear statements regarding the issue of life before birth, but my focus in this chapter is on science and logic. Since non-Christian critics do not recognize the Bible as authoritative, this chapter is intended to provide information to help you address the audience that you, as a Christian, may have to confront. I hope that the insight provided will make you better equipped to participate in the debate, should the occasion arise.

Clearly, no one would disagree that a squirming, crying newborn is a human being. Whether the baby is full-term or pre-term, he or she is a human being. This raises an interesting point. Whether a baby weighs two pounds or ten pounds, we consider him or her to be a human being. A two-pound baby would only be at 25 weeks’ gestation in most cases, which is 15 weeks premature. But if a two-pound baby is born alive, squirming and breathing, he or she is considered a human being, and that baby is protected by law as a human being. If that living baby’s life is taken, it is considered murder—the law is clear on that.

The current law of the land in the United States would allow the destruction of a two-pound baby (or any baby at any gestational age) prior to birth, before the first breath. As long as an abortion is performed before the baby is born, it is considered legal. After that, it is not. Technically, there are several phases of the birth process. In a normal vaginal birth, the baby’s head first passes through the vagina and is technically outside the woman’s body. While no actual breath has been taken by the baby at this point, the baby’s face is usually moving, and sometimes the eyes are open and the nostrils are flaring.

I would expect that most people, if polled, would state that this baby is a human being. I raise these points to try to bring into sharp focus the question of whether a baby in the uterus is a human being. By default, our laws say that it is okay to destroy a baby as long as it is inside the womb, before a breath is taken, but not if it is outside the womb.

In this chapter, we are focusing on the point at which a baby is considered a human being. As we consider late-term abortions performed while the baby is still in the womb, it is clear that while it is legal to destroy a baby that can survive outside the womb in the United States today, if one were to state that what is destroyed is not actually a human being, then when does it become human?

I think a rational person would have to agree that nothing apart from time and position (neither of which affects what actually exists) determines when the baby exits the womb. Is this a matter of possession? That is, can a woman say that because the baby resides within her it is her possession to do with as she pleases? If the baby could be considered a human being while residing within the woman’s body, then new concerns begin to emerge. Human beings do not give up their right to life depending on their location. This is why it is so important to consider the question of when human life begins. If human life is deemed to exist within the uterus, then the human inside the uterus cannot have her right to life taken away, even if she is located inside another person’s body.

So far, we have considered only whether a pre-born baby who is capable of life outside the womb is human. To argue that a two-pound baby inside the womb is not a human being and that the same baby, if outside the womb but moving and breathing, is a human defies common sense and logic. All human beings who reside on this planet were inside a womb at one time. There is no distinction, other than opportunity, between a baby who has been born and another baby at the same age that is still in utero.

Hopefully you are at least considering that human beings exist inside the womb. I was looking through an old family photo album recently, and I found a picture of myself as a five-year-old. I don’t look like that young child today, but I am the same human being. So it is with a baby in a mother’s womb. All it takes is time and opportunity to transform a baby in utero to a newborn, a five-year-old, or a fully grown adult.

Since there is no biological argument to explain a transformation from inhuman to human, one would have to resort to the legal matter of rights. The argument would be that possession by the mother and the right to do what she wishes with the baby she is carrying supersede any right to life the baby has, and this right is given to the mother by the United States courts. It is clear that courts of law are subject to error, and even the Supreme Court has overturned its own decisions in the past. If there is even the slightest possibility that the baby residing inside a woman is human, shouldn’t we err on the side of caution and consider his right to live?

As a practicing physician for more than 40 years, I have a perspective that probably only a few have. Consider my credentials: I aborted more than 700 babies before becoming pro-life, and I inspected their tiny fragmented limbs, heads, and torsos that had been removed during the early stages of pregnancy. I cared for multiple thousands of pregnant women, watching the development of their babies inside them with real-time and 3D ultrasound. I have studied this issue for more than 30 years from a medical, ethical, and religious perspective. I am certainly not infallible, but I reiterate this to make a point regarding the beginning of human life.

All but the most ardent supporters of abortion will agree that a baby who is inside its mother’s body just a few seconds before birth is considered a human being. The reasons most would say this are based on logic and experience. After all, what does a woman say after she has a pregnancy loss? She says, “I lost the baby,” not “I lost the fetus.” This is because the experience of every woman is that if she is pregnant, then she is carrying a baby. Moreover, a moment before birth there is always anticipation. What will she look like? Will he look like the mommy or the daddy? A moment before birth or a moment after birth, a mother or father will consider the baby to be a human being. What, you may be asked, is the difference if the mother and/or father does not want the baby? Does calling it something else change what it is? Sadly, our culture has tried to draw a line of distinction in which a desired fetus equates to a human being but an undesired fetus does not. In reality, no such line exists, but proclamations that it does make the decision to support abortion on demand much easier.

Why, then, do ardent abortion supporters not agree that a moment before birth the baby is not a human being and, therefore, is without rights? The obvious answer is that if the baby has rights, then the high court’s decision to allow its destruction is turned upside down and would have to be reconsidered. For this reason alone, you likely will never convince an abortion rights activist to agree that a moment before birth a baby is a human being, but this is an excellent place to start.

I would ask them, “What happens to make the baby a human being at the moment it takes a breath?” This is a question without a clear answer because there is nothing other than the court’s arbitrary decision to deem it to be so. Second, if you agree that a baby in the womb is a human being a moment before birth, then when does the fetus-to-human transformation take place? Is there a clear point at which the substance of what is inside the womb changes? Let’s look at all the points along the process of intrauterine development to see if we can determine a clear point of demarcation.

The most common point that many abortionists might agree to is that when a baby is viable outside of the womb, they would not support an abortion. After all, they may argue, even if we removed a baby at a certain gestational age, it could not survive outside of the womb on its own. This is a pragmatic and non-scientific answer to the question because viability is not a static point in time.

As a point of reference, my youngest son was born at 26 weeks in 1982. There was little hope that he would survive at that gestational age in 1982, but he beat all the odds and not only survived but is a computer genius today. Due to advances in medicine, the prospect of survival is much greater at 26 weeks today than it was then. Not only is viability dependent on the level of medical expertise to care for the extremely premature infant, but from a medical standpoint viability is also not associated with a dramatic alteration or change in the structure of the baby in utero.

I would argue that the baby didn’t go from being nonviable outside the womb on April 22 to being viable on April 23. The viability argument is designed only to placate those who would say that a viable baby should not be destroyed. It does not answer the question of when the baby becomes a human. I would also add that a newborn of any gestational age requires care and nourishment from a parent in order to live. If you take the healthiest full-term baby girl or boy and ignore its needs for food and shelter, it would not survive. Thus, viability outside the womb does not end with birth. Furthermore, neglecting to meet the needs of a newborn can be considered murder by the courts.

Beyond viability, another developmental milestone that some may point to when describing when life begins is the point of quickening, or the mother’s recognition of a baby’s movement inside her. This is also arbitrary, as some women feel this occur at 14–15 weeks, while others may not feel it until 20–22 weeks or later. Fetal movement is seen on real-time ultrasound as early as 7–8 weeks, so perception by the mother is certainly not the first movement of the baby but only the first perceived movement. Furthermore, movement is only a characteristic of the neuromuscular development of the baby, not a landmark for determining its humanity.

Implantation is another point of development that people may reference. This is the point at which the fertilized egg or zygote burrows into the uterine lining to get nourishment. If implantation does not occur, the fertilized egg will not survive. Indeed, there is not a pregnancy test available that would tell you that a woman was pregnant before implantation, since the pregnancy hormone HCG is not produced in the mother until a few days after this event. Implantation does not change the internal structure of the fertilized egg in any way and, therefore, could not be considered a point of demarcation from inhuman to human.

Since there would not be a positive pregnancy test at this point, no one would seek an abortion at this stage of development regardless. The only reason to debate this point in the first place is in defense of the morning-after pill, which is a high-dose hormone designed to make conditions hostile for the implantation of a fertilized egg. If implantation were the undisputed point of conversion from inhuman to human, then there would be no real objection to its use. However, implantation is only a step along the way, and though it is a necessary step it does not alter the substance of the developing embryo. I would even argue that prevention or disruption of implantation is just as much an abortion as destroying a baby moments before delivery!

The most logical and scientifically defensible answer to the question of when life begins is conception.

There are many points to defend this position. First, prior to conception the sperm and the egg have only half the number of chromosomes found in all other human cells. Once they connect, the full complement of chromosomes—23 from the egg and 23 from the sperm—combine to make 46 in the fertilized egg. This new entity is called a zygote, and it is different from all the cells of the mother and father. In fact, except as in the case of identical twins, no other human being who has ever existed on planet Earth has the same chromosomal makeup as this particular zygote.

Uniqueness is only one aspect that differentiates this cell from all other cells of the mother and father; the 46 chromosomes have the ability to direct the development of a new and unique human being from the very moment of conception. While there is usually only one egg produced by a woman each month, the male contributes millions of sperm, but only one of them actually fertilizes the egg. All human beings on this planet were once a single fertilized egg!

I’d also like to discuss the material inside the fertilized egg. I mentioned that there are 46 chromosomes in a fertilized egg, and these chromosomes are arranged in a tightly woven DNA pattern called a double helix. If we could stretch out the chromosomes from a single zygote, the strand would be about two meters long. On each chromosome are units called genes. These genes are like computer code that will determine if the baby is a boy or girl, whether the eyes will be blue or brown, etc. In fact, every characteristic of this eventual adult is embedded in the genetic code on these 46 chromosomes. This is the most incredible computer known to man. If we could take all the genetic material in all the fertilized eggs of all the human beings on planet Earth and compress them together, they would be about the size of two or three aspirin tablets! The genetic material that would be sufficient to replicate the entire human race that is now living on the earth could be encoded in this small amount of genetic material. How incredible!

Once fertilized, the egg begins to divide. First, one cell becomes two cells. Then, something very interesting happens. For a very short time, there are three cells before the three become four. Molecular scientists have determined that as early as this three cell stage, there is a “communication” between the cells that directs this ultimate differentiation of the zygote into all the cells necessary to create a unique human being. If we were to take a cell from any living animal and stimulate it to replicate itself, it would split, and two would become four, which would then become eight, and so forth.

A skin cell can only divide and produce another skin cell, a liver cell can only produce a liver cell, etc. While so-called stem cells have the ability to make more than one type of cell, no cell has the ability to make all the cells in the body that this now-dividing human zygote has. In vitro fertilization must start with a sperm and an egg. Even cloning, which has been done in animals, requires genetic material from a species and an egg into which the DNA has been injected. Clearly, in the case of people, conception results in a genetically unique zygote that will eventually result in a human being born. Prior to conception, no such potential exists.

If, at conception, a new being with a unique set of chromosomes on which there is unique genetic material is created, we must at least conclude that this new being is genetically separate from the mother who is carrying it. Also, we can conclude that this new being will eventually (if not intentionally or accidentally terminated) become an adult human being.

Although this has been a scientific/philosophical argument, I can’t help but reflect on Psalm 139:13–16:

For you formed my inward parts; you knitted me together in my mother’s womb

I praise you, for I am fearfully and wonderfully made.

Wonderful are your works; my soul knows it very well.

My frame was not hidden from you, when I was being made in secret, intricately woven in the depths of the earth.

Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there was none of them.

King David had not gone to medical school and likely had not even seen a baby delivered. He penned these words not knowing about fertilization/conception, implantation, and fetal development. Nonetheless, he described what I have argued: human life begins at conception. Abortion—the intentional disruption of a pregnancy after conception—is the destruction of a human being.

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