Do you receive many questions regarding sterilization or birth control?
I am having trouble finding any direct doctrine and people in the church seem to have very strong opinions! Where can I go to find doctrine about sex without baby-making intention and how my husband and I can make decisions about permanent birth control after children?
That is an excellent question. I do not get a lot of questions on birth control, but it is certainly an appropriate subject that involves sex and sexuality, and the General Authorities have addressed this subject many times.
Both the Bishop's Handbook of Instruction (BHI) and the Eternal Marriage Student Manual have a lot of information to give. The BHI basically says:
- The Church will not take an official stance on what a husband and wife can or cannot do sexually in marriage.
- The Church will not dictate how many children any married couple should have. Leaders are instructed to counsel the members that they should have as many children as they can without jeopardizing the health of the mother or children. They should also make it a matter of prayer (as a couple) to determine when they should stop having children, and by what means.
In general, the following seems to hold true:
- The only method of birth control opposed openly by the Church is abortion. Even with abortion, there are rare circumstances (such as rape, incest, or when it’s medically determined necessary to protect the mother's life) when it would be an acceptable (if heartbreaking) option. Mothers who have chosen abortion as an option before they were aware of this can still find peace and forgiveness through the Lord’s atonement.
- The Church does have some say about more permanent methods of birth control. Bishops are generally told to discourage vasectomies, but the decision should be serious a matter of prayer for the couple. My belief of why it’s discouraged might have to do with its more permanent nature in the body. It's quick and cheap to have done, but it's typically very expensive to reverse – sometimes $10,000 or more - and reversals may not be covered by insurance or even be effective in some.
A couple may not want children now, but who’s to say what the future will bring? A wife may pass away, and the husband may remarry. His new wife may want children. We don't know. It's something to consider in your decision. There are circumstances where a vasectomy might be justified, even though it’s officially discouraged in the BHI. These are decisions a couple must prayerfully make for themselves.
Tubal ligation (the operation to close the Fallopian tubes in a woman, also called ‘tying your tubes’) or a hysterectomy are options too, but are also discouraged. Again, the reason may have to do with the permanence of it and the effect it may have on the body or health of the wife. These are serious operations, and also very hard and expensive to reverse, so I believe these procedures are discouraged for the same reason. A hysterectomy will put a woman immediately into menopause if her ovaries are removed, which brings its own set of troubles to contend with. However, there may be very specific circumstances where a tubal ligation or a hysterectomy might be called for.
“Abortion must be considered one of the most revolting and sinful practices in this day, when we are witnessing a frightening evidence of permissiveness leading to sexual immorality. We take the solemn view that any tampering with the fountains of life is serious, morally, mentally, psychologically, physically. To interfere with any of the processes in the procreation of offspring is to violate one of the most sacred of God’s commandments—to “multiply, and replenish the earth.” 
I'm presenting this quote President Kimball gave about abortion on purpose. Quotes like this are most often twisted by those who would give wrong counsel that we should not use birth control of any kind, anywhere, for any reason. But I ask you, if this was the case, why would there also be counsel such as this from President Hinckley?
“I am offended by the sophistry that the only lot of the Latter-Day Saint woman is to be barefoot and pregnant. It’s a clever phrase, but it’s false.Of course we believe in children. The Lord has told us to multiply and replenish the earth that we might have joy in our posterity, and there is no greater joy than the joy that comes of happy children in good families. But he did not designate the number, nor has the Church. That is a sacred matter left to the couple and the Lord.The official statement of the Church includes this language: ‘Husbands must be considerate of their wives, who have the greater responsibility not only of bearing children but of caring for them through childhood, and should help them conserve their health and strength. Married couples should exercise self-control in all of their relationships.They should seek inspiration from the Lord in meeting their marital challenges and rearing their children according to the teachings of the gospel”
Such comments may seem to contradict each other, but when you think about it, they really don’t. When the brethren talk about not using birth control, they aren’t saying ‘don’t use birth control under any circumstances’. They're saying "don't postpone your family. Start having children right after you get married. Let them come and then work with the Lord on when and how to stop.
Women have a short window from youth to middle age in which they are physically capable of bearing children. After that time, health issues begin to impede the process of childbirth, and they can become less able to handle the physical rigors of raising young children.
Those who choose to postpone their family can often face problems such as infertility, or a higher risk of birth defects such as Down ’s syndrome. Artificial insemination is available for help with fertility problems, but it tends to be expensive, physically uncomfortable, emotionally disruptive, and leads to a greater possibility of multiple births instead of single births. This can increase the difficulty in raising the children, and can increase the temptation towards abortion.
Some biological evidence has been set forth that children born to older parents might have changes to the telomeres in their DNA, which can lead to additional vulnerability to disease or perhaps a shortened lifespan for the child in some cases.
I don’t know that these things would happen to every person – they may not, but these are very real potential variables. Deliberately choosing to waste the very short window of opportunity for building your family in the name of such things as education, or career, or freedom to travel, might end up a bitter trade.
In addition, it’s my understanding (which is becoming more and more supported through research) that denying a woman children for financial reasons or otherwise, denies a very basic and fundamental aspect of her sexuality. Some of the strongest desires a woman has in regards to sexuality center around having a baby. These desires can awaken at different times and in different ways, but they are very similar to the powerful sex drive that a man experiences. While a man’s sexual cycle is fulfilled at the time of ejaculation, a woman’s cycle can be much longer, and usually isn’t fully fulfilled until she has given birth to a child.
What’s the bottom line on birth control? It's really a spirit of the law thing. There can be no hard and fast rules because there are too many variables to life's circumstances. When it comes to birth control as a married couple, all that is required is to use our best judgment and include the Lord in our decision.
Put the responsibility back on the Lord. That way, when you stand in judgment, you can say "Well, we asked you in prayer, and went by what we felt you wanted us to do. If it wasn't what you wanted, we misunderstood, but we were doing our best to be obedient." I believe that is all that the Lord requires - that we are sincerely doing our best to be obedient to him. He knows our hearts. The only one who can make that distinction is you and the Lord – not your parents, not your neighbors or fellow ward members, or even your bishop.
Once you’ve had your children and you feel ready for birth control, there are lots of forms of birth control you can use. Condoms are an option, especially the female condom (which I believe is a work of genius.) They are comfortable, with little loss of feeling for the husband or wife. They are easier to use and make cleanup easy.
Hormone treatments such as the Pill or Depo Provera can have side effects, but also can be very reliable. There is a new method for men to use that is undergoing clinical trials as of this writing, and may be available soon. It’s called Vasalgel, aka RISUG - where a spermicidal gel is injected into the male’s vas deferens, which lasts around 10 years (it's undergoing clinical trial now). There are many other birth control options as well.
The general membership of the Church really does not have authority, right or power to judge or to pass social sanctions when it comes to birth control use in marriage.
“When to have a child and how many children to have are private decisions to be made between a husband and wife and the Lord. These are sacred decisions—decisions that should be made with sincere prayer and acted on with great faith…The bearing of children is a sensitive subject that can be very painful for righteous women who do not have the opportunity to marry and have a family. To you noble women, our Heavenly Father knows your prayers and desires. How grateful we are for your remarkable influence, including reaching out with loving arms to children who need your faith and strength.The bearing of children can also be a heartbreaking subject for righteous couples who marry and find that they are unable to have the children they so anxiously anticipated or for a husband and wife who plan on having a large family but are blessed with a smaller family….Brothers and sisters, we should not be judgmental with one another in this sacred and private responsibility.”
There is much to be found on this topic. Much good information is found in the section on birth control in the Eternal Marriage student manual. It’s available through www.lds.org and costs about $3.00. There’s also www.lds.org itself, which is free, and a search on the terms ‘birth control’ will bring back a lot of information as well.
Members of the Church of Jesus Christ of Latter-Day Saints who may be telling you that we as Saints are forbidden from using birth control under any and all circumstances are misinformed. I think it would be valuable for them to take a deeper look into the origins of where their beliefs come from, because such pronouncements are not based in LDS doctrine as it currently stands.
 Russell M. Nelson, Abortion – An Assault On The Defenseless, Ensign, Oct, 2008 http://www.lds.org/ensign/2008/10/abortion-an-assault-on-the-defenseless?lang=eng
 President Spencer W. Kimball, May 1975 Ensign, italics added
 President Gordon B. Hinckley, Cornerstones of a Happy Home, pamphlet released to the Church in 1984, pg. 6
 Kimura, Masayuki, et al. “Offspring's Leukocyte Telomere Length, Paternal Age, and Telomere Elongation in Sperm”, PLoS Genetics, 15 Feb 2008. http://www.plosgenetics.org/article/info%3Adoi%2F10.1371%2Fjournal.pgen.0040037
 An excellent discussion of this point can be found in the documentary, “Orgasmic Birth”, which can be found on Netflix for viewing. A short review of this documentary can be found at this link: http://parenting.blogs.nytimes.com/2008/12/11/orgasms-during-childbirth/
 Neil Anderson, ‘Children’, Oct 2011 Ensign