Ask The Rabbi: On being fruitful, part II

When birth control is permissible, which forms of contraceptives may be used?

By SHLOMO BRODY
In our previous column regarding birth control for newlyweds, we discussed whether couples must immediately attempt to fulfill the obligation to procreate, or whether they may temporarily delay before attempting to fulfill this central commandment. Inevitably, however, the risks and responsibilities of bearing and raising children lead to questions of proper spacing between pregnancies. Scholars debate the propriety of such family planning and which mechanisms may be employed toward that goal.
In a complex talmudic passage, the sages discussed the propriety of three women, including a nursing mother, of using a moch, usually translated as an absorbent tampon, to avoid pregnancy (Yevamot 12b). While most scholars understand the Talmud to debate whether using a moch is obligatory or optional, they disagree whether this was a pre-coital insertion (Yam Shel Shlomo Yevamot 1:8) or post-coital absorbent (Hatam Sofer YD 172). In addition to cases of concern for the safety of the mother and the fetus, the sages took into consideration the welfare of a mother’s infant child, who may be weaned prematurely before completing two years of nursing, the standard in talmudic times (Yevamot 36b).
Many scholars, including Rabbi Moshe Feinstein, deduce that barring potential health hazards, one should not use any contraceptives, particularly if the precept of procreation has not yet been fulfilled (Igrot Moshe EH 1:64, 1:102, 3:24). Legitimate concerns include development of diseases, postpartum depression and the possibility of bearing sick children (Nishmat Avraham EH 5:13).
Other decisors, however, have adopted a more lenient approach when an acceptable contraceptive method is employed. Mothers were granted by the sages certain dispensations, regularly given to the moderately sick, for the first two years following childbirth (Nidda 9a). This might precipitate a relaxation of the obligation to procreate. Equally significant, women nursing their newborns through full breast feeding are biologically unlikely to become pregnant. (This was particularly true in talmudic times, when nutrition was limited.) Nonetheless, the Talmud did not impose a limitation on nursing, even though it impedes pregnancy (Ketubot 60a). As such, Rabbi Yosef E. Henkin permitted birth control to allow mothers to give more attentive care to their children, although he expressed skepticism for this dispensation to facilitate returning to work (Bnei Banim 1:30).
Rabbi Ya’acov Ariel of Ramat Gan (Be’ohala Shel Torah 1:67), however, has contended that following the birth of a first child, a young mother may (temporarily) employ birth control for financial or educational concerns, since according to Halacha, the legal onus for procreation falls upon men alone (Yevamot 65b). Some have explained that women, possessed with a strong inclination to motherhood, do not need an additional command, with others alternatively explaining that the Torah does not obligate acts of self-endangerment (Meshech Chochma Genesis 9:7). Scholars debate whether women have an ancillary obligation to partner with their husband to fulfill this commandment (Shu”t Ran 32), or are included in the general obligation of populating the world (Aruch Hashulhan EH 1:4).
Be that as it may, Rabbi Ariel contends that this level of obligation does not preclude a woman from spacing her children in a manner that allows for basic educational and economic advancement, especially given the other considerations mentioned above. Similarly, in the context of permitting spacing, Rabbi Nahum Rabinovitch (Siah Nahum 94) cited the famed 10th-century philosopher Saadia Gaon (Emunot Vede’ot 10:9) for noting the complex emotional, societal and economic factors in raising families.
Leaving aside the larger question of precluding procreation, various contraceptive methods might also lead to violations of a woman’s conjugal rights (ona, EH 76) and illicit emission of semen (hotza’at zera l’vatala, EH 23). To avoid these problems, preferred contraceptives are those that minimally obtrude natural intercourse (EH 23:5). As such, condoms and coitus interruptus should not be used as methods of birth control (Otzar Haposkim EH 23). Voluntary abstinence, of course, might obviate these problems, and while a couple may choose such action (76:6), many scholars permit (when birth control is sanctioned) other contraceptive methods to preserve marital bliss (Igrot Moshe EH 1:63.) Tubal ligation and vasectomies should not be regularly performed since the Torah forbids permanent sterilization, except in cases of medical necessity (5:11).
Many decisors believe that diaphragms are halachicly superior to the talmudic moch since they block the entrance of sperm into the cervix, as opposed to directly catching the semen (Maharsham 1:58). This remains an option when necessary, even when used with spermicide (Havatzelet Hasharon II, Hashmatot). Yet most scholars give strong preference to hormonal pills, which temporarily inhibit fertility by preventing ovulation but do not impact intercourse, possibly similar to a liquid potion permitted in talmudic times (5:12). Medical interventions, however, have many ramifications, and couples should consult with their rabbi and doctor to determine the appropriate contraceptive for them.
The writer, on-line editor of Tradition and its blog Text & Texture (text.rcarabbis.org), teaches at Yeshivat Hakotel.JPostRabbi@yahoo.com