Scripture does not speak directly to the question of whether or not it is biblically appropriate to use contraceptive measures. There is no explicit biblical passage that mentions the term "contraception," nor are there any plain texts that specifically address the issue of whether or not it might be appropriate to use contraceptive measures. This said, however, one should not assume that Scripture is completely silent on the matter.
The Question of the Legitimacy of Contraception in General
As noted above, Genesis 1:28 identifies procreation as a primary end of the marital union, while Psalm 127 describes children as a blessing from God. Thus, when considering the question of whether or not to use contraception, one must start from the perspective that having children is the expected norm for marriages and should be understood as a good gift from a loving heavenly Father. In the words of Albert Mohler, "We must start with a rejection of the contraceptive mentality that sees pregnancy and children as impositions to be avoided rather than as gifts to be received, loved, and nurtured. This contraceptive mentality is an insidious attack upon God's glory in creation, and the Creator's gift of procreation to the married couple."
Having recognized the important connection between sexual expression and childbearing, however, does it follow that every act of sexual intercourse must "be open" to conception? Those who answer this question in the affirmative will often cite the Genesis 38:6-10 account of Onan and Tamar in support of their position. In this passage, God takes the life of Er, the oldest son of Judah, because he was "evil in the sight of the Lord" (NASB) leaving his wife Tamar a widow. The Hebrew custom known as levirate marriage (Deut. 25:5-10) stipulated that when a married man died without leaving offspring, his widow should marry the dead man's next closest male relative. The first child from that subsequent marriage would then take on the name of the older brother and become his heir so that the name of the first husband "will not be blotted out from Israel" (Deut. 25:6, NIV).
In the present instance, Onan, as Er's next oldest brother, therefore was to take on the responsibility of providing Tamar with a child. According to Genesis 38:9, however, while Onan did indeed have sexual intercourse with Tamar, he prevented her from conceiving a child by withdrawing from her prior to ejaculation. Instead of providing her with an heir for her first husband, Scripture indicates that he "wasted his seed on the ground" (NASB). As a result, his action was "displeasing in the sight of the Lord," and God took his life as well (v. 10, NASB).
Roman Catholics typically cite this passage to suggest that what particularly displeased the Lord was the interruption of the sexual process for the purpose of preventing procreation. Every act of sexual intercourse, it is argued, ought to be open to procreation. Thus, the interruption by Onan, as well as any form of interruption or use of artificial means to prevent conception during sexual intercourse, is morally reprehensible. In their view, all means of contraception that interrupt the natural process of procreation are contrary to God's will.
Upon closer scrutiny, however, it appears that the Lord's displeasure in Genesis 38:10 ought not to be equated with the prevention of pregnancy per se but with the particularly exploitive, abusive, and wasteful way in which Onan carried out his sexual relations with Tamar. Deuteronomy 25:5-10 indicates that if the brother refuses to complete his "duty" to provide an offspring, the penalty is not death but shaming (vv. 9-10). It would appear, then, that the severity of the punishment indicates that reasons beside the refusal to provide an offspring for his deceased brother prompted God to take Onan's life.
How, then, ought oneo reason biblically with regard to contraception? Scripture indicates that, in addition to procreation, God created marriage to meet other ends as well. Companionship through the development of a sacred marital bond (Gen. 2:18, 24), sexual pleasure (Prov. 5:15-23, Song of Songs), and fidelity (1 Cor. 7:1-9), to name but a few, are all biblically appropriate purposes for which God created the marital sexual union. Therefore, while it seems clear that over the course of their marriage a couple ought to seek to have children (perhaps even many, see Ps. 127:5), it does not follow that in every particular sexual encounter the couple need to refrain from the use of contraception. The sexual encounter in marriage retains a high value for the purposes of union, pleasure, fidelity, and so on, even in the event that a couple uses contraception as a part of their family planning. Indeed, "[t]he focus on 'each and every act' of sexual intercourse within a faithful marriage that is open to the gift of children goes beyond the biblical demand."
Morally Permissible and Impermissible Forms of Contraception
Concluding that the use of contraception is morally permissible in general, however, does not mean that any and every particular form of birth control is morally acceptable. Indeed, because passages like Exodus 20:13 specifically prohibit the taking of innocent life, the "profound respect for life in the prenatal stage" found in the Judeo-Christian ethic must also influence one's perspective on which forms of birth control are biblically permissible.
Acceptable Forms of Birth Control
Which forms of birth control are morally acceptable? In short, the answer is that it is only those that are contraceptive in nature, that is, those that exclusively prohibit conception. Resting on this foundational principle, one can then fairly easily evaluate which forms of family planning are appropriate and which are not.
Acceptable forms include natural methods such as abstinence (the only biblically legitimate option for those who are not married) and the rhythm or calendar method (in its various forms such as relying on the body temperature cycles or timing of ovulation and fertility periods).
In addition, artificial methods that exclusively seek to prevent conception are also morally acceptable. These include "barrier methods" such as a diaphragm, a cervical cap, and condoms and spermicides such as foams, creams, sponges, or vaginal suppositories.
Unacceptable Forms of Birth Control
Unacceptable forms of family planning include all forms of induced abortion. Thus, the intrauterine device or "IUD" is an unacceptable method, because its primary function is to create an unstable environment for the fertilized egg to implant in the uterine wall by depleting the endometrial lining, making it incapable of supporting the life of the child.
RU-486 or the so-called "abortion" or "morning after" pill is likewise morally unacceptable since its primary function is to prevent the implantation of a new fetus in the uterine wall. The drug works to directly prohibit the establishment and continuation of the pregnancy by blocking the body's natural secretion of progesterone, the vital hormone that prepares the uterus to receive a fertilized egg and to help maintain the pregnancy once it occurs.
Methods Requiring Special Mention and Extra Care
Special mention needs to be made at this point about two forms of birth control widely practiced by Christians and non-Christians alike: sterilization and the use of "the pill."
Sterilization as a means of contraception involves a surgical procedure designed to permanently terminate a person's fertility. For the male, a vasectomy blocks the vas deferens (ejaculatory duct) and thus prevents the sperm from leaving the body during ejaculation. For the female, "tubal occlusion" is the procedure that effectively blocks a woman's fallopian tubes in order to prevent sperm from coming into contact with the woman's eggs, thereby preventing fertilization.
There are several important considerations with sterilization that may caution us against its use. For instance, it is an elective procedure that involves the intentional and permanent setting aside or inactivation of a bodily function. The permanence of the procedure makes it a different case from the use of a condom or other temporary measures. In addition, we might ask whether it is ever right to remove a part of one's body (cf. Lev. 21:20; Deut. 23:1; 1 Cor. 6:19) simply for convenience's sake, and whether this is the proper way to treat the body as the "temple of the Holy Spirit" (1 Cor. 6:19).
In both Old and New Testaments, Scripture indicates that while care for the physical body is not to be of primary concern, it should be treated with honor and respect (cf., e.g., Gen. 2:7; Ex. 21:22-25; 1 Cor. 6:12-20). As ethicist John Jefferson Davis contends,
The apostle's point is that the believer does not have the right to exercise unlimited dominion over his or her body but should view the body as a trust from the Lord, to be cared for in ways that are glorifying to God. And surgical operation -- such as sterilization -- is not merely a personal "choice," but a decision that needs to be seen within the biblical framework of stewardship of the human body. Given the fact that our human bodies are a trust from God, and in light of the positive valuation placed on human procreative powers and large families in the Old Testament, these powers should not be rejected or surgically destroyed without compelling justification.While the subject has yet to receive adequate attention among evangelicals, some might respond that the same reasoning adduced above regarding the appropriateness of using certain forms of contraception applies here as well. God has given us intelligence and powers of judgment to fulfill his command to "be fruitful and multiply" in our individual personal circumstances in keeping with scriptural commands and principles (such as the sacredness of human life). In light of our conclusion that it is fallacious to interpret this command to mean that every act of marital sexual intercourse must be open to procreation, it would seem appropriate that a given couple could determine that they have reached the point where they believe God would not have them conceive any more children. The question, then, becomes whether or not sterilization is a legitimate means of ensuring that no additional children are conceived. Indeed, while not every Christian would agree that sterilization involves an improper violation of one's body as the temple of the Holy Spirit, it is vital that believers submit their personal desires to a prayerful consideration of what is scripturally permissible.
While arguments can be made both against and in favor of sterilization as a form of birth control for Christians, therefore, since Scripture does not directly address the various forms of modern sterilization practices, it seems appropriate to refrain from dogmatism in this area. Where Scripture does not directly address a given matter, biblically informed principles must be applied to specific issues with wisdom and care. We have known godly couples who assured us that they pursued sterilization in an attitude of prayer and trusting the Lord. We have also known other, equally godly, couples who later regretted having followed through with this procedure and sought to reverse it in order to have more children. Both cases suggest that it is imperative that a couple who would use a given method honestly search their hearts and motives during the process of making such a decision and be certain that pragmatic considerations and personal desires do not override scriptural principles or unduly shape what they perceive to be the leading of the Holy Spirit.
Another birth control method requiring special mention and extra care is what is popularly known as "the pill." Because of its wide acceptance in the culture, some Christians may be surprised to learn that the moral acceptability of "the pill" (and the many various applications of the same basic chemical products) is under question by Christian ethicists. Yet, while the convenience and effectiveness of this form of birth control have certainly commended it to many, there are serious moral questions that must be addressed before a decision is made as to whether or not "the pill" qualifies as an acceptable form of contraception.
There are two basic categories of hormonally based chemical contraceptives: combined and progestin-only contraceptives. Combined contraceptives (containing both estrogen and progestin) come in both an oral form (usually referred to as COCs -- combination oral contraceptives -- such as Ortho Cyclen or Ortho-trycyclen) and an injectable form (CICs -- combined injectable contraceptives -- such as Cyclofem and Mesigyna). Progestin-only contraceptives likewise are produced in oral and injectable form. Progestin-only pills (POPs) contain the hormone progestin and are taken daily, while progestin-only injectable contraceptives (PICs) such as Depro-Prevara and Noristerat require an injection roughly once every two to three months. Norplant is another version of progestin-based birth control involving a surgical procedure to insert small tubules containing progestin under the skin. This method is said to be effective for years.
According to the Physician's Desk Reference, all of these versions of both combined contraceptives and progestin-only contraceptives work by employing the same three basic mechanisms of action. The first of these is to prevent ovulation (a contraceptive mechanism). The second is to alter the cervical mucus buildup which increases the difficulty of the sperm entering the uterus and thereby fertilizing the egg (a contraceptive mechanism). The third mechanism -- in all forms of both combined contraceptives and progestin-only contraceptives -- whether intended or not, is to inhibit the endometrium (uterine lining), thereby making it incapable of supporting the life of the newly conceived child should fertilization take place. This third mechanism, then, is not a contraceptive measure but an abortifacient, that is, the mechanism works as a "fail safe" means to control birth if the other two mechanisms do not prevent contraception.
PDRHealth.com, a web service provider which bases its information on the material from the Physician's Desk Reference, describes these three mechanisms in the following manner:
Suppression of ovulation is the main mode by which OCs, Depo-Provera, and Lunelle prevent pregnancy; the implant system causes ovulation suppression about 50 percent of the time. However, throughout each pill cycle, and continuously with Norplant implants and Depo-Provera, the mucous covering the cervix -- the site where sperm enters the uterus -- stays thick and sticky, making it very difficult for sperm to get through. This gooey impediment also acts on the sperm cell itself. It prevents fertilization by interfering with chemical changes inside the sperm that allow it to penetrate an egg's outer coating.To summarize, with regard to both the combined contraceptives and progestin-only contraceptives the main moral problem occurs when the first and second mechanisms of action fail (prevention of ovulation and of fertilization due to mucus buildup) and fertilization of an egg takes place. At this point these methods cease to be contraceptive in nature and function as abortifacients. While the chances of the first two methods failing are admittedly low (more so with combined contraceptives), given the fact that so many women are using these forms of birth control there is no question that for some "the pill" or its equivalents are functioning at least at times to terminate the life of a conceived child. Indeed, if the "profound respect for life in the prenatal stages" of a child's development discussed earlier holds the moral authority it ought to, then perhaps it is right to reevaluate whether a low chance of aborting one's child is worth the risk at all.
Even if ovulation and fertilization do take place, hormonal methods provide another measure of protection: changes to the uterine lining. Normally, estrogen initiates the thickening of the lining of the uterus in the first part of the cycle, while progesterone kicks in later to help the lining mature. Since both hormones are present throughout the pill cycle, and progestin is supplied continuously by implants and the shot, the usual hormonal variations are masked and the lining rarely has a chance to develop enough to nurture a fertilized egg. [Emphasis added by author.]
Finally, due to the somewhat enigmatic use of terminology relating to this subject, those who wisely seek advice from a primary care physician and/or OB/GYN ought to ask questions with precision and care. For example, a young couple may ask their doctor whether or not a particular form of oral or chemical contraceptive runs the risk of causing an abortion. Depending on how that doctor defines "abortion" and "pregnancy," the answer may vary. For some the word "abortion" is understood to mean the termination of a pregnancy. The term "pregnancy," however, may be understood to mean that the fertilized egg has already implanted in the uterine wall. If this is how the doctor defines pregnancy, he or she may indicate that combined contraceptives and progestin-only contraceptives do not cause abortion because they do not terminate the growth of a fertilized egg once it has become embedded in the uterine wall. What is left unclear to that couple, however, is that "the pill" may indeed function to terminate the life of a newly conceived child by preventing the fertilized egg from implanting in the uterine wall where the "pregnancy" would otherwise begin.
For this reason, then, instead of inquiring as to whether or not a certain form of combined contraceptives and progestin-only contraceptives "can function to cause an abortion," the wise couple will seek to determine whether or not the combined contraceptive or progestin-only contraceptive functions to inhibit the growth of the endometrial lining. If so, it could then prevent a fertilized egg from implanting in the uterine wall and thereby cause the death of a newly conceived child. Other points of clarification that might prove helpful when discussing this issue with one's physician or OB/GYN are: (1) whether or not the method of birth control prevents fertilization of the egg 100 percent of the time; (2) whether or not there are any products on the market that have been proven by clear documentation to prevent fertilization of the egg 100 percent of the time; and (3) whether or not there are any forms of combined contraceptives or progestin-only contraceptives that do not change the endometrium (the lining of the uterine wall) so that it cannot sustain a fertilized egg that might otherwise implant and grow toward birth. To date, this author has not been able to substantiate an affirmative answer to any of these questions.
By way of conclusion, with regard to sterilization it is important to reiterate the need to take great care in avoiding dogmatism on matters that Scripture either does not prohibit or does not directly address. It is the principle of honoring "the temple of the Holy Spirit" that one must seriously consider before deciding whether or not to employ such a method. With regard to the use of "the pill," moral justification for its use is much more tenuous due to the simple fact that the principle of the sanctity of life directly applies. In both cases, however, it would seem that the consideration of scriptural principles ought to lead one away from employing sterilization of "the pill" with its many variations as a means of family planning.