Birth control is one of the most controversial subjects in contemporary Christianity—and permanent birth control even more so. Ultimately, the use of birth control, even permanent, is a matter of grace. The Bible does not specifically state if birth control is good or bad. As with many other things, God expects us to develop the spiritual maturity we need to make a decision that lines up with what the Bible says as well as how the Holy Spirit guides us individually. Often, even among the most vehement supporters and detractors, the use (or not) of birth control reveals other issues at play.
Does the Bible say anything about permanent forms of birth control?
There are solid reasons a couple may consider permanent birth control. Not all of them are simply to prevent future pregnancies.
Medical conditions: Surgical procedures which naturally result in permanent infertility can relieve many serious medical conditions. It is generally biblical to seek relief from medical issues (Matthew 9:20-22). And women who suffer with chronic disease may not feel they have the ability to care for a child. Bear in mind, however, that pregnancy may temporarily alleviate some autoimmune diseases.
Stewardship: The Proverbs 31 woman is described as a woman who carefully considers the state of her finances and her household, and makes decisions based on what is best for her family. Similarly, 1 Timothy 5:8 exhorts men to provide for their families. It is generally biblical for a couple to determine that their financial situation is such that a new child would cause a financial hardship. This is an ambiguous matter, however. Circumstances change, and it is possible the family could have more resources in the future. Guidance from the Holy Spirit should absolutely be sought before permanent birth control is performed.
Mission: Children take a lot of time and resources. It's hard to give 100% to a job or ministry when caring for children at home. Is it biblical for a couple to reject any chance of children (or more children) for the sake of a career? In general, no. The Bible is clear that children are a blessing, and we are not to seek success as the world defines it. This, like all the other considerations, is not universal. It may be that God has a specific plan for a couple that does not include children.
Age: Age can be considered "stewardship of time." The chance of a newborn having medical difficulties goes up slightly with the age of the mother. And the exhaustion of the parents goes up significantly with age. At the same time, older parents may be more grounded and have more patience with their young children. It is not unbiblical to stop having children because of age, but, again, it's not universal. The Bible is filled with older couples who gave birth to very significant characters.
Many Christians throughout history have been categorically against birth control. This can lead to a legalism that the Bible does not support.
Quiverful: There is a movement among modern Christian circles that discourages the use of any birth control. The belief is that God will give a couple the children He wants them to have, as well as the resources to care for them. If that is truly the conviction of the couple, that's fine. But stewardship of resources must be taken into consideration. Not just money or space, but time and emotional energy. Too many little ones in large families are functionally raised by older siblings. Parents should bear in mind that they are the parents and need to raise their own children.
Baby-addiction: It's natural for mothers of preschoolers to gradually feel the desire for another baby. Taken to the extreme, however, it may be a sign of a significant issue. It's possible that the mother feels a great loss when her youngest child gains some measure of independence. She feels unneeded and misses having someone that is completely reliant on her. If the feeling becomes an obsession, the mother should seek help to work through exacerbating issues in her heart and/or marriage.
Potential future marriage: One of the most macabre, but perhaps most practical, reasons for rejecting permanent birth control is the possibility that one spouse may die, the other may remarry, and the new couple may want children together. Despite the darkness of the motivation, there is nothing unbiblical about it.
The Biblical View
The Bible says that children are a gift from God (Psalm 127:3-5). In biblical culture, children usually meant support for the parents, not a burden. At the same time, Jesus was always sympathetic toward those who suffered from chronic medical conditions, as well as mothers caring for young children during times of extreme hardship (Matthew 24:15-21). There is no universal biblical mandate concerning birth control—just as there is no number given of how many children God expects us all to have. If a couple is considering permanent birth control, whether for medical reasons or simply to prevent having children, James 1:5 is key: "If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him."
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