Are Rabbis Too Strict about Birth Control and Abortion?

baby-footThe Orthodox website Kipa.co.il billed the Kolech conference on fertility as an “anti-Puah” event. Puah is an institute that helps couples with issues related to sexual health and fertility in a halachic framework. (A representative of Kolech insisted that the headline was invented by Kipa.)

I gathered from the forum discussion that the main complaint against Puah is that it tends to be machmir on certain issues, perhaps because they want to be acceptable to a haredi clientele. This means that fewer options might be offered to infertile couples, especially if the problem lies with the man. And since most fertility treatments for women involve hormones, they may increase risk of cancer and other health problems.

This ties into the lecture by Ronit Ir-Shai of the gender studies program in Bar-Ilan, who spoke on “Halacha and Fertility: Ideology and Reality.” Ir-Shai was the most outspoken and “feminist” of the speakers. She raised many issues that made me uncomfortable, and I suspect some readers will be  as well. If you come here for inspiring stories or aliyah tips, and feminism makes you cringe, you may want to stop reading.

Ir-Shai quoted many rabbinic sources, but I wasn’t able to get them all down. The conference was taped and I hope it is available on line.

Ir-Shai started off by saying that only in recent times has abortion been viewed solely as an issur de-orayta. In previous generations, some poskim held that it was de-rabbanan.  Most rabbis today only permit abortions in the case of real physical danger to the woman. If there is a problem with the baby including Down Syndrome, leniencies are also found. But if the mother has financial, personal or career reasons for wishing to end the pregnancy, these are not taken into consideration.

The same thing is true with birth control. The rabbis give little weight to considerations of finances and chinuch. A great deal of self-sacrifice is expected from women, in order to continue to have more children.

When it comes to technological advances in fertility, however, the opposite is true. Rabbis permit artificial insemination and surrogate motherhood without much debate. The only halachic discussion about surrogacy is about which mother is considered the halachic mother. Except for Rabbi Yuval Cherlow, no rabbi has brought up the ethical issues involved, such as whether surrogate motherhood takes advantage of underprivileged women, and the ethics of —œrenting— someone’s body part.

Ir-Shai concluded that when it comes to questions that limit birth, like abortion and birth control, the rabbis are extremely strict. But when it comes to matters that encourage birth, leniencies are found to allow new technologies. And these technologies cause women to suffer, as does the push to have more children.

Ir-Shai maintains that the woman’s point of view in these issues is not considered. The woman is simply seen as a vessel for producing more children.

She then went on to quote a number of responsa by well-known poskim, including rishonim, that were much more lenient about both birth control and abortion. Yet today their opinions are rarely cited.

Glossary:

  • machmir: rules strictly on Jewish law.
  • poskim: arbiters of Jewish law
  • issur de-orayta: a prohibition on the Torah level, with little room for lenience
  • issur de-rabanan: a rabbinic prohibition, allowing more leeway than de-orayta
  • chinuch: education. This doesn’t mean tuition, but the ability to raise the child properly.
  • rishonim: poskim from after the talmudic period (10th to 15th century), whose opinions hold extra weigh in Jewish law.

Thanks to reader Keren for sending me the links to the Kipa discussions.

Ynet report on conference (English)

Fertility and Halacha

Are Mature Religious Women Leaving the Fold?

Body and Soul in Fertility, Halacha and Science

Legal Age of Marriage: 18, 17, or . . . 15?

Interview with an Orthodox Sex Therapist

Photo credit: sabianmaggy

Check out the 2016 fashions at Hydrochic modest swimwear.

Comments

  1. That sounds pretty accurate – what is offensive about it?
    Makor rishon had an article a few months ago about this issue. Many couples are infertile, because ovulation falls in the “clean week” after menstration. Machon Puah recommends that these women take hormones (with all the problems mentioned above) rather than go to the mikvah earlier. The clean week is clearly derabanan, yet very few poskim are willing to let women go to the mikvah early.

    • The Shiva Nekiim while Rabbinic, are based on a sofek d’orraitta, as our Rabbis decided that we are no longer expert enough to be able to tell the difference between dam zava and dam niddah. The d’rabbanan of this is that today we apply the stringencies of both to any bleeding. So it is a little more complicated than simply saying that they are “only d’rabbanan.”

      The Shiva Nekiim(clean week) is actually a d’oraitta for a zava gedola. Thus any Rabbi who want to psak l’kula has to consider that he may be instructing someone to transgress a lav d’oraitta.

    • Ariella another and much easier answer is an IUI timed with ovulation, which many authorities do permit.

  2. what I wrote above is a clear example of modern halachik authority viewing the woman as a vessel adn not taking her health into account.

  3. I think it’s important to add the she showed how earlier responsa considers financial reasons a perfectly good reason to postpone children, even before the couple had a boy and a girl thus fulfilling the halachic demand of pru urvu. today it is considered a problematic reason- if not a selfish excuse. another reason that allows pushing of children in early days is the father’s wish to learn Torah!.
    Another point she made that I found important is that because Halacha stresses the mitzvah of having children so strongly (possibly for historical-survival reasons) it puts infertile couples in a position that almost doesn’t allow them to give up. The assumption is that everyone wants to have children and the halachic and medical advances are to everyone’s benefit, but if someone was willing to come to terms with their infertility, Judaism almost forces them to keep on trying painful and invasive methods to solve their fertility problem

    • When you say Judaism almost forces couples to keep trying, are you referring to halachic or social pressures? If you mean the latter, I’d agree. But as one who suffered through primary infertility (including halachic infertility as part of my problem), I never encountered anything halachically that made me feel forced to conitnue.

      • her claim was that alot of the social preassure results from the stong halachic preassure. it is almost unacceptable to be a jewish family without kids.

        • The social pressure exists, but there is zero halachic pressure. A couple who cannot conceive naturally is patur from pru urvu (i.e. the man is) no mathe if it’s female or male infertility. Also, I’ve heard of no rabbis will pressure a man to divorce his wife after 10 years. Many rabbis do not allow fertility treatments after the couple had a certain nnumber of kids (2 or a boy and girl depending on the rabbi). The logic behind this is that infertility treatments pose a risk to the woman (and sometimes the man too) but a childless woman usually suffers a lot so ending her suffering takes precedence over the risk of treatment. Once she had children then there is no heter to risk her life again.

          The important point is that halacha and rabbanim who are experts in infertility do not put pressure on couples. Everyone else does.

    • Shlomit there’s financial and there’s financial. Nowadays many of those who are talking financial hardship mean that with one more child they can’t send anyone to summer camp. A teacher of mine claimed in the Old Yishuv there were abortions (let’s guess at an earlier stage of pregnancy than when Downs gets detected) because financial hardship meant no one could EAT!

  4. Not sure what is offensive about this. She makes some salient points. Very interesting.

  5. anon4this says:

    i understand that things happen in infertility treatments and other procedures that would need a halachic ruling, but in terms of birth control i am over having a rabbi be a part of it.

    when i got pregnant with my youngest i had let my heter for bc peter out, expecting that it would not be renewed because i didn’t have a “good enough reason”. i operated on hope that i wouldn’t get pregnant. it didn’t work.

    i spent a lot of that pregnancy wishing i wasn’t pregnant. it was horrible. i wasn’t a good wife or mother or mother-to-be.

    thankfully it was all ok in the end. i guess a lot of people would tell my story as an emunah-strengthening story with swelling violin music or something, but i took the opposite tack and from then on made birth control decisions with my husband instead of outsourcing them. this probably makes me less frum, but i feel more in control of my life.

  6. Anon, good for you. The Talmud mentions birth control, but never a woman or her husband discussing it, much less asking permission, from a rabbi.

  7. It is indeed the case that some strains of contemporary halachic literature have taken stringency on this issue to unprecedented levels. This is, of course, partly a reaction to modernising trends. Here are a couple of articles which explain the basis for using contraception, even at the start of marriage (the second link is to a journal with the article in it):

    http://www.yctorah.org/component/option,com_docman/task,doc_view/gid,1398/
    http://www.yctorah.org/content/view/371/53/

    It should also be remembered that the mitzva of having more than a boy and a girl is not a chiyyuv according to most rishonim, as paskened by the Aruch HaShulchan, who also stresses that the mitzva is for one ‘whose economic position allows him to support them’ (I don’t think accepting welfare should qualify for that – essentially you are being makpid on a mitzva at public expense, which is frowned on by Chazal; ‘aseh shabbatcha chol ve’al tiztarech labriyot’). There are even elements of our tradition (see Emunot Ve’Deiot of Rav Saadia Gaon 10:9) which do not see a huge family as an unmitigated blessing. Rav Henkin and Rav Hershel Schachter hold that even the mitzva of ‘la’erev al tanach yadecha’ is fulfilled with two girls and two boys. The Avnei Nezer (EH 1) brings a limmud zechut to consider one who has only had two boys and no girls to have fulfilled ‘pru urevu’. Rav Schachter (in a shiur available on the yutorah website) criticises those who have children when they cannot cope, and even when they cannot pay their school fees, leaving the burden on others. Rav Henkin stresses that 7 children is considered an extremely large family in Tanach (by Yaakov Avinu it was from more than one mother), and on a website run by his talmidot is quoted as ruling that “(he) permits a couple that has already fulfilled the mitzvah of piryah v’rivyah (the Torah commandment to be fruitful and multiply) and has compelling reasons not to have more children, such as concerns about the woman’s health, finances or shalom bayit, to practice contraception indefinitely, (B’nei Banim II:38).
    There is a teshuva from R. Moshe Feinstein in Igrot Moshe (EH 4:74) which allows the using contraception after peru urevu has been fulfilled ‘if there is a financial reason or another important reason’.

  8. Personally, I think that birth control should be solely the decision of the couple.

    However, I am offended by the idea of having an abortion contrary to Jewish law. It is fairly clear in Jewish law that we only permit abortion when the mother’s life is danger(Sh”A C”M 425:2). Doing so for convenience, or a possible diagnosis of Down’s Syndrome does offend me. Especially as we were *strongly* encouraged to abort our son, because he was “diagnosed” with Down’s based on a faulty ultra-sound. He was born perfectly healthy.

    • encouraged to abort at 40+ weeks as a matter of fact. By a doctor wearing a scarf on her head. Don’t even get me started on the “emergency” c-section that I was later told wasn’t necessary.

  9. In the U.S., the generally accepted psak says you can’t limit family size due to financial reasons, though you can for other reasons, like not being able to handle any more kids. It never made sense to me, because many people could handle more kids if they had more money – they could hire more household help, for example. It seems silly to forbid birth control completely for financial reasons. One’s ability to nurture a large family is partially based on one’s financial means.

  10. There are many poskim who extend that hetter for abortions far beyond cases where the mother’s life is threatened. See here:
    http://rationalistmedicalhalacha.blogspot.com/
    and here:
    http://hirhurim.blogspot.com/2005/06/abortion-iv.html
    Rav Shaul Yisraeli, a leading posek, allowed (in certain cases) abortion if the foetus was severely disabled. The Tzitz Eliezer permitted abortion when a foetus was diagnosed with Tay-Sachs. In the rishonim one finds even more lenient opinions.

  11. Rabbis allow IVF without much discussion?! Really?! She must be reading a VERY limited set of Poskim, because it’s actually quite a sensitive issue.

    As for the issue of “halachik infertility” it turns out that in most cases, there are other issues anyway, because under most circumstances this should not be happening. In most case when this kind of thing happens, it’s actually a signal that other issues may be at play. For instance, if a woman has a very short cycle (less than 27 days), she’s likely to run into timing issues, but in many cases she is not ovulating anyway. And even when she is, often the short cycle indicates hormonal issues that make a woman’s chance of conceiving lower. Of course, this is not true all of the time, but the issue of infertility purely as a matter of timing is a lot rarer than it’s often made out to be. In those cases Rabbanim DO look for ways to deal with it. It’s not always that easy, but they do try. And, ultimately, if it comes down to using hormonal methods to push off ovulation, a woman can always decode that she isn’t willing to take that extra level of risk.

    • Another observer says:

      I usually “lurk” here due to time constraints, but will make the effort to chime in on this one.

      “Observer’s” contention that a cycle shorter than 27 days generally indicates other problems is, quite simply, incorrect. The medical community regards anything between 21 and 35 days as normal.

      Many “older” kallahs (30+) suffer from halachic infertility simply due to age-related cycle shortening. They might have cycles in the 25-27 day range, which is perfectly “normal,” but problematic from a “timing” point of view. There is no reason to assume that these women have hormonal or other problems, apart from the natural decline in fertility that comes with age. There definitely is a population of women in their 30s who are still quite fertile, but who would have trouble conceiving without medical intervention due to the timing problems that arise with taharat hamishpacha.

      It is great that this issue has become more widely discussed in the Orthodox community. When I was an “older” kallah in the late 90s — and well aware of the potential problem — my madricha seemed never to have heard of it, and had nothing reassuring to say to me.

      Of course, it only took one gynecologist visit to get the reassurance and help that I needed in order to conceive. I have trouble understanding why hormonal treatment for halachic infertility is getting such a bad rap. If we’re talking about women who have no real medical issues, just a shortish cycle, it shouldn’t take that many months to conceive, and so the risk factor is not all that high. OTOH, if one had to take hormones for a couple of years due to halachic infertility, that would be a different story. But in such an instance, there might indeed be other problems.
      It’s a lot easier to take hormones for a couple of months than to chuck out centuries of halacha.

      • “Another observer,” thanks for checking in with that information.
        I don’t believe that we are talking about a couple of months of hormones. I think the issue is long-term use, or repeated IVFs.

        • Hannah,
          1. you’d be surprised. some women and some doctors are against giving any amount of hormones for any given time, since there is still not enough knowledge on how this effects women’s health, and the knowledge that does exist- well, not encouraging. These women would claim exactly what your first commenter said- that giving hormones to a women as opposed of pasking lekula on tvila, no matter how many generations it’s been around, does not take the women as a subject into consideration.

          2. I don’t know enough about potential problems, but the woman from Nishmat who spoke after Ronit referred to the issue of Halachic infertility and said, that it got a lot of attention but the fact of the matter is, there is a much smaller percentage of women who suffer from it than we’d think, and there are many other issues out there that are not as simple as pushing off your cycle by a few days.

      • –The medical community regards anything between 21 and 35 days as normal.–

        Not most specialists. While it’s true that for some women, it really is not an issue, I’ve seen enough REs (those are the doctors who specialize in this issue) refer to anything lower that 27 days as “medically irregular.”

        –There is no reason to assume that these women have hormonal or other problems, apart from the natural decline in fertility that comes with age.–

        Yes, but that decline is a real issue. And, it’s the reason why many doctors will say that the normal medical advice to wait for a year of trying should not be applied to a woman over 30, because the decline in fertility can make it much harder to find a successful treatment for an otherwise healthy woman.

  12. IT seems that if she said: “The same thing is true with birth control. The rabbis lives little weight to considerations of finances and chinuch. A great deal of self-sacrifice is expected from women, in order to continue to have more children”. Then this is a big generalization. Machaon Puah is trying to be acceptable to many people but they do not generalize, but treat each couple as an idividual according to their relgious backgrounds. They are the forerunners of halachic rulings about Nidda laws that are very different from those of haredi rabbis.

    I think that most people are aware that there are a wide range of different rabbis and that rabbis in the datu leumi keep halacha just as well as haredi rabbis.

    Today a wide range of rabbis do say that women can use birth control for a wide range of reasons, especially psycological and emotional. Today there are rabbis who permit a couple to use it immediately after marriage.

    I think that she was presenting a too extreme view of the rabbinical camp, which is not something that helps are argument

    (p.s, I think it was not me who sent the link to ynet).

    • I don’t know what she would say to that, but MY criticism of this is exactly this personal level private ruling. there are a lot of couples out there who do NOT know that they could get a heter for birth control and that is because the public rhetoric against it is very different than the private, personal-based rulings which in certain circles tends to be surprisingly mekel. this stops people from asking because they are assuming they know the answer. I am pretty sure I know a case like this- a mother of seveal children who does not seem to be handling the pressure all that well. I have a strong suspicion she does not even consider the possibility she may be eligible for a birth control heter.

      • That’s a shame. But the real problem is not the public rhetoric, but the poor education that leaves people unaware that most things need a personal discussion with a *knowledgeable* Rav (of whatever camp you belong to.) Rhetoric of the sort presented here, including claims that “Rabbis don’t consider a woman’s point of view” (flatly untrue, by the way) don’t help.

    • It’s a big jump from:

      “Ir-Shai concluded that when it comes to questions that limit birth, like abortion and birth control, the rabbis are extremely strict. But when it comes to matters that encourage birth, leniencies are found to allow new technologies.”

      which is pretty agreeable, to:

      “Ir-Shai maintains that the woman’s point of view in these issues is not considered. The woman is simply seen as a vessel for producing more children.”

      Which sounds alot like, those rabbis are just using the patriarchal power of halacha to keep women down.

      Pretty offensive to anyone who is shomer mitzvot.

  13. re short cycles and going mikveh early – there is definitely a kula to make a hefsek on the 4th day, which i have heard from rabbinic experts. sometimes 1 day can make enough difference for a woman who is trying to conceive. AIH is another halachically acceptable and often successful option. the hormone route involves only taking something for a few days a month, for a few months at most and it often has a “knockon” effect so that subsequent cycles are longer. As a kallah teacher i mention this to all my kallahs, so they should be prepared if it happens to them, rather than struggling to conceive and despairing. all these solutions should be checked with your sympathetic rav.

    • –As a kallah teacher i mention this to all my kallahs, so they should be prepared if it happens to them, rather than struggling to conceive and despairing. all these solutions should be checked with your sympathetic rav.–

      SOOO important to encourage young women to ask a Rov, and never assume anything. “everyone knows” is a really, really bad basis for decisions.

      I had a really awful Kallah teacher. But, one good thing she did was to knock into our heads that you need to “Ask a Rov! Don’t assume it’s assur!”

      May I make another suggestion, that fits right in? Let your students know that if their Rav makes them feel stupid, it’s ok to find another Rov. “Rov shopping” to get the psak you want is a problem. But finding a Rav that will take you seriously and will treat you right is another whole kettle of fish, and is generally the right thing to do.

  14. Mrs Belogski says:

    There are herbal/alternative remedies for adjusting one’s cycle. Dong Kwai if you are under 40 and agnus castus if you are over 40. they can also reduce symptoms of PMT, which can only be good!

  15. Shlomit I agree with your concern that the public discussion doesn’t seem to be very accommodating. And while Puah might be very helpful to many couples on a one-on-one level, there are plenty of reasons for them not to publish some sort of “hey look how meikel we are” document for the public.

    For one, ultimately these issues are very private. For another, the point is to work both with a posek and in a framework of knowledge and support – while someone who reads a poster and makes their own decision will miss both.

    Society is rather dysfunctional nowadays – whether it’s wealth that has gotten us into this mess (too many people to keep track of and raise well!) or some other reason, so we get these extreme presentations (all Rabbis say no, all feminists say ditch them). But B”H for those kallah teachers who do mention some basic availability for heiterim – as regards shortened cycles or overwhelmed mothers – because that opens the door to realize there might be even more to discuss.

    And sometimes you find a Charedi couple seeking out Puah or an obviously non-Charedi but heavy-weight Rav because they know a heiter might be available, or at the very least a non-judgmental discussion.

    Standing up and making a stink at a conference only further entrenches the intolerance we want to fight – it sounds like the variegated view from the Nishmat speaker has a better chance of making the right inroads in the public awareness.

  16. I think the leniencies for fertility treatments are b/c couples – and women – are asking for them! And often expressly asking for them not only to “be mekayem pirya verivya,” and for the couple’s happiness – also specifically to alleviate the woman’s pain and become a mother. I don’t think there’s any requirement to take advantage of fertility treatments. It’s true that when they are available, and considered permissible, and many OJ couples who are having trouble conceiving use them – that social reality creates pressure. But this is a social fact created by the couples themselves! Indeed, some time ago, I saw a thread discussing a rabbi who spoke at a fertility conference and was somewhat negative toward fertility treatment. He didnt say it was ossur, merely that the woman is not obligated to undergo health risks and take treatment and that he’s not in favor of it. The response was really hostile! I wrote in that voices like that are necessary, because woman and couples may feel it is their duty to undergo treatment and they should know that its not clear-cut and that anyway they have the right to forgo treatment. I got back responses like “what woman wouldn’t do EVERYTHING IN HER POWER to have children.” “How dangerous is it anyway.” “He is scaring women, and it’s not dangerous.” The women writing in wanted to be encouraged to do everything they could to have children. The message that this is not necessary was not welcome. Naturally there are women and couples “out there” who don’t want to undergo repeated treatments, but realistically, the pressure to do so most likely comes from the social reality that others do want to do “Everything in their power,” rather than from the rabbis who issue lenient rulings.

    • –I think the leniencies for fertility treatments are b/c couples – and women – are asking for them! And often expressly asking for them not only to “be mekayem pirya verivya,” and for the couple’s happiness – also specifically to alleviate the woman’s pain and become a mother.–

      This is absolutely the case. Talk to the people who run ATIME (or Machon Puah, but ATIME does more of the support stuff), and they will confirm that.

  17. In the YU world, a number of poskim are VERY considerate of newly married couples with regard to using brth control. Some give a heter for a year, but the more sensible approach (in my very un-halachic opinion), is a 6 month dispensation.

    The rav sits down with the couple and discuss es why they feel they need it, giving particular attention to the woman and what her concerns are. Then, he usually gives a 6 month heter and tells then to check in with him then to see where they are holding with regard to having children and what their lives entail.

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