God’s command to have children
As we have noted repeatedly in the course of this series of articles, for human beings to live rightly means for them to live in the light of the fact that they have been created by God as men and women, in his image, and after his likeness (Genesis 1:26-27). In the final article in this series we shall look at what this means in relation to the two issues of birth control and infertility treatment.
Having declared that human beings have been created by God in his image and likeness, the Book of Genesis immediately goes on to say that, as those who have created in this way, human beings are called by God to reproduce. In the words of Genesis 1:28:
‘And God blessed them, and God said to them, ‘Be fruitful and multiply, and fill the earth and subdue it; and have dominion over the fish of the sea and over the birds of the air and over every living thing that moves upon the earth.’’
As the second half of this verse indicates, for human beings to live as God’s image bearers involves them acting as God’s stewards, ruling over the rest of creation on God’s behalf, and in order for this to happen each successive generation of human beings is called to beget more human beings to fulfil this calling (hence the command to ‘be fruitful and multiply’).
What Genesis also goes to say, is that God created marriage between one man and one woman to be the context in which the command to be fruitful and multiply is to be fulfilled. That is how it was with the first humans, Adam and Eve (Genesis 4:1-2, 4:25, 5:1-3) and that is how it is mean to be ever thereafter.
Given that human beings have been commanded by God to beget children within marriage the questions that then arise are (a) whether it is ever right for a husband and wife to deliberately restrict the number of children they have and (b) if they may do this, what means they may legitimately use to achieve such a restriction.
The answer to (a) is that there may be morally good reasons for a married couple to restrict the number of children they have, because of the particular circumstances of their lives, or the particular vocations to which God has called them. Examples of such reasons would be the health of the mother, the well-being of existing children, or a call to a form of ministry or service that could not be satisfactorily combined with parenthood.
The answer to (b) is that there are number of means for restricting the number of children that do not raise any moral problems. This is true of what is known as ‘natural family planning’ based on sexual abstinence and the natural cycle of female fertility. It is also true of ‘barrier’ methods such as the use of condoms, diaphragms, cervical caps or spermicidal sponges that prevent the fertilisation of an egg by a sperm, and of male or female sterilisation in situations where there are morally justifiable reasons for preventing pregnancy altogether.
However, there are moral problems with methods of birth control such as the abortion pill (RU 146) which is specifically designed to abort an existing embryo and with the use of hormonal contraceptives such as the birth control pill, intrauterine devices (IUDs) using copper, and emergency contraception (the so-called ‘morning after’ pill), which may have the effect causing embryos to perish by lessening the chance of an embryo implanting successfully in the lining of the womb.
The reason such methods of birth control are morally problematic is because it seems clear that God has so designed the human race that human life begins at the point where a woman’s egg is fertilised by a man’s sperm. To quote Sean Doherty:
‘Fertilisation is when a new human life begins physically. A fertilised egg is not a part of the father or the mother in the way that the sperm or the egg were—something new has begun. No new beginning takes place after this: all that ensues is the natural development of the new life that has already begun.’
If human life begins at fertilisation, then the deliberate destruction of the embryo through the use of the abortion pill is certainly morally unacceptable, and the use of methods of birth control that may prevent implantation of the embryo also raises serious moral questions. Is the risk of preventing the implantation of an embryo, even if it is very small, a risk worth taking given that the destruction of a human life would be involved and that other methods of birth control are available? 
Treatments for infertility
As well as couples who wish to restrict the number of children that they will have, there are also couples who would like to obey God’s command to ‘be fruitful and multiply, but who, like Abraham and Sarah (Genesis 15-21) , Elkanah and Hannah (1 Samuel 1) and Zechariah and Elizabeth (and Luke 1-2), have problems with conceiving any children at all.
In this situation there are no moral objections to medical intervention which is designed to allow a married couple to conceive through sexual intercourse. This would include surgery to clear a blockage in a man’s testicles, or a woman’s fallopian tubes, the use of drugs to aid or stimulate ovulation, or even a womb transplant. In all these cases the aim is to try to counteract a disorder resulting from the Fall so that conception may then place as normal.
There also seems to be no moral objection in principle to forms of fertility treatment in which a husband’s sperm and a wife’s egg are artificially brought together before being implanted into the wife so that pregnancy and birth may then follow. This is still a form of sexual conception involving a husband and wife even though the circumstances of the conception are abnormal.
However, there are three forms of infertility treatment that are morally problematic.
The first is conception using sperm or eggs from someone other than the husband or wife. The problem with this is that it severs the link intended by God between the sexual relationship of a husband and a wife and the birth of children. In the words of Oliver O’Donovan: ‘This is a knot tied by God, which men should not untie.’ 
The second is those forms of artificial conception that result in a surplus of embryos which are either destroyed or frozen. If, as we saw above, life begins at fertilization, this is deeply troubling because it means that human beings are being deliberately destroyed or left indefinitely in freezers.
The third is the use of a surrogate mother to carry, and give birth to, an artificially conceived child. This is morally problematic because:
- Surrogacy very often involves the commercial exploitation of vulnerable women: 
- Even when this is not the case, surrogacy breaks the God designed nexus between marriage, conception, pregnancy and birth. As before this is a knot tied by God which we should not untie.
- Surrogacy can very often result in deep emotional distress to the birth mother due to her having to give up the baby she has carried and to which she has given birth and with whom she has formed a strong emotional bond. 
What all this means in practice is that however valid our reasons for wishing to restrict or avoid pregnancy and however deep our wish to have children we have to take into account the moral issues relating to birth control and infertility treatment sketched out in this article.
As human beings we cannot simply do what we want and what is now technologically possible. We can only rightly do that which accords with God’s will by respecting God’s general call to his human creatures to ‘be fruitful and multiply,’ the God given dignity of all human life from the moment it comes into existence, and the God given link between procreation and the sexual union between a husband and wife in marriage.
 Sean Doherty, The Only Way is Ethics, Part 2: Life and Death (Milton Keynes, Authentic Media, 2016), p.13.
 It is also worth noting that even if one is not entirely certain when human life begins, if the point of fertilisation is a possibility, then one would have an obligation n to act as if it did begin at that point (in the same way that one would have to act on the possibility that someone was trapped in a burning building).360 The same moral issues relating to birth control would therefore apply
 Oliver O’Donovan, Begotten or Made? (Oxford: OUP. 1984), p.17.
 See Kathleen Sloan, ‘Trading on the Female Body: Surrogacy, Exploitation, and Collusion by the US Government,’ Public Discourse, 25 April, 2017 at https://www.thepublicdiscourse.com/2017/04/19109/
 Where there is both conception outside of the married relationship between husband and wife and surrogacy, as in the case of Adam and Ian on the Archers, this is doubly problematic.