Pregnancy tissue


3 november 2022
An essay on the status of the embryo in response to the
anti-abortion laws being introduced in several states in the U.S.


(Link to PDF with images)

Visibility as value judgemen l? An essay.

The attached post is currently a little hype on Instagram (up to 10-24-2022 good for 24,572 likes). "What an Early Pregnancy Looks Like: Doctors Explain Viral Photos" is the title.

 One Dr. Joan Fleischman claims that "The most important perspective is literally absent from the imagination and discussion of abortion." "She says an embryo is not visible until nine weeks," states a comment on Instagram. At least this comment shows how the message is interpreted and understood on the Internet (Instagram). 'Invisibility' apparently as an argument pro abortion? At least with the good intention of presenting the 'real reality' of abortion in the fight against misinformation as disseminated by anti-abortion activists in the form of inappropriate images?

It seems to me that there is a scientific and ethical lopsidedness here. Since I don't quite understand how "being visible or not" or "what it really looks like" could be a consideration pro or contra aborting an embryo, I'm going to test that against the criteria I usually apply when it comes to the "humanity" and/or protectability of human prenatal life.

First, "visibility" or "what it really looks like" seems to me to be an irrelevant category when it comes to the (ethical) status determination of any living being. Is aborting an invisible embryo less harmful than aborting a visible one? Or perhaps less burdensome to the performing physician? Then why? A single cancer cell is also invisible but that doesn't make that cell any less cancerous than a bunch of cells together that form a visible cancerous tumor, does it? I suspect Dr. Fleischman wants to take a stand against the misleading images that anti-abortion activists often use where embryos and fetuses of older age (deformed and damaged or not) are depicted to emotionally manipulate and motivate people against abortion. But to then use as a counter-argument that in most cases abortion involves an embryo that is not even visible to the naked eye yet ("is only very small") is, in my view, at least as misleading, because a form of closing one's eyes to reality. Being "invisible" is not, by any means, a moral or ethical criterion. Does something not exist, has a different value, if it is not visible to the naked eye and can only be seen through a microscope? In this way you make being big and being small into a kind of qualitative and moral quantities. In this context, by the way, it is interesting that from the very beginning (and by this I mean the zygote stage immediately after fertilization) the human embryo is just above the visibility threshold of about 0.2 mm (sand grain size). This is, in fact, the size of a human egg cell (200 mu) which is thus one of the largest cells in the human body (by the way: a 7 or 8 week embryo is really visible, mind you).

Second, in the image in question, Dr. Fleischman shows an amniotic sac four times to apparently demonstrate that early embryos are not visible to the naked eye. It may be that at the magnification she uses, the embryo contained in the amniotic sac is not yet visible or may be absent. It depends on where this material came from. Is it from an abortion or from a spontaneous miscarriage? It may very well be that the amniotic sac is "empty" and the embryo has perished inside it. By the way, I suspect that Fleischman also thinks that amniotic sacs apparently do not belong to the embryo. With that, she is in the company of the vast majority of gynecologists and, like them, fails to understand that the human embryo (as well as all mammalian embryos) has a different physicality before birth than after birth and that the placenta and membranes are not adnexa’s or secundinae but represent the prenatal functional physicality of embryo and fetus.

Moreover - and you can certainly blame a scientist for this - an informational error is also made by not mentioning whether it is an 'age' of 5-9 weeks p.c.(after conception) or embryos of a gestational age of 5-9 weeks? As everyone knows, there is a two-week difference between them.

Really at fault in terms of objective image and opinion formation is Dr. Fleischman when she refers to the material shown as 'pregnancy tissue'. Pregnancy tissue? What the hell is that? I also sometimes hear gynecologists talk about "the pregnancy product. Then they mean the child, the baby, the fetus, the embryo. Terrible! Truly an example of neutralizing, supposedly objective, reductionist terminology. Clinically concealing euphemism. Moreover, it sounds like we are the product of pregnancy? Huh? I think it's the other way around and the child, the unborn, induces a pregnancy in the mother, right? 'So am I pregnant '(or, worse, 'expecting') from 'pregnancy tissue'? Introducing the term 'pregnancy tissue' here a kind of trick that is often used in this kind of discussion under the motto "If you don't call the animal by its name, but introduce a substitute less explicit label, that often helps people accept something more easily." By naming an embryo or a 'fruit' in a different way, you thereby implicitly give it a different ethical value judgment and also thereby disguise the fact that you are the one who picked up the label. 'Pregnancy tissue' is a very much more neutral and objective and abstract term than baby, baby, fetus, embryo. Especially in modern reductionist science, very often things are defined as simply "nothing but....' . Labels are not objective observations, but are thoughts and interpretations. There are quite a few ethicists and biologists who a few decades ago introduced the term "pre-embryo" for the first week of human embryonic development, for example. This was a deliberate (at least I assume) attempt to qualify (disqualify?) the first week as not yet-embryo and thus not yet-human. There is every reason to describe the so-called first week of human embryonic development as a stage explicitly different from the situation in the second week of embryonic drawing, that is, after implantation. That made it easier for the fertility technologists (so by the way, I admit, a loaded labeling on my part!) to defend themselves against difficult questioning ethicists: "It is not yet a human being I am experimenting with here." There is every reason to describe the so-called first week of human embryonic development as a stage expressly different from the situation in the second week of embryonic development, that is, after implantation. For example, in that "first week" the embryo still exists more or less independently of the maternal organism. But that did not yet make this phase a 'yet-embryo existence' and therefore not a 'yet-not-human existence.' .

"Pregnancy tissue" is a verbose and deliberately introduced euphemism. In my career as a university professor, I have on occasion had to deal with students, young women who sought my advice when faced with the choice of whether or not to terminate an "unwanted pregnancy". They always hoped that, as an expert, I would paint a less disturbing picture of the young early embryo ("Ah, it's still so small and still so insignificant and/or imperfect ..."). In any case, I have never done that. Nor the opposite. I believe that in those cases I have always tried in all honesty to help them to be able to make as concrete a consideration as possible. I almost always succeeded. Which really did not always mean that they abandoned their choice for abortion. I tried to help them form their images and opinions; the final decision making was entirely their own business. My responsibility as an expert, as a teacher, lies in the formation of an image and in doing so, especially as a scientist, I must be very aware of the distinction of that with my interpretation, opinion or judgment.

By the way, in this context, something about the posted picture. In the picture, I think I can clearly see four amniotic sacs. Is the scientist Fleischmann aware that it is the embryo's amniotic sac that triggers the pregnancy? You cannot terminate (let alone 'interrupt') a pregnancy, you can kill an embryo which terminates the pregnancy. And that is also the actual functional purpose of abortion: not to terminate the pregnancy but to expel the embryo. The child is unwanted, the pregnancy in this context is a kind of inevitable side effect (epiphenomenon).

Dr. Fleischmann claims that in the imagery of around abortion, the item that it is actually about (namely, the embryo) is not yet in visible ("The most important perspective is literally absent from the imagery and discussion about abortion"). As if being visible has to do with imagery. I try to explain in my courses The Embryo in Us and also on my website that in the pro-and-contra-abortion discussion one should precisely not come up with arguments based on whether or not or not an embryo is 'human' or 'human-worthy'. Biologically speaking, it makes no sense to distinguish stages of development in a living organism according to criteria of "not yet worthy" or of less worthy, with the final adult stage being regarded as value-determining and normative. . We are not machines that are ready at one point and then begin to function. Every living being must function continuously during its development. This is called "autopoiesis" and is fundamentally peculiar to living beings. In my opinion, modern biology has now really demonstrated that the tadpole is really not a 'less' stage than the adult frog (because supposedly 'not yet ready') and that living beings are apparitions or emergences and that earlier stages are not to be considered as not yet-ready stages. The frog does not 'emerge' from the tadpole; the tadpole is already (or: also) a frog. A fetus is biologically no less human than a newborn, an embryo no less human than a fetus, and certainly there are no stages that are yet-not-human(worthy). Yes, of course one can (should) discuss or hold an opinion or judgment about increasing protectiveness of human prenatal life but one cannot measure or value that protectiveness by any supposed grading of human worthiness or "being human. So then don't come up with pseudoscientific biological arguments and certainly not with emotionally charged notions like being or not being visible. Moreover, visibility is also rather dependent on whether or not you wear glasses (.....) Or whether or not you use the microscope. Again, what is this referring to?

In each case, the images here above depict the "actual" dimensions and aspects of human embryos of the age referred to in the post. The ages given there are, as is customary for the embryologist, p.c., that is, counted from conception.

Nevertheless, even if you consider a human embryo to be a full-fledged stage of a human organism from the outset, there may well be situations in which arguments may have to be made to kill an embryo. That is called embryocide. I am often charged that because I apparently take a so-called "pro-life" position when it comes to the ethical and moral valuation of an embryo, I am therefore by definition opposed to abortion. Well, that is not the case. Being "pro live" or not does not necessarily get in the way of the position that abortion is indeed necessary or should be possible in certain emergencies, and that the final decision on that lies with the woman. But this position does not take away from the fact that I will continue to strive to prevent abortion. "Help abortion out of the world" is and remains my starting point. Because at the end of the day, it is still about ending a human life and that should be avoided and prevented in principle. I want to contribute to ensuring that people do not make judgments and opinions or define terms and boundaries based on an incorrect interpretation (in my opinion) of facts. Attributing to early embryos the moral status of "it's only small and not yet perfect so it's not so bad if it's aborted" is, in my opinion, of the same short-sightedness as when people think they can comfort a parental couple who have had to experience a premature birth or miscarriage with a similar valuation regarding the premature child. Still my daughter talks about the (premature) loss of her child when she talks about her premature fourth child at 20 weeks. I really didn't bury and name " pregnancy tissue" with her at the time. Her medical status states that she "gave birth to a 20-week fetus" at the time. But whether this matter-of-fact and medically-scientifically accurate statement does justice to the tragedy of a mother losing her child? What is the "real" reality? The string of common misinterpretations of the moral status of the embryo apparently now includes the argument, "You can't see it yet, we're just removing some 'pregnancy tissue”. And so the early embryo is not yet ethically worthy of being considered a victim of embryocide?".

I call this scientifically burying your head in the sand, deliberately putting on certain glasses (or blinders?) and basically looking away from reality. So it is actually just as obfuscating as the gruesome pictures often put forward by anti-abortion activists, which indeed often do not at all give the correct picture that belongs to the stage that a "timely" abortion is also often about. But as far as I am concerned, Dr. Fleischman should also show pictures of embryos (plus the dimensions indicated) from the embryological literature and not reduce early embryos to 'nothing but some pregnancy tissue'. Because that is also a half-truth. If you deliberately keep yourself ignorant of the complexity and functionality of the human embryo and then use that as some sort of ethical excuse, you do violence to the truth, to reality, in my opinion.

I will just admit here that it does seem somewhat frustrating to me that the "truth" posted here on Instagram has already been seen and liked by more than 24,000 "visitors. I may rejoice in a lot less visits and approval on my website In this case, however, I can conclude nothing but half-truth, ignorance and pseudoscientific reasoning, despite all the expertise of the author.

So dear reader, please also visit and take note of other scientific views. Maybe it will help you to see that 'pro live' really doesn't necessarily mean 'anti abortion' (as people often judge my ethical stance on unborn life)'. These days, as a person who comments on and objects to abortion, you are also immediately categorized as being anti-woman and anti-emancipation. It is also true of this day and age that you are immediately categorized and assigned to the 'opposing party': taking a middle position is hardly allowed anymore. Something similar often happens to me when it comes to the (neo)Darwinist views on descent and evolution[1]: you can only be 'for Darwin' or 'against Darwin'. If you comment on these theories or do not endorse them on all fronts - as I do in my courses, because that is what I learned about evolution from the embryo. The embryo which Darwin says is "the weightiest argument of all" for his theory of descent - then you are immediately classified with the orthodox Christian creationists. As if there is no intermediate position possible that connects and does justice to both views. Evolution and creation need not be mutually exclusive. That is precisely the tragedy hidden in the abortion ban in those 13 U.S. states: nowhere is the possibility of compromise or an intermediate position seriously sought. As everywhere in political America, dialogue, compromise and the middle ground have been lost in the hardened polarization of Democrats and Republicans.

Dr. Schumacher: "I've seen, my entire career, that people come in having been shamed and judged. But now adding to that, criminalization is incomprehensible to me because essentially we are criminalizing a third of women in their reproductive years that end up in the situation."

Hear, hear. I agree. I also fight for an abortion-free world. To regard every embryocide as a criminal and punishable act, is just as stupid as condemning and punishing as a criminal every soldier who kills another soldier (often on our orders, or our nation's). That's not how you help war out of the world, that's not how you help abortion out of the world. It is quite possible to regard abortion as 'cide' (killing) without always and qualitatively having to regard it as criminal. Many a 'murderer' is not condemned as such by a judge because his/her act could be defended with good arguments or as a necessity. That still does not mean that the judge or society thereby approves of killing a human being. My slogan is: abortion, often unfortunately bitter necessity, sometimes painful impotence or incompetence, but always something we must get out of the world. Not by criminalizing it or punishing it or banning it legally but by offering prevention and help in the event that it seems inevitable. Nor by avoiding the terrible dilemma (Who should be born? The woman or the child?) with pseudoscientific arguments and neutralizing it, for example, with irrelevant criteria of humanity.

There is certainly such a thing as increasing protectiveness of human life (and perhaps decreasing) but that is about other, socio-ethical criteria and you cannot base it on so-called scientific biological or anthropological arguments of increasing (and decreasing?) human worth. It is not about a choice between a human being who has 'less worth' and a human being who has more 'value'. And it is not only up to the woman, this choice and decision, it is also about the ethical value society assigns to unborn children. The child is not someone's property over which another human being can decide at their own discretion. Nobody owns nobody. In fact, this is basic human right number one; the child also has a right to a secure existence. The view that men make women pregnant or that parents make their child together and thereby own them, has been a misconception for centuries and should have long since been superseded by advancing scientific understanding. Children come through us, not from us. One must realize what one is doing when one aborts a "fruit" (well-known and widely used euphemism), an embryo, a child. Even then, it is possible to (have to) do that and women (and men) should be assisted in that. But not first devalue the child as a "clump of cells" or as a "fruit" or "pregnancy product" and similar euphemisms and thus put it out of action and then be able to wash their hands of it. My problem (which I am still far from unambiguous about) is that both among the absolute proponents of women's freedom of choice and among the mordant opponents who criminalize and leave that same woman out in the cold, that on both sides the child is first manipulated away and given no right to be. How you think about things determines what your actions are. The many women who later in life come to terms with the traumatic processing of their made choice of abortion of yesteryear (for there are such in large numbers as well), are "proof" that abortion is not something to be lightly chosen or permitted nor lightly forbidden and criminalized.

I agree with the slogan I read; "Criminalizing abortion does not stop abortion, it just makes abortion less safe".

I know that fencing and coquetting with your supposed academic titles is often a trick to strengthen your arguments and convince people that you are right. I am also guilty of this sometimes, especially when I now sign this essay with: I am Jaap van der Wal MD PhD, emeritus senior lecturer of anatomy and embryology, UM, Maastricht, The Netherlands and have been teaching human embryonic development for 40 years. Look at


October 24, 2022
Jaap van der Wal MD PhD

Version: 11/3/2022

[1] By the way, evolution is not a "theory" but fact, descent is.

The invisible Embryo.pdf
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