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

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IUD permissibility

3 April, 2005

Question:

I am so confused. I have never used birth control before. We have 5 sons and we  just had a daughter 6 months ago. We are living in tight quarters and the oldest is 12. Yeshiva is so expensive here. We do not own a house. I am over 40 but I have no idea what method of birth control to use. I am afraid of the pill because my sister died of a stroke at a young age after using hormone replacement. My Rabbi said the diaghram was not permissible and recommended the minipill. But my doctor said the minipill had only a 92% effacacy and was good only while nursing. While I was at the doctor's office, the doctor and I came to the decision that the IUD would be the best way to go. The Rabbi recommended not to use the IUD because he has heard 4 current cases of pregnancies after its use. I am also scared of long term risks such as cysts. My question is: does the IUD cause abortion of a fertilized egg? (copper 10 year?) Also, if I stain do I have to count 5 days and 7 clean days or can I just count 7 clean days from the time that I stain? Thank you.


Answer:

Typically, the copper IUD prevents fertilization.  Current studies show that the IUD works mainly by creating a hostile environment for the sperm, which prevents fertilization. There is controversy as to whether it sometimes also leads to abortion of a fertilized egg.  Rabbis are aware of these factors and widely favor use of the IUD where hormonal contraceptives are not appropriate.  Staining on the IUD or the pill is subject to the same laws as other stains.  Some do make a woman a niddah and some do not.  (See our article ketamim for more details.)  When a woman has become a niddah through staining, she waits five days before counting seven.

We recommend that you get back in touch with your rabbi.  You could explain to him that your doctor has assured you that the IUD would be the best, most effective contraceptive choice for you.  Studies show the IUD to be 98% effective.  Although some cases of pregnancy result when the IUD has been expelled, a woman can avoid this by checking prior to relations that it is still there. This is done by seeing if one can feel the strings that protrude into the vagina and can be done as part of mikveh preparation.  Since his objection was based on his understanding of the medical efficacy of the IUD, he should weigh your doctor's advice heavily.

Although it sounds as though you have some misgivings about using the IUD, based on the medical and halachic counsel that you received, you should give it a try.  Should a problem arise, chas veshalom, please contact us. 


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