The Washington PostDemocracy Dies in Darkness

Opinion How one doctor tried for 30 years to bring clarity to the abortion conversation

The Joneses pose for a photo in Norfolk, Va., in 1998. The work of Howard Jones, who died July 31, and his late wife, Georgeanna Jones, led to the nation’s first child born as a result of IVF in 1981. (Bill Tiernan/The Virginian-Pilot via Associated Press)

This analysis is by Daniel Silliman, an instructor of American religion and culture for the Heidelberg Center for American Studies at Heidelberg University.

Howard W. Jones Jr. was expecting controversy.

But not this controversy.

Jones was pioneering the developing science of in vitro fertilization in the United States. He and his wife, Georgeanna Jones, one of the nation’s first specialists in reproductive hormones, had retired from Johns Hopkins University in 1978. They moved to Norfolk, Va., the next year and were trying to start a clinic at Eastern Virginia Medical School to help couples struggling to conceive.

The Joneses were familiar with opposition to fertility treatment and fears about so-called test-tube babies. But they didn’t expect their work to become a flashpoint in the then-burgeoning battle against abortion. After all, they weren’t in the business of unwanted pregnancies. Theirs was the science of helping people who desperately wanted babies.

It was actually supposed to be a fairly straightforward and bureaucratic meeting of the Virginia Statewide Health Coordinating Council. Yet the hearing room filled to capacity on Halloween day, 1979, and pro-life protestors gathered outside making dire predictions about this new science.

“Incredible claims were made,” Howard Jones recalled in his memoir. “Protestors [said] that in vitro fertilization would surely promote incest, human-animal hybrids, and other bizarre scenarios which were both shocking and unbelievable.”

It wasn’t the last time Jones found himself confused in a conversation with the pro-life movement. Jones died July 31 at the age of 104. In the years between that hearing and Jones’s death, little changed in the public conversation over abortion.

According to Gallup, the majority of Americans have consistently held a middle position — abortion should be legal only in certain circumstances — since 1975.

A recent YouGov poll looked for reactions to recently revealed undercover videos showing Planned Parenthood officials talking about abortion and fetal remains in shocking ways. The poll found little shift in public opinion, despite pro-life advocates’ hopes for a cultural moment of clarity. Sixteen percent of people said abortion should always be illegal, about the same percentage that believed that two years ago. On the other side, 17 percent said it should always be legal, a negligible two-point decline from the 2013 poll. Everyone else was somewhere in the middle.

[How the Planned Parenthood videos set off a renewed wave of activism on abortion]

Even when Americans identify with pro-life or pro-choice labels, they often mean something fuzzy. When given the chance in a Vox poll published earlier this year, nearly 20 percent of people said they were both pro-life and pro-choice. More than 20 percent said they were neither.

Jones’ life provides an interesting case study of confused conversations over abortions. For more than 30 years, he engaged pro-life advocates, who frequently opposed his work helping people conceive.

The science he helped develop was “far too wasteful of human life,” as one pro-life group put it, “resulting in thousands of embryos which are destroyed, either by chance in the womb or on purpose when they are no longer needed for the treatment. The process also encourages a mentality which views people as things to be bought or sold.”

He tried to talk to them out of that opinion. Some conversations he was invited to while others were thrust upon him. None resulted in any sort of consensus or clarity.

Failures before eventual success

From 1980 to 1981, the Joneses’ clinic performed 41 in vitro fertilization procedures without success. The first patient, Howard Jones recalled in “In Vitro Fertilization Comes to America,” was a woman named Sarah Smith, a teacher in Virginia Beach. Smith had no fallopian tubes. Her fertilized ova could not naturally travel from her ovaries to implant in her uterus.

Another patient — the 13th — was Judy Carr. Carr and her husband, Roger, had conceived three times, but each time the embryo had implanted in Carr’s fallopian tube, resulting in dangerous ectopic pregnancies. Surgeons removed her fallopian tubes to save her life, making it impossible for Carr to get pregnant naturally.

The day the Carrs got the bad news about the results of the third surgery, a story about the Joneses’ efforts at in vitro fertilization ran in the paper. Carr’s treatment at the Joneses’ clinic began in May 1981.

At the same time, a Catholic pro-life advocate named Charles Dean was standing in front of East Virginia Medical School with a sandwich-board sign that said “See Me For the Truth.” The truth, as Dean saw it, was that the Joneses were performing experiments on humans because it was cheaper than experiments on animals. Dean distributed pro-life literature quoting a Catholic scholar saying: “The tiny human being has no price nowadays. You can kill it. It does not cost anything to manipulate it because it has been entirely abandoned, even by the parents.”

Dean wasn’t the only critic of the Joneses efforts to help women like Judy Carr and Sarah Smith conceive.

A local newspaper published an editorial warning that “those doctors” cavalierly disregarded human life. The editorial said the doctors would pressure women to have abortions if their unborn children were “abnormal,” meaning developmentally disabled. The Joneses were horrified by the allegation and sued the newspaper for libel. They received an undisclosed settlement. According to Howard Jones, it funded the clinic for several years.

There was concern among medical professionals about the health of babies conceived in vitro, however. One doctor speculated in the New England Journal of  Medicine that these children would be born “deformed, sterile, or retarded.” The Joneses didn’t have any reason to think that would happen, but there was enough concern that Howard Jones drafted a press release, experimenting with what he would say if the clinic’s first child was malformed or developmentally disabled.

“Georgeanna never shared my misgivings,” Jones wrote in his memoir. “In the event, my anxieties were needless, because Baby Elizabeth was not only beautiful, but perfectly normal.”

Carr gave birth to Elizabeth a few days after Christmas 1981, the first in vitro-conceived baby in the United States. Smith gave birth to twins a short time later. To date, it is estimated that more than 5 million people worldwide are alive because of in vitro fertilization. It is thought that, in the United States, about 1 percent of all babes are conceived with in vitro fertilization. Follow-up studies have shown no side effects to the procedure.

As an adult, Elizabeth Carr Comeau praised the Joneses. Despite the controversies, she said, they “never lost sight of the fact that the most important part about [in vitro fertilization] was making babies.”

Engagement with the Catholic Church

In vitro fertilization did not seem that simple to everyone. The Catholic Church, for example, had a number of concerns about the procedure.

Church leaders wondered if this way of making babies didn’t demean procreation.

The Joneses were invited to the Vatican to discuss in vitro fertilization. They were wary, at first, but excited, too, to engage with pro-life advocates in a good faith conversation. They attended the symposium of the Pontifical Academy of Sciences in November 1984. They were greeted warmly, they felt, and told the conversation was a search for truth.

Howard Jones wrote about the symposium three times: once immediately after, in a memo to those working in the Virginia fertility clinic, once in 1999 for the American Society of Reproductive Medicine and once in his memoir, which was published in 2014. That record shows he frequently didn’t understand the terms of the conversation at the Vatican. Jones was surprised, for example, that there was no talk about when life begins. For the Catholic officials, that question was settled.

What the Catholics did want to talk about were the “bonds of conjugal love.” They understood this in terms of Pope Paul VI’s 1968 encyclical, “Humanae Vita.” The Joneses, however, were not Catholic. They couldn’t always follow the discussion of the question of whether in vitro fertilization “circumvented conjugal love.”

“There was a great of discussion about this latter point,” Jones noted in 1984, “and it went on and on and on.”

Jones believed a number of the Catholic officials were in favor of approving the morality of in vitro fertilization. The notable exception was Monsignor Carlo Caffarra, today a cardinal in the church. According to Jones’s notes, Caffarra objected to the morality of having a third party, a technician, involved in procreation. He objected to the idea that people had a right to have children, even if they were infertile. And he said the procedure didn’t respect human dignity.

The church released its official teaching a few years later. The document reflected Caffarra’s thinking.

“Such fertilization,” the “Donum Vitae says, “entrusts the life and identity of the embryo into the power of doctors and biologists and establishes the domination of technology over the origin and destiny of the human person.”

Even if every precaution was taken to respect human life, the church warned, the procedure was corrupted by an “abortion mentality” and “can lead to a system of radical eugenics.”

The Joneses felt betrayed by the “Donum Vitae,” and were upset to see none of their input seemed to matter. The document didn’t cite them or any other scientific experts. They didn’t feel heard or understood.

When does life begin?

Howard Jones continued to be frustrated as pro-life advocates regularly condemned in vitro fertilization. He acknowledged that not every embryo was implanted and not every implanted embryo was carried to term. But this, he said, was “not the kind of abortions one usually envisions.” It was “the loss of free-floating fertilized eggs which mostly perish as a microscopic ball of cells.” His protests were ignored.

In 2012 a Virginia politician described in vitro fertilization as “kind of evil,” and supported a “personhood” law that would deem embryos human.

It was not only pro-life advocates who were concerned with the embryos that were fertilized in vitro but not implanted in a womb. Even some people who were staunchly pro-choice thought of frozen embryos as “‘virtual’ children having interests that must be considered and protected,” as Mother Jones reported in 2006.

Those critiques seemed to Jones like a grave misunderstanding of the science of reproduction. It seemed to him the problem was there still hadn’t been a good conversation about abortion and the critical question of when life begins.

At age 102, Jones decided to try to have that conversation one last time. Reviewing the scientific literature, religious texts and legal history, Jones wrote “Personhood Revisited.”

“When did each of us become a person?” Jones wrote. “In the early decades of the twenty-first century, the acquisition of personhood is again a lively topic … Through the ages, various stages of development have been considered as milestones for this acquisition. For example, a heartbeat, quickening, brain waves, and viability, among others, have been considered as the events that bestow personhood, and therefore societal protection.”

The book was self-published, was not reviewed or widely read and is not readily available. To date, the book has only one rating on It just didn’t work to start the conversation that Jones wanted to have.

When he died last month, Jones was hailed as the father of in vitro fertilization and remembered as a man who accomplished many things. In one respect, however, he was a tragic figure. He tried for more than 30 years to engage with pro-life advocates in a discussion about abortion, but that conversation is arguably just as conflicted and confused as it ever was.

Daniel Silliman is an associate editor of “Religion and the Marketplace in the United States.” You can follow him on Twitter @danielsilliman.

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