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Published online by Cambridge University Press: 23 May 2018
This article tries to construct an ethical framework to address the issue of infertility through a creative use of Thomas Aquinas’ thought. Involuntary childlessness is one of the forgotten issues among Christian communities in West and Central Africa. Starting with the scientific definition of infertility, the article shows the gender differences and biases in the perception of childlessness in that region. Although infertility equally affects men and women, the latter, most of the time, are blamed for it. Although Scripture contains some ambivalent elements concerning infertility, on the whole it offers valuable insights by presenting childlessness as a type of life also blessed by God. Likewise, the language of the church since Vatican II has done away with the hierarchical view of the ends of marriage (or the idea that procreation is the primary goal of marriage over and against the unity of the spouses). Aquinas teaches us about the true nature of marriage and the value of childlessness. In addition, Aquinas’ understanding of love helps articulate areas that could guide infertile individuals and childless couples, on the one hand, and Christian communities, on the other hand, who have to deal with childless members.
1 For instance, the apostolic exhortations of the 1994 and 2009 synods of African bishops, while mentioning marriage many times, never refer to infertility. John Paul II, On the Church in Africa and Its Evangelizing Mission: Post-synodal Apostolic Exhortation Ecclesia in Africa (Yaoundé, Cameroon: Libreria Editrice Vaticana, 1995), http://www.vatican.va/holy_father/john_paul_ii/apost_exhortations/documents/hf_jp-ii_exh_14091995_ecclesia-in-africa_en.html; Benedict, XVI, On the Church in Africa in Service to Reconciliation, Justice, and Peace: Post-synodal Apostolic Exhortation Africae Munus (Ouidah, Benin: Libreria Editrice Vaticana, 2011)Google Scholar, http://www.vatican.va/holy_father/benedict_xvi/apost_exhortations/documents/hf_ben-xvi_exh_20111119_africae-munus_en.html.
2 Dimka, Ritgak A. and Dein, Simon L., “The Work of a Woman Is to Give Birth to Children: Cultural Constructions of Infertility in Nigeria,” African Journal of Reproductive Health 17, no. 2 (2013): 106Google ScholarPubMed.
3 Mascarenhas, Maya N. et al. , “Measuring Infertility in Populations: Constructing a Standard Definition for Use with Demographic and Reproductive Health Surveys,” Population Health Metrics 10, no. 1 (2012), doi:10.1186/1478-7954-10-17CrossRefGoogle ScholarPubMed.
4 From here onward, I am paraphrasing from the World Health Organization's article “Infertility Definitions and Terminology,” 2016, http://www.who.int/reproductivehealth/topics/infertility/definitions/en/.
5 WHO, “Infertility Definitions and Terminology.” From a demographic perspective, infertility is the inability of those of procreative age (15–49 years) to get or keep a pregnancy within five years of exposure to unprotected sex. The epidemiological definition targets women in a special way. It defines infertility as “women of reproductive age … at risk of becoming pregnant (not pregnant, sexually active, not using contraception and not lactating) who report trying unsuccessfully for a pregnancy for two years or more.”
6 Dimka and Dein, “The Work of a Woman Is to Give Birth to Children,” 106.
7 Ibid., 107.
8 Boyd, K. M., “Disability,” Journal of Medical Ethics 27, no. 6 (2001): 361–62, doi:10.1136/jme.27.6.361CrossRefGoogle ScholarPubMed.
9 Mascarenhas, Maya N. et al. , “National, Regional, and Global Trends in Infertility Prevalence since 1990: A Systematic Analysis of 277 Health Surveys,” ed. Low, Nicola, PLoS Medicine 9, no. 12 (2012): e1001356, doi:10.1371/journal.pmed.1001356CrossRefGoogle ScholarPubMed.
10 Among the causes of infertility for women in areas like sub-Saharan Africa are untreated infections of the reproductive tract such as STIs, post-abortion complications, and pregnancy complications. Infertility is caused mostly in women by dysfunctional fallopian tubes, and in men by bad or poor sperm quality and erection problems; see Mascarenhas et al., “National, Regional, and Global Trends”; Tabong, Philip Teg-Nefaah and Adongo, Philip Baba, “Infertility and Childlessness: A Qualitative Study of the Experiences of Infertile Couples in Northern Ghana,” BMC Pregnancy and Childbirth 13, no. 1 (2013), doi:10.1186/1471-2393-13-72CrossRefGoogle ScholarPubMed.
11 Mascarenhas et al., “National, Regional, and Global Trends.” In addition, with 2.9 percent, sub-Saharan Africa is ranked fourth in terms of primary infertility, and with 11.6 percent of women affected by secondary infertility it is in the bottom three regions. In general, younger women (20–24 years) show higher percentages of primary infertility, while older women (40–44 years) are more affected by secondary infertility.
12 Agarwal, Ashok et al. , “A Unique View on Male Infertility around the Globe,” Reproductive Biology and Endocrinology 13, no. 1 (2015): 2, 7, doi:10.1186/s12958-015-0032-1CrossRefGoogle ScholarPubMed.
13 Mascarenhas et al., “National, Regional, and Global Trends.”
14 Tabong and Adongo, “Infertility and Childlessness.”
15 Dimka and Dein, “The Work of a Woman Is to Give Birth to Children,” 115; countries like Cameroon, the Central African Republic, Chad, and Gabon have high rates of fertility: respectively, 5.2, 5.1, 6.6, and 4.3 children per woman; these contrast with high rates of primary infertility (5.3, 7, 3.25, and 5.2 percent of women aged 20–44 years, respectively, in Cameroon, the Central African Republic, Chad, and Gabon) and higher rates of secondary infertility (23.4, 27.4, 19.1, and 29.4 percent of women aged 20–44 years, respectively, in Cameroon, the Central African Republic, Chad, and Gabon); for more, see Larsen, Ulla, “Infertility in Central Africa,” Tropical Medicine and International Health 8, no. 4 (2003): 355CrossRefGoogle ScholarPubMed, 359.
16 Feldman-Savelsberg, Pamela, “Is Infertility an Unrecognized Public Health and Population Problem? The View from the Cameroon Grassfields,” in Infertility around the Globe: New Thinking on Childlessness, Gender, and Reproductive Technologies, ed. Inhorn, Marcia C. and van Balen, Frank (Berkeley and Los Angeles: University of California Press, 2002), 222–23Google Scholar; Nieuwenhuis, Sonja L. et al. , “The Impact of Infertility on Infertile Men and Women in Ibadan, Oyo State, Nigeria: A Qualitative Study,” African Journal of Reproductive Health 13, no. 3 (2009): 86Google ScholarPubMed.
17 As illustration, a study carried out in Cameroon, Chad, Central African Republic, and Gabon among more than 20,000 women revealed that all of those who were childless desired children; see Larsen, “Infertility in Central Africa,” 358, 360; Dimka and Dein, “The Work of a Woman Is to Give Birth to Children,” 114.
18 Magesa, Laurenti, African Religion: The Moral Traditions of Abundant Life (Maryknoll, NY: Orbis Books, 1997)Google Scholar.
19 Bujo, Bénézet, “Reasoning and Methodology in African Ethics,” in Catholic Theological Ethics Past, Present, and Future: The Trento Conference, ed. Keenan, James F., Catholic Theological Ethics in the World Church (Maryknoll, NY: Orbis Books, 2011), 148Google Scholar.
20 Ibid.
21 Magesa, African Religion, 64–65; Lutz, David W., “African ‘Ubuntu’ Philosophy and Global Management,” Journal of Business Ethics 84, no. 3 (2009): 314CrossRefGoogle Scholar.
22 Bujo, “Reasoning and Methodology in African Ethics,” 149.
23 Magesa, African Religion, 66.
24 For more on this, see Oduyoye, Mercy Amba, “A Coming Home to Myself: The Childless Woman in the West African Space,” in Liberating Eschatology: Essays in Honor of Letty M. Russel, ed. Farley, Margaret A. and Jones, Serenes (Louisville: Westminster John Knox Press, 1999), 107–16Google Scholar.
25 It took her more than two decades to share her story within her circle of female theologians, and another decade to finally publish it. See Oduyoye, “A Coming Home to Myself,” 109; Weinger, Susan, “‘Infertile’ Cameroonian Women: Social Marginalization and Coping Strategies,” Qualitative Social Work 8, no. 1 (2009): 45–64, doi:10.1177/1473325008100425CrossRefGoogle Scholar.
26 Weinger, “‘Infertile’ Cameroonian Women,” 62; Oduyoye, “A Coming Home to Myself,” 115.
27 Tabong and Adongo, “Infertility and Childlessness”; Weinger, “‘Infertile’ Cameroonian Women.” In the next paragraphs I borrow heavily from these two articles.
28 Oduyoye, “A Coming Home to Myself,” 113.
29 See Tabong and Adongo, “Infertility and Childlessness.”
30 Oduyoye, “A Coming Home to Myself,” 114. One should recall from the book of Job that Job's friends, instead of comforting him in his hardships, blamed him by suggesting he might have done something evil that triggered the unfortunate chain of events in his life.
31 In addition to note 11 above, see also Kasia, Jean Marie et al. , “Laparoscopic Fimbrioplasty and Neosalpingostomy in Female Infertility: A Review of 402 Cases at the Gynecological Endoscopic Surgery and Human Reproductive Teaching Hospital in Yaoundé-Cameroon,” Journal of Reproduction and Infertility 17, no. 2 (2016): 106Google Scholar; Gerrits, Trudie, “Infertility and Matrilineality: The Exceptional Case of the Macua of Mozambique,” in Infertility around the Globe: New Thinking on Childlessness, Gender, and Reproductive Technologies, ed. Inhorn, Marcia C. and van Balen, Frank (Berkeley and Los Angeles: University of California Press, 2002), 239–40Google Scholar; Nieuwenhuis et al., “The Impact of Infertility on Infertile Men and Women in Ibadan,” 86; Larsen, “Infertility in Central Africa,” 365; Agarwal et al., “A Unique View on Male Infertility around the Globe,” 7.
32 Dimka and Dein, “The Work of a Woman Is to Give Birth to Children,” 108; Gerrits, “Infertility and Matrilineality,” 239; Feldman-Savelsberg, “The View from the Cameroon Grassfields,” 228.
33 Dimka and Dein, “The Work of a Woman Is to Give Birth to Children,” 111.
34 Gerrits, “Infertility and Matrilineality,” 238; Nieuwenhuis et al., “The Impact of Infertility on Infertile Men and Women in Ibadan,” 95.
35 Cui, Weiyuan, “Mother or Nothing: The Agony of Infertility,” Bulletin of the World Health Organization 88, no. 12 (2010): 881–82, doi:10.2471/BLT.10.011210CrossRefGoogle ScholarPubMed.
36 Ola, Tolulope Monisola, “The Socio-Cultural Perception and Implications of Childlessness among Men and Women in an Urban Area, Southwest, Nigeria,” African Journal of Social Sciences 21, no. 3 (2009): 205–9CrossRefGoogle Scholar.
37 Tabong and Adongo, “Infertility and Childlessness.”
38 They are accused of, among other things, earlier unsafe abortions, promiscuity, pursuing a long education, and being a witch (who sold her womb for success); for more, see Oduyoye, “A Coming Home to Myself,” 117.
39 Tabong and Adongo, “Infertility and Childlessness”; Ola, “The Socio-Cultural Perception and Implications of Childlessness,” 208.
40 Dimka and Dein, “The Work of a Woman Is to Give Birth to Children,” 113.
41 Oduyoye, “A Coming Home to Myself,” 110. As Oduyoye asserts, “No African escapes financial and moral responsibility for members of the extended family, especially if they are themselves childless.” This is the main form that this taxation takes.
42 Weinger, “‘Infertile’ Cameroonian Women,” 54.
43 Ibid., 55.
44 Ibid., 53–54.
45 Cui, “Mother or Nothing,” 882.
46 Tabong and Adongo, “Infertility and Childlessness.”
47 Weinger, “‘Infertile’ Cameroonian Women,” 56–58; Tabong and Adongo, “Infertility and Childlessness.”
48 Weinger, “‘Infertile’ Cameroonian Women,” 53, 58.
49 Ibid., 53; Dimka and Dein, “The Work of a Woman Is to Give Birth to Children,” 108.
50 Weinger, “‘Infertile’ Cameroonian Women,” 58.
51 Willis, Timothy, “Barren, Barrenness,” in The New Interpreter's Dictionary of the Bible: A–C, ed. Doob, Katharine Sakenfeld (Nashville: Abingdon Press, 2006), 400Google Scholar.
52 Witherup, Ronald D., SS, “Barrenness,” in The Collegeville Pastoral Dictionary of Biblical Theology, ed. Stuhlmueller, Carroll, CP (Collegeville, MN: Liturgical Press, 1996), 74Google Scholar.
53 Ibid.
54 Ibid., 75–76.
55 Kolarcik, Michael, SJ, “The Book of Wisdom: Introduction, Commentary, and Reflections,” in The New Interpreter's Bible (Nashville: Abingdon Press, 1997), 5:473Google Scholar.
56 One should bear in mind that eunuchs were excluded “from the priesthood and the assembly of the Lord” (Lev 21:20; Deut 23:2). Kolarcik, “The Book of Wisdom,” 5:473.
57 I am drawing from Oduyoye, “A Coming Home to Myself,” 115.
58 Witherup, “Barrenness,” 77.
59 Saint Augustine, Of the Good of Marriage, ed. Kevin Knight, trans. C. L. Cornish, 17–19, http://www.newadvent.org/fathers/1309.htm.
60 XI, Pope Pius, On Christian Marriage, Encyclical Casti Connubii (Rome: The Holy See, 1930), §36Google Scholar, http://w2.vatican.va/content/pius-xi/en/encyclicals/documents/hf_p-xi_enc_19301231_casti-connubii.html.
61 Pope Paul VI, Pastoral Constitution on the Church in the Modern World (Gaudium et Spes), December 7, 1965, §50, http://www.vatican.va/archive/hist_councils/ii_vatican_council/documents/vat-ii_cons_19651207_gaudium-et-spes_en.html.
62 Paul, Pope John II, Exhortation, Apostolic, On the Role of the Christian Family in the Modern World (Familiaris Consortio) (Rome: Libreria Editrice Vaticana, 1981), §14Google Scholar, http://www.vatican.va/holy_father/john_paul_ii/apost_exhortations/documents/hf_jp-ii_exh_19811122_familiaris-consortio_en.html.
63 Congregation for the Doctrine of the Faith, Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation (Donum Vitae), February 22, 1987, II, 8, http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html.
64 Congregation for the Doctrine of the Faith, Instruction Dignitas Personae on Certain Bioethical Questions, September 8, 2008, §1, http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20081208_dignitas-personae_en.html.
65 Pope Francis, Post-Synodal Apostolic Exhortation, Amoris Laetitia (On Love in the Family) (Rome: Libreria Editrice Vaticana, 2016), https://w2.vatican.va/content/dam/francesco/pdf/apost_exhortations/documents/papa-francesco_esortazione-ap_20160319_amoris-laetitia_en.pdf.
66 SCEAM, L’avenir de la famille, notre mission: Contribution à la 14e Assemblée Générale Ordinaire du Synode des Evêques sur la famille (Accra: SCEAM-SECAM Publications, 2015), 149.
67 Ibid., 150–51.
68 Ibid., 152–53.
69 Ibid., 154.
70 Ibid., 153.
71 Cox, Kathryn Lilla, “Toward a Theology of Infertility and the Role of Donum Vitae,” Horizons 40, no. 1 (2013): 28–52, doi:10.1017/hor.2013.2CrossRefGoogle Scholar.
72 Oduyoye, “A Coming Home to Myself,” 111.
73 Weinger, “‘Infertile’ Cameroonian Women,” 57.
74 Ibid.
75 Oduyoye, “A Coming Home to Myself,” 115.
76 Saint Thomas d'Aquin, Lecture de l’Evangile de Saint Matthieu, trans. Dominique Pillet, Jacques Ménard, and Marie-Hélène Deloffre, OSB, (Institut Docteur Angélique, 2005), http://docteurangelique.free.fr/bibliotheque/ecriture/matthieu.htm.
77 Saint Thomas d'Aquin, Commentaire du livre des sentences de Pierre Lombard (Scriptum super Sententiis) 1254–1256, Livre IV, trans. Jacques Ménard, (Institut Docteur Angélique, 2007), d. 26, q. 1, 1, http://docteurangelique.free.fr/bibliotheque/sommes/SENTENCES4.htm. I have chosen this early work of Aquinas because it inspires the supplement of the Summa Theologiae, which was not written by Aquinas.
78 Aquinas, Thomas, Summa Contra Gentiles, Book IV: Salvation, ed. Kenny, Joseph, OP, trans. O'Neil, Charles, online (New York: Hanover House, 1955)Google Scholar, chap. 78.2, http://www.dhspriory.org/thomas/ContraGentiles4.htm.
79 Ibid.
80 Saint Thomas Aquinas, Summa Theologiae III, trans. Fathers of the English Dominican Province, online (Kevin Knight, 2016), q. 65, a. 3, ad 1, http://www.newadvent.org/summa/4.htm.
81 Aquinas, ST III, q. 65, a. 1.
82 Thomas Aquinas, Summa Contra Gentiles IV, chap. 78.5.
83 Aquinas, Thomas, Summa Contra Gentiles, Book III: Providence (Q. 1–83), ed. Kenny, Joseph, OP, trans. Bourke, Vernon, online (New York: Hanover House, 1955)Google Scholar, chap. 58.5, http://dhspriory.org/thomas/ContraGentiles3a.htm; St. Thomas Aquinas, Summa Theologiae III, q. 65, a. 3, ad 1.
84 Aquinas, ST III, q. 65, a. 2.
85 Ibid.
86 Walsh, Liam G., OP, “Sacraments,” in The Theology of Thomas Aquinas, ed. Van Nieuwenhove, Rik and Wawrykow, Joseph (Notre Dame, IN: University of Notre Dame Press, 2005), 359Google Scholar.
87 St. Thomas Aquinas, Summa Theologiae Ia–IIae, trans. Fathers of the English Dominican Province, online (Kevin Knight, 2008), q. 110, 1, http://www.newadvent.org/summa/2.htm.
88 ST Ia–IIae, q. 111, 3.
89 Ibid., q. 111, a. 1.
90 Walsh, “Sacraments,” 332.
91 Thomas d'Aquin, Commentaire des sentences, IV, d. 26, q. 1, a. 1.
92 Aquinas, Thomas, Summa Contra Gentiles, Book III: Providence (Q. 84–163), ed. Kenny, Joseph, OP, trans. Bourke, Vernon J., online (New York: Hanover House, 1955)Google Scholar, chap. 122.4, 6, http://dhspriory.org/thomas/ContraGentiles3b.htm.
93 St. Thomas Aquinas, Summa Theologiae III, chap. 122.6, 8.
94 St. Thomas d'Aquin, Commentaire des sentences, IV, d. 27, q. 1, a. 1, sq. 2, ad 3.
95 Ibid., d. 26, q. 1, a. 1.
96 Ibid., d. 27, q. 1, a. 2, sq. 1.
97 Ibid., d. 27, q. 1, a. 2, sq. 4.
98 Ibid., d. 31, q. 1, a. 2.
99 Ibid., d. 31, q. 1, a. 3.
100 Thomas Aquinas, Summa Contra Gentiles, Book III: Providence (Q. 84–163), chap. 123.3.
101 Ibid., chap. 123.6.
102 Ibid.
103 St. Thomas d'Aquin, Commentaire des sentences, IV, d. 27, q. 1, a. 3, sq. 2.
104 Ibid., d. 34, q. 1, a. 1.
105 St. Thomas Aquinas, Summa Theologiae IIa–IIae, trans. Fathers of the English Dominican Province, online (Kevin Knight, 2008), 152, 4, http://www.newadvent.org/summa/2.htm.
106 Thomas Aquinas, Summa Contra Gentiles, Book III: Providence (Q. 84–163), chap. 136.7.
107 Ibid., chap. 136.4.
108 Ibid., chap. 136.7.
109 Ibid., chap. 123.7.
110 Ibid., chap. 136.9.
111 Ibid., chap. 136.10.
112 Ibid., chap. 136.11.
113 St. Thomas d'Aquin, Commentaire de la première épître de Saint Paul aux Corinthiens, trans. Charles Duyck, http://docteurangelique.free.fr/bibliotheque/ecriture/1co.htm; Thomas Aquinas, Summa Contra Gentiles, Book III: Providence (Q. 84–163), chap. 136.15.
114 Tabong and Adongo, “Infertility and Childlessness.”
115 Benjamin O. Nwoko, “Childless Marriage: A Pastoral Case Study of a Christian Practical Problem in Southeastern Nigeria” (PhD diss., Pontificia Universita Lateranense, 1986), 131–33.
116 See, for instance, Benjamin Nwoko's suggestions in Nwoko, “Childless Marriage,” 135–48.”
117 St. Thomas Aquinas, Summa Theologiae Ia–IIae, qq. 1, 7–8.
118 Ibid., q. 5, a. 3.
119 Ibid., q. 5, a. 5.
120 Ibid., q. 62, a. 1.
121 Ibid., q. 4, a. 8, ad 3.
122 Ibid., q. 62, a. 4.
123 St. Thomas Aquinas, Summa Theologiae IIa–IIae, q. 184, a. 2, ad 3.
124 Ibid. “First, as to the extent of love, through a man loving not only his friends and acquaintances but also strangers and even his enemies, for as Augustine says (Enchiridion lxxiii) this is a mark of the perfect children of God. Secondly, as to the intensity of love, which is shown by the things which man despises for his neighbor's sake, through his despising not only external goods for the sake of his neighbor, but also bodily hardships and even death, according to John 15:13, “Greater love than this no man hath, that a man lay down his life for his friends.” Thirdly, as to the effect of love, so that a man will surrender not only temporal but also spiritual goods and even himself, for his neighbor's sake, according to the words of the Apostle (2 Corinthians 12:15): “But I most gladly will spend and be spent myself for your souls.”
125 Ruhi-López, Angelique and Santamaría, Carmen, The Infertility Companion for Catholics: Spiritual and Practical Support for Couples (Notre Dame, IN: Ave Maria Press, 2012), 125–26Google Scholar.
126 Ibid., 124.
127 St. Thomas Aquinas, Summa Theologiae IIa–IIae, q. 26, a. 4.
128 Pope, Stephen J., The Evolution of Altruism and the Ordering of Love (Washington, DC: Georgetown University Press, 1994), 59Google Scholar.
129 St. Thomas Aquinas, Summa Theologiae IIa–IIae, q. 25, a. 4–5.
130 Pope, The Evolution of Altruism, 59.
131 Cox, “Toward a Theology of Infertility,” 30.
132 Cox is suggesting, for instance, that a theological move should be made from unitive and procreative to unitive and generative, where generative is more inclusive: “Generativity can encompass biological procreation yet also provide a framework for perceiving ‘fruitfulness’ more broadly.” See Cox, “Toward a Theology of Infertility,” 44–50.
133 Devor, Nancy Gieseler, PhD, “Pastoral Care for Infertile Couples,” Journal of Pastoral Care 48, no. 4 (1994): 355CrossRefGoogle Scholar.
134 Ruhi-López and Santamaría, The Infertility Companion for Catholics, 103–4; Gerrits, “Infertility and Matrilineality,” 240.
135 Ruhi-López and Santamaría, The Infertility Companion for Catholics, 121; Devor, “Pastoral Care for Infertile Couples,” 356.
136 Ruhi-López and Santamaría, The Infertility Companion for Catholics, 121.
137 Cox, “Toward a Theology of Infertility,” 50.
138 Tabong and Adongo, “Infertility and Childlessness.”
139 Devor, “Pastoral Care for Infertile Couples,” 357. As Devor points out, there is a loss of control and identity around sexuality and reproduction.
140 Ruhi-López and Santamaría, The Infertility Companion for Catholics, 88.
141 Ibid., 87.
142 St. Thomas Aquinas, Summa Theologiae IIa–IIae, q. 23, a. 1.
143 Ibid.
144 Devor, “Pastoral Care for Infertile Couples,” 358.
145 Ruhi-López and Santamaría, The Infertility Companion for Catholics, 86–87.
146 Ibid., 130.
147 Ibid., 132.
148 Cox, “Toward a Theology of Infertility,” 38.
149 Calpino, Teresa J., Women, Work, and Leadership in Acts, Wissenschaftliche Untersuchungen zum Neuen Testament 2, Reihe 361 (Tübingen: Mohr Siebeck, 2014), 2Google Scholar.
150 Ibid., 2.
151 Ibid., 166.
152 Calpino, Women, Work, and Leadership in Acts, 159.
153 Calpino, Women, Work and Leadership in Acts, 151.