What the Bible Says about Birth Control, Infertility, Reproductive Technology, and Adoption

by Wayne Grudem

Advances in technology offer couples wanting to have children more options than ever before—fertility treatment methods; prefertilization genetic screening; and embryo adoption. With all of these options available, plus the blessing of adoption, it can be difficult for Christian couples to determine which to consider when the Bible doesn't give explicit direction. Wayne Grudem applies biblical truth and ethical reasoning to help Christians navigate these questions as they seek to live out God's word in an ever-changing society.

Genres: Christian, Nonfiction, Health, Christian Non Fiction

Audiobook

Published February 16, 2021

About the author

Wayne Grudem (PhD, University of Cambridge; DD, Westminster Theological Seminary) is research professor of theology and biblical studies at Phoenix Seminary, having previously taught for 20 years at Trinity Evangelical Divinity School. Grudem earned his undergraduate degree at Harvard University, as well as an MDiv from Westminster Seminary. He is the former president of the Evangelical Theological Society, a cofounder and past president of the Council on Biblical Manhood and Womanhood, a member of the Translation Oversight Committee for the English Standard Version of the Bible, the general editor of the ESV Study Bible, and has published over 20 books, including Systematic Theology, Evangelical Feminism, Politics—According to the Bible, and Business for the Glory of God.

Reviews

[Jeanie · Rating 5 out of 5]

I was very surprised by this text. It was gospel saturated and grace filled. Even though this was a short text, it packed context of scripture and the yearnings of our own desires. How we look at children is a good starting point for Christians. Do we look at children as a blessing from God or a burden. There is a right answer to this question and will lead to the next question. How does our decision for children whether it regards birth control, infertility, reproductive technology, and adoption, how does it hold to scripture. It outline form, the author goes thru each of these. He gives a scripture that coincides with the attributes of God. For example on infertility - God has given us medicine to help in these matters however, there are questionable deliveries that can be grievous to God because it goes against His character and to your marriage. The author digs deep but he also gives his personal take on it as well. For example on cloning. We are made in the image of God and cloning can be a slippery slope.

There is a sensitivity as well. Parents that are unable to conceive and become desperate. In my own experiences (not with infertility) I have found my desperation can lead me to lean on God's understanding and not my own. This is not something that is easily shared when someone we love is in desperate times but we can be there for them in prayer and support. It is where community strengthens.

I am past child bearing years but I will never be past what the Gospel does. There is the hope.

A special thank you to Crossway Publishing and Netgalley for the ARC and the opportunity to post an honest review.

[sincerely · Rating 1 out of 5]

Here is a great example of why we read critically instead of just seeing up encampment on the "side" with which he feel safest. Overall, I gave this book one star because it felt so mentally lazy. I do not recommend. If you're interested in knowing why, read on ❤️

The topics are so much larger than the scope presented here. This felt like an author who really wanted to weigh in when he really should be quiet if he's unwilling to partner with a doctor or research. This truly is ONLY what the Bible says about these topics - not what science or research says, which is only helpful in terms of a purely theological debate, and not at all helpful in actually determining if any of these choices or interventions are good and right. It completely misses the mark regarding how these issues affect women and children holistically. The points are also all taken from the perspective of the adult, not of the child, which is super harmful in issues having to *do* with children's rights. For instance, surrogacy always removes the right of the child to their birth mother - is this morally inconsequential? I don't think so. It's not covered. The ill effects of the birth mother growing a baby and then giving it away (research shows most times this is not done altruistically, but for monetary gain, so "giving" it away is inaccurate, just like "donating" sperm is a misnomer) aren't really addressed well either.

It's also outright incorrect in terms of the intricacies of hormonal birth control? They *can* be abortificants in that they can prevent a fertilized egg from implanting. They make a woman inhospitable to life, which is why hordes of women are against them? Hello? Seriously?
I would expect someone writing on this topic to be aware of this. By his own definition, they are morally unacceptable, and yet he condones their usage. Hormonal birth control can also be harmful to women and destructive to relationships by negatively affecting libido, which absolutely has a detrimental effect on marriages. Finally, hormonal BC are chemicals which can result in breast cancer, stroke, blood clots, pelvic inflammatory disease, and cervical inflammation. Does this not matter? Should these issues, which are oftentimes never discussed with women, not be discussed here as a theological issue? When something can so harshly impact a woman's health, is there not a moral requirement to discuss it? Finally, the author's EXTREMELY weird pass for seemingly all medical technology because, "all of the medicines we have today are made from resources from the earth," just boggles the mind. I'm just scratching my head as to how someone could be so ill-informed and yet still wade into such an important topic.

Single motherhood is given a pass in relation to adopting snowflake babies. The whole section there was mentally lazy. This is not at all how we should approach these topics! This discussion is so much larger and deeper.

Adoption is on the cover, but it is not addressed hardly at all - I thought there was a glitch with my Kindle, and I was missing a whole chapter. Absolutely felt like a bait and switch.

I was relieved to see an outright condemnation of some practices involving IVF, such as selective reduction (which is abortion), artificial insemination by a donor, and freezing embryos. The commentary on eugenics was appropriate as well. I did find his rebuttals to those who promote the idea of blind trust in their family size to be reasonable. And I was glad to see the spiritual normalization of a woman wanting to be a mother, and the caution to the husband to not deny her this privilege for long. Too often women are seen as nagging simply because their God-given desire to be a mother is not heard for what it is.

For a more robust, challenging read I'd suggest Them Before Us by Katy Faust and also taking the time to educate oneself about the harms of hormonal birth control and surrogacy. If we're going to discuss these issues, we need to do so in ways that respect and care for women's bodies and children's rights both long-term and holistically ❤️

[Chloe Cox · Rating 5 out of 5]

This book is clear, thoughtful, and deeply pastoral. Wayne Grudem tackles birth control, infertility, reproductive technology, and adoption with real care—both for what the Bible actually says and for the people living with these questions.

What I appreciated most is the tone. Grudem doesn’t shame couples, push extremes, or dodge hard truths. He affirms that children are a genuine blessing from God, while also recognizing that family planning decisions require wisdom, prayer, and freedom of conscience.

His discussion of reproductive technologies is careful and clear, helping readers think ethically without panic or oversimplification. And the chapter on adoption is hopeful and grounding, without treating it as a quick fix for suffering.

[Jade Scouller · Rating 3 out of 5]

A helpful overview of the biblical acceptability of different forms of birth control and reproductive technology, but I found the brevity of the text challenging. I was sometimes confused as to conclusions drawn and found myself desiring more discussion on differing viewpoints to that of the author. However, the book was very Bible centred and easy to read.

[Chad · Rating 4 out of 5]

Concisely describes what the Bible says about birth control and reproductive technology such as fertility treatments. Even though "adoption" is in the title, it's barely covered.

Notes
Birth Control
Bible speaks positively about children as blessings from God, in both testaments (Gen 1:28; Ps 127:3-5; 128:3-4; Mal 2:15; Matt 19:13-15; 1 Tim 5:14).

To multiply (Gen 1:28) implies having more than 2 children, because 2 children simply replace parents without multiplying population.

Married couples should, in almost all cases, have children at some point in their marriages.

Couples don't have a moral obligation to have as many children as they're physically capable of. A couple may delay having children until a few years into marriage (to complete education, or become more financially stable), and this can be wise and morally good. After having children, a couple may decide to stop having them, because they can't do a good job of raising more, and this can be wise and morally good because we need to provide for our families (1 Tim 5:8).

We can't do all the morally good things that are possible, so we need to choose not to do some good things so that we can do other good things. We may choose not to have as many children as we're capable of, so that we can do other good things.

Abortifacient forms of birth control are immoral, because they kill a fertilized egg, which is a living human (Ps 51:5).

Objection: "You shouldn't limit children, because that's limiting your blessings."
Response: Just because something is good or a blessing, doesn't mean we should maximize it. Sleep, food, work, exercise, giving to poor, evangelism, worship, and Bible study are morally good, but the Bible doesn't tell us to get or do as much of these as we can, and actually warns against too much of some of them (sleep, food, work, exercise).

Each couple must prayerfully, wisely consider their gifts and callings from God to determine the right number of children for them, and how much time to devote to ministries and other worthwhile activities (1 Cor 7:17).

Objection: "We should trust God to decide how many children we should have, and when; we should not interfere."
Response: You wouldn't tell a farmer to let God decide how many weeds will grow and not to remove them. You wouldn't tell a person not to plan a vacation, their next meal, or where to live, and simply let God decide. "This concept of God's sovereignty could justify every kind of laziness and inaction, including refusal of medical care." It also assumes that God wants the couple to have more children, but we don't know God's will for each couple.

Objection: "Birth control is unnatural."
Response: God doesn't command us to simply follow what's natural, but to follow His commands in Scripture. Regarding sex specifically, God tells us to limit sex to within marriage, not to follow our natural instincts, which for most people would lead to sex with multiple partners. We're not to just let untouched nature take its course, but to direct and sometimes overcome untouched nature (Gen 1:28; 3:18-19).

Objection: "Procreation is the main (or only) purpose of sex."
Response: This idea isn't found in Scripture. Sex gives realization to the one-flesh union of marriage (Gen 2:24; Eph 5:31). Sex in marriage is given for mutual pleasure and deep companionship (Pro 5:18-19; Song of Solomon).

The Bible doesn't say how many children a couple should have. A couple can decide by praying for God's wisdom (Jas 1:5-6) and asking others for counsel.

A couple must count the cost of undertaking the weighty responsibility of having more children (Luke 14:28).

If a couple decides to have more children, they must trust God to provide for their needs and enable them to provide for their family (1 Tim 5:8), as long as they don't make a reckless, foolish decision that demands miraculous provision from God.

A couple must avoid basing decision to have more children on fear, selfishness, expectations of non-Christian culture, or on reckless sort of "faith."

Infertility and Reproductive Technology
Some kinds of reproductive technologies are acceptable, and others aren't, based on these biblical principles:
1. Modern medicine, in general, is morally good.
2. An unborn child is a human person from the moment of conception.
3. God intends that a child be conceived by, and born to, a man and woman married to each other, and not in any other situation or relationship.

It may be permissible for a single woman (never married or divorced) to adopt and raise a frozen embryo, because to be raised by a single parent is better for the child than to be killed or remain perpetually frozen.

Cloning a human is morally unacceptable, because it would violate principle that God intends that a child be conceived by, and born to, a man and woman married to each other.

[Sara Christians · Rating 1 out of 5]

I really wanted to like this book because rarely do leaders in the church address the morally problematic issues of reproductive technology and birth control in an effort to not offend church goers that have used these methods in their pursuit of children. However, Grudem really missed the mark, in my opinion, particularly because he never addressed any of the medical risks inherent in these technologies. Assessing risks to participants in imperative in determining the morality of any activity, this should be apparent on its face. Grudem also seems to be misinformed about many of these technologies and would have greatly benefitted from working with a Christian doctor that works in the field of reproduction.

First, the birth control section was incredibly disappointing, primarily because Grudem sees no issue with Christians utilizing hormonal birth control pills. He does seem to understand that IUDs are abortifacients and are not morally acceptable for Christians to use, but birth control pills are morally unacceptable for the same reason: despite their primary method of pregnancy prevention being ovulation prevention, they have a secondary function of preventing implantation of a fertilized embryo should ovulation still occur, which it does occasionally. All hormonal birth control is an abortifacient whether its primary function is to prevent ovulation or implantation, as implantation is still prevented as a "backup measure" should ovulation occur on the traditional birth control pill. There are also many problems that plague women that are on the Pill, which could have been included in the booklet but are not. The effects of hormonal birth control on a woman's body are vast and can seriously damage a woman's health. There are many books on this that I suggest Grudem read. Additionally, he seems to be dismissive of Natural Family Planning, which is a very effective form of birth control that is best used in committed relationships, such as a Christian marriage. It is my belief that NFP is the best form of birth control available to Bible believing Christians, and Grudem is wrong to act dismissive of it as something only Catholics would pursue.

His assessment of IVF is also problematic, in that almost no fertility clinics practice what he deems "morally acceptable", as the cost of IVF is so high and the success rate so low that genetic testing is almost always done on the embryos and more than one or two is created after the egg retrieval. The difficulties of the egg retrieval are also not addressed, as the medication given to women to super ovulate and produce multiple eggs has never had extensive testing and has led to health problems for many women - critics say informed consent on egg retrieval and egg donation is impossible because no one knows all the risks, as they have not been studied, and the drugs used in egg retrieval are being used off label. It is impossible to separate IVF from eugenics. Additionally, the freezing of embryos is harmful to embryos and the freeze/thaw process results in the death of roughly half of embryos. This can hardly be viewed as morally acceptable to the Christian that believes life begins at conception. Children of IVF and IVF pregnancies generally have higher incidences of health problems and complications as well, and this must be considered. Finally, on the subject of IVF, Grudem misrepresents the statistics of success rates, which are in fact very low and require multiple cycles to achieve. Less than 7% of embryos created in IVF are born alive, but the advertised success rates that Grudem uses are based on confirmed pregnancies, not on babies born. Many IVF cycles result in miscarriage, which is damaging to the couple participating as well as resulting in the death of a child that would not have occurred had the practice not been participated in. Again, in my opinion, it is never acceptable for a Christian to participate in IVF.

Lastly, in the issue of surrogacy, Grudem does not address the health risks to the woman and child that are significantly higher in a surrogate pregnancy. Surrogacy is the buying and selling of children and the trafficking of another woman's body. Grudem does not addresses any of these concerns.

In this booklet, Grudem comes off as simultaneously arrogant and misinformed, misrepresenting the postions of evangelicals that disagree with him on these matters, and neglecting to consider the effects that "modern medicine" in "reproductive technologies" have on women and children. It is extremely disappointing, as the church needs a valuable and concise resource on these issues of bioethics and many young couples need guidance in these areas. Grudem had an opportunity here to provide it, but really needed to do more extensive research.

[Ali C · Rating 4 out of 5]

I found this a helpful guide in navigating the ethical and moral questions surrounding fertility. It felt like a fair assessment of questions on all sides of the discussion, but is definitely just an introduction into many of these conversations.

I gave it four stars and not five because I am not entirely sure why adoption is in the title as it seems to have barely been addressed and only within the context of infertility. I believe it would have been more helpful to remove this from the title and still address it in the book.

[Daniel · Rating 4 out of 5]

A good introduction to these issues. This book is short and easy to read, so while it does not give a thorough treatment of each topic, it provides a starting point for thinking through these things. Even as short as the book is, the section on adoption is incredibly short (~1 1/2 pages) given that it is in the title, so that is a little disappointing.

[Elizabeth · Rating 5 out of 5]

Short. Well organized. Thought provoking. Highly recommend

[Leah · Rating 4 out of 5]

Interesting topic, interesting read. Glad to be more informed about these topics...

[Emma Dotter · Rating 5 out of 5]

VERY HELPFUL. VERY INSIGHTFUL. Absolutely recommend.

[Sara A · Rating 4 out of 5]

Very clear and scripture based
Would recommend

[Chuqin Anderson · Rating 3 out of 5]

A brief primer on the foundational framework for thinking about these issues biblically. The author presents Scripture faithfully and shows compassion and grace. It is only a high-level overview though. Using the same framework, but considering more nuances of the modern medicine and technology, may lead you to completely different convictions. I wish the nuances were discussed.

[Joshua Chipchase · Rating 5 out of 5]

Another solidly biblical, clear, well organized, and practical book on ethics by Grudem. He defends his views well (from scripture) and deals well with objections to his views. Solidly conservative/evangelical in his views.

[Amanda · Rating 2 out of 5]

Disappointing. It is just too short a book to do justice to most of the topics it covers. I also disagree with the author on a couple of significant points and found his arguments unconvincing.

[Jordan Lubben · Rating 3 out of 5]

Very good book overall! However he missed the mark on birth control. He did not accurately explain how all birth control pills have the potential to end a life due to them containing progestin which thins the uterine lining, preventing implantation of a fertilized egg. He instead includes birth control pills as “morally acceptable,” which is factually incorrect by his own definition of what is or is not morally acceptable. Birth control pills should have been placed in the “morally unacceptable” category as they are abortifacients. I see this as problematic because the majority of birth control users are using pills, and this book does not provide accurate information about how they can in fact end a life.

I also would have loved to see more on adoption since it was included in the title of the book. It was too vague to even call that it’s own chapter/topic.