Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Contraceptive options at 46

31 May, 2009

Question:

We have 10 children, baruchHashem/bli ayin harah, and I am 46 years old.  I have nearly been diabetic for the last four pregnancies and have been bed-ridden for a major part of the last five pregnancies.  I have varicose veins, very high cholesterol, mood swings, and am extremely financially challanged.

My gynecologist has told me I am not a good candidate for hormones and my physiological make-up will not benefit from a diaphram.  IUD would be OK (but I have some uneasy feelings about it, it seems to me to be a perpetual abortion?).  I would like to know halachically what is recommended for someone in my situation.  I understand that having one's 'tubes tied' is not a halachically acceptable option.  I will be having bladder surgery shortly; one doctor recommended I have a hysterectomy at that time.  It seems drastic.  I would greatly value advice as we are using 'abstinence' at present.

I am about to wean my two-year-old. I have only been in niddah once since her birth, so I have no regular period to use any kind of 'rhythm method.'


Answer:

In your case, the IUD could be a good option. 

Current studies show that the IUD works mainly by creating a hostile environment for sperm, which prevents fertilization. There is controversy as to whether it sometimes also leads to abortion of a fertilized egg.  But indications are that, if this happens, it happens only something like one percent of the time.  Rabbis are aware of these factors and widely favor use of the IUD where hormonal contraceptives are not appropriate. Please see our article on the IUD for more information.

Another possibility to raise with your physician would be spermicide.  Spermicide is significantly less effective than other methods of birth control.  However, fertility tends to decrease with age.  Depending on your current fertility level, spermicide may provide a sufficient level of efficacy. 

Contraception via sterilization, as with a tubal ligation or hysterectomy, is not usually permissible.  Both contravene a rabbinic-level prohibition against a woman's sterilizaton.  Tubal ligation is sometimes considered as a method of last resort if other methods cannot be used.


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