Family Planning - Barrier Methods


Family Planning - Barrier Methods

Some contraceptive methods work by creating a barrier that prevents sperm from entering the uterus. The diaphragm and similar devices are inserted before relations and cover the opening of the cervix. These methods are permitted by some halachic authorities under certain circumstances. Condoms are not permitted, although an individual question can be asked in very extreme circumstances.

Spermicides are used together with some barrier methods to increase their effectiveness. When used alone, spermicides present few halachic problems (where contraception itself is permitted), but are only about 80% effective.

Diaphragm

Spermicide

Condoms

The Diaphragm

The diaphragm is a latex cup that is placed deep inside the vagina near the cervix, blocking the passage of sperm into the cervix. Spermicidal gel or foam is placed into the diaphragm to further discourage conception. The diaphragm needs to be fitted by a physician or by a qualified nurse or midwife. It is inserted before intercourse with the concave side surrounding the cervix, and removed after six hours. Used properly together with spermicide, it is about 95-98% effective in preventing pregnancy.

There are additional barrier devices such as the cervical cap, the contraceptive sponge, the Fem Cap, and Lea’s Shield. The contraceptive sponge, FemCap, and Lea’s Shield, do not require fitting by a health care professional. The efficacy of these methods is lower – about 85% for the sponge, 80% for the cervical cap, 84% for the FemCap for women who have never delivered vaginally and 71% for those who have, and 90% for Lea's Shield.

The diaphragm and similar devices are halachically more problematic than hormonal methods for two reasons. First, their use may violate the prohibition against illegitimate expulsion of semen (hotza'at zera l'vatalah). Second, they may prevent relations from taking place in a natural manner as required by halacha. Thus, contemporary halachic authorities disagree about the permissibility of the diaphragm.

Some rabbis consider using a diaphragm similar to "casting seed on wood and on stones," and prohibit its use except in rare circumstances. Others, equally authoritative, maintain that, since semen enters the vagina normally when the diaphragm is in place, there is no problem of illegitimate expulsion of semen. They also argue that intercourse is considered natural because the diaphragm is inserted too deeply to interfere with relations. According to these authorities, the diaphragm may be used in situations where contraception is permitted. As usual, a specific halachic question should be asked before using any barrier method of contraception. The response will depend on the rabbi's halachic approach and the couple's particular circumstances.

The cervical cap is similar to the diaphragm and raises similar halachic concerns. Since it covers only the cervix, there may be more cases in which its use would be permitted. The contraceptive sponge, FemCap, and Lea’s Shield occupy more of the vaginal canal than the diaphragm or cervical cap and are more likely to be felt during relations, so rabbis tend to be more hesitant to allow them. However, some authorities do permit their use.

Blood found on a diaphragm or similar device, like that found on bedikah cloths and tampons, is likely to make one niddah. The leniencies of stains do not apply. Therefore, it is best to remove and rinse a diaphragm or similar device without looking at it. If a woman does find blood on a diaphragm, and suspects it is from irritation to the cervix, there is room to ask a question.

Information in Hebrew on obtaining a diaphragm in Israel, including a list of women qualified to fit diaphragms, is available here.

Spermicide

Spermicide alone is available as a gel, foam, or vaginal suppository. It does not kill sperm cells, but creates a hostile environment for them. Most halachic authorities permit spermicide use when a couple is halachically permitted to delay pregnancy.

Spermicides that dissolve (e.g., films and suppositories) may be halachically preferable to foams, which create a physical barrier to sperm.

Spermicides are safe. Their major drawback is that they are only about 80% effective in preventing pregnancy. But spermicide can play a valuable role as a short-term contraceptive, where the consequences of pregnancy would not be catastrophic, especially when there are other factors (e.g., breastfeeding) that tend to reduce fertility. They may also be recommended as a backup method (e.g., if a woman missed a contraceptive pill).

For additional medical information about spermicides, please see our article Contraceptive Spermicides.

Note: As of summer 2015, over-the-counter spermicides are not readily available in Israel. They can be obtained from some pharmacies and private distributors. We are happy to respond to individual questions with referrals. Vaginal Contraceptive Film (VCF) can also be acquired with a form 29-gimmel, filled out by your physician.

Condoms

The male condom is a latex sheath that fits over the penis and prevents sperm from entering the vagina. A female condom is a plastic sheath between two flexible rings - one is placed in the vaginal canal and one is left outside the vaginal opening. Whether male or female, condoms prevent the natural flow of semen into the vaginal canal, violating the prohibition of hotza'at zera l'vatalah, and impede natural sexual contact. Therefore, they are prohibited as a method of contraception in almost all cases.

When required for infection control (e.g., one spouse is awaiting results of an HIV test following possible exposure, or the husband contracts CMV during the pregnancy of his CMV negative wife), condoms may be permitted temporarily according to some opinions (but not others) - a specific question must be asked.

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