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

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Preferred contraceptive methods

19 April, 2005
Question:

Can you please tell me what the progesterone only options are for birth control?
Estrogen and Estrogen/Progesterone combinations are not an option.
Also, can you offer a hierarchy of best to worst form of birth control?
Thank you.


Answer:

The progesterone only options are: Progestin-only pills (“POP’s” – a few different formulations), Progesterone IUDs (Mirena), injectables (Depo Provera), and implants (Implanon, Nexplanon). Of these, the halachic preference is for Progestin-only pills.  Other options would be considered should problems arise with them.  Depo Provera is not usually recommended for women who keep hilchot niddah because it may lead to bleeding and staining that cannot be eliminated during the several months that the hormones remain active.

In general, the preferred option is hormonal birth control. For combination contraceptives this includes pills, rings and patches (there is no halachic advantage to any of these methods over the others). Next come the IUD and the diaphragm.  In Israel, the IUD is strongly favored over the diaphragm.  In the United States, some authorities favor the diaphragm over the IUD.  However, in some circumstances spermicide provides sufficient protection – and it is less of a halachic question than the IUD or diaphragm. In other circumstances, only long term contraception, such as an injectable, may be indicated.  In other words, a hierarchy of best to worst form of birth control depends on the individual woman, her medical history, and the reasons for birth control.

Please see our article on Choosing a Contraceptive Method for a more extensive discussion.

A rabbi should send a woman to her doctor for a ranked list of the options suitable for her and take that list into account before rendering a halachic ruling.

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