Only in a Case of Danger Rabbi Gideon Weitzman

WEITZMAN

Only in a Case of Danger

Recently we presented the question as to whether a woman can undergo tubal ligation in the case where she is in no danger but is under great stress. Since there is a discussion as to whether this procedure compromises a Torah or a rabbinic prohibition, there is a corresponding disagreement as to whether it can only be permitted in the case of pikuach nefesh or under less severe circumstances.

It should be stated that the woman in question could use other forms of birth control that present less halachic problems. She preferred not to use them for her own reasons and concerns but many of the poskim that we asked did not feel that this was sufficient grounds for permitting a possible Torah prohibition. In addition, since her life would not be in danger if she got pregnant it would be preferable to use other forms of contraception that were less problematic on a halachic basis.

One of the reasons that the woman did not want to get pregnant was out of a fear that her child would be born with genetic abnormalities. This is indeed a major concern for women over the age of forty and a valid reason for choosing not to have children at this age. However, the reality is that even a woman in her mid-forties has a very good chance of having a perfectly healthy baby. The risk of having a child with Trisomy 21, otherwise known as Down’s Syndrome, for a woman of 40 years old is about 1 in 106 and for a woman of 45 about 1 in 30. The risk of having a child with any chromosomal abnormality is around 1 in 66 for a woman of 40 and about 1 in 21 for a woman who is 45 years old. While these numbers are significant and can be seen to be high, the most likely is that her child will have no genetic abnormality as a result of maternal age. Again, this is a valid reason for a couple to decide to have their children earlier in life and subsequently to choose to use contraception, but it is not simple to permit a potential Torah prohibition based on this likelihood.

Therefore, many of the poskim who were asked replied that they would permit using contraception in this case, but they could not permit undergoing tubal ligation. It should be stated that none of the poskim ignored the woman’s predicament and her psychological state, but some of them found it difficult to permit tubal ligation in her case.

The Puah Institute is based in Jerusalem and helps couples from all over the world who are experiencing fertility problems. Offices in Jerusalem, New York, Los Angeles & Paris. Contact (Isr) 02-651-5050 (US) 718- 336-0603 www.puahonline.org