Abstract: Jewish law (halacha) permits contraception under some circumstances and prohibits it under others. Contraception may be permitted for personal or health reasons and is required where pregnancy would endanger the mother's health. The couple should consult with a rabbi about delaying pregnancy and about choosing a contraceptive method.

Discussion: Jewish law (halacha) permits contraception under some circumstances and prohibits it under others.

Men are biblically obligated to have children (women have a central role in the fulfillment of this obligation). A man has fulfilled this requirement when he has a son and a daughter. There is also a rabbinic injunction to continue to have children even after the biblical commandment has been fulfilled. These obligations must be balanced with competing concerns, such as the mother's health and ability to cope.

According to Jewish law, the decision to delay pregnancy should be made by the couple after consultation with a rabbi who understands their personal and medical circumstances. The couple will turn to the physician for clarification of the medical issues needed to make the appropriate decision.

When there is a clear and current medical danger to the mother’s health, halacha mandates contraceptive use - something not all couples may be aware of. Should there be such a clear need, one important role of the physician is to articulate to his or her patients why pregnancy must be medically avoided and for how long.

The permissibility of contraception for the halachically observant couple involves two separate questions:

1. Is delaying conception permitted for this couple in their current life circumstances?
2. When permitted, what is the halachically preferred method?

Although not all observant couples consult with a rabbi first, most are concerned with using methods that religious guidelines deem most appropriate and that present the fewest side effects with religious implications (such as breakthrough bleeding).

Implications for Patient Care: Judaism does provide for the use of contraception when medically indicated. The physician should play an active role in explaining the need for such intervention.

The choice of a contraceptive method raises halachic issues, which should be taken into consideration when deciding on the appropriate method.

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