Could You Give Me Your Theological Understanding Concerning Vasectomies?

Question from a reader:

Could you give me your theological understanding concerning vasectomies? We have 7 children. I realize that my body is not my own. I have been bought with a price. Therefore I want to do what Jesus wants me to do regarding this.

Answer from Randy Alcorn:

Let me first say, before I speculate, what I know for sure. As I’m sure you know, Scripture teaches that it is God that opens and closes the womb, and that children are a blessing of the Lord (Psalm 127). Reproductive fruitfulness is commanded and commended by God. Scripture knows nothing of the tragic bias often demonstrated today against people with large families.

While child-bearing is not the only purpose of sex (the two becoming one flesh fosters marital oneness and intimacy that even speaks of Christ’s love for his church, Eph. 5), certainly it is a primary purpose. Does God want us to circumvent or undercut the procreative purpose of marriage and sex in any way, including by means of contraceptives or a vasectomy? Is it right that we would do whatever we can to eliminate the possibility of a child’s arising from our marital union? When we do this, do we reduce sex to a pleasure unattached from potential responsibility? Do we rob sex of its life-giving sacredness and mystery?

When I’ve taught ethics classes, I’ve asked my students, “If we believe the Bible when it says children are a blessing from the Lord, why are we so determined to be sure we don’t get too many of those blessings? Financial provision is also a blessing of God, and so is good health—which of us is trying desperately not to get too much of those blessings?” Here we live in the most affluent society in human history and we have people with straight faces saying, “We can’t afford to have more children.”

And where are the biblical models for contraceptive use? Contraceptives, though crude by our standards, did exist in ancient cultures. We are never given a model for contraceptive use. (On the other hand, we are never explicitly commanded against it.)

In the New Testament, Galatians 5:19-21, there is a list of those unrepentant souls who will not inherit the kingdom of God; among them are those who use “sorcery” (“witchcraft” in the KJV). The Greek word translated sorcery is pharmakeia, the word that we derive “pharmacy” from. In the Greek pharmakeia has a semantic range that includes “medicines,” “drugs,” or “spells.” In the Galatians passage, just preceding this particular word are others having to do with “fleshly lusts,” including immorality, impurity, sensuality, and idolatry. Some offer the argument that pharmakeia refers to the use of potions to prevent or end a pregnancy since practitioners of witchcraft or sorcery were often sought out for toxic potions. There is not enough biblical evidence to say what the understanding is intended to be in this context. Most frequently the words—Old Testament and New—translated as “sorcery” are used within a context of conjuring up dead spirits, demons, or performing acts of magic. Extrabiblical sources would need to be reviewed to see if the common first century understanding of pharmakeia was also conclusively bound up with the idea of preventing or ending pregnancy.

The only strong biblical evidence in either direction is simply that it is God who continues to act in the creation of each person (Psalm 139:13-16); who opens and closes the womb (Gen. 30:2; 29:31; 30:22; Luke 1:36-37); and it is he who “gives to all people life and breath and all things…having  determined their appointed times and the boundaries of their habitation” (Acts 17:25-26). Both testaments subscribe to the fact that God is involved in the conception and birth of children, whether in a land of famine or land of plenty.

I wonder if this hasn’t become an issue of control. Do we think we own our children, rather than God? Are we the baby-makers, or is he? We think in terms of our purposes and our needs and our convenience—what about the purposes of God? Are we usurping his prerogatives in the regular use of contraceptives (or even “natural” methods of determining family size)? Are we putting our convenience and preferences above his purposes and his glory and his sole prerogatives over the giving and taking of life? (How much has our uncritical acceptance of contraceptives led to our practice of abortion?)

Now, some qualifications. I spoke with a family who has five small children and they are trying to figure out whether to use contraception. They haven’t because they’ve wanted God to choose the size of their family. But their fertility is such that pregnancy keeps happening, and they wondered if God would understand and approve if they tried to space them out more, because the physical demands on the Mom have become very hard on her, and the intimacy of their marriage has suffered, and they feel they aren’t giving each other and each child the attention they need. I said, in light of their desire to please God, that I felt their concerns could be valid and that God might very well want them to engage in thoughtful “family planning.” So I’m not an absolutist here, and do believe that there’s a place for wisdom and discernment, and keeping your fingers on the pulse of the marriage partner and the family God has given you.

I admit that even as I say this I’m a bit uncomfortable. Is it gray or is it black and white? If we have total faith in God why not just trust him to determine family size? But could you also say that of a thousand other things—if we really have faith in God, why not keep our doors unlocked (or remove the locks), keep our keys in the car and leave our valuables out on the porch? Sure, there’s a difference between these things and having children, but there are some parallels too. Do wisdom and planning issues come to bear at all with having children?

If a woman will likely die from another pregnancy, would it be all right for her to have her tubes tied? If yes, then the door is open—now what about if there was a 10% chance of dying, or that it would make her extremely ill and unable to care for her other children? What if her chances of having a severely deformed child are very high? Can her husband have a vasectomy then? If so, then are we saying we shouldn’t prevent the conception of “normal” children, but it’s okay to seek to prevent the conception of “abnormal” children? Once you say wisdom is a factor in determining whether to control family size, why isn’t it still a factor in less critical situations? Where do you draw the line—and is wisdom applicable, or do we disregard wisdom and function 100% on the basis of “whatever increases the chances of pregnancy is right, whatever decreases the chances is wrong”? If so, then why not oppose breast-feeding on the basis that it significantly lowers the chances of pregnancy? Many women who breastfed might have had 3 or 4 more children in their child-bearing years if they wouldn’t have.

There’s sometimes a bit of a double standard, I think, with people who use natural family planning on the one hand, but cite the Scriptures about “children are a blessing” and “God opens and closes the womb” on the other hand, arguing against the use of contraceptives. Sure, they’re not using artificial devices like condoms or diaphragms, but they are nonetheless trying to limit the number of children just as those who use devices are trying to do. So don’t the passages they cite apply as much to them as to those using contraceptives?

So, in my mind, those who practice natural family planning (which I think is really great in lots of ways) are not fully “allowing God to determine the size of our families,” in that they are paying attention to strategies to space their children, which will ultimately mean having less children than they otherwise would have. But it does cultivate more of a consciousness about the gift of fertility and more of a sense of responsibility related to the sacredness of that gift. The communication required between couples, and the self-restraint practiced at certain times of the month, can be good for the relationship, and I’ve heard couples who practice it say it cultivates intimacy and makes women feel like they aren’t being just used for sex, but that there’s a thoughtfulness about, in essence, putting sex on the calendar rather than leaving it to whenever the drive happens to hit. On the other hand, if sexual abstinence becomes too dominant a theme, it could violate the command of 1 Corinthians 7.

But total access is qualified in verse 5 where Paul instructs, “Stop depriving one another, except by agreement for a time, so that you may devote yourselves to prayer, and come together again so that Satan will not tempt you because of your lack of self-control” (emphasis added). Couples may abstain from sex for the purpose of devoting time to prayer, but prayer about what? Certainly one may approach God in prayer freely, day or night, so what is Paul’s point here? If context applies, then it might be that Christian freedom (chapter 6) and sexual relations are at the heart of the prayer. It may be that Paul was addressing a first century fear as the Jews were undergoing persecution and dispersion; a tough time to have a baby. Then rather than use a worldly method of preventing pregnancy, perhaps Paul is suggesting that abstaining “for a time” and prayer are the best posture for the believer whose circumstances are uncertain. That in turn might suggest that when prayerfully and nonabortively approached, some manner of respectfully attempting to avoid pregnancy is legitimate. After all, “All things are lawful for me, but not all things are profitable. All things are lawful for me, but I will not be mastered by anything” (1 Corinthians 6:12).

So then, the issue of being “mastered” is raised and brings us back to nonabortive contracepting in a permanent way, through tubal ligation or vasectomy. Such surgical remedies are reversible, but in most cases they are permanent even if a couple decides later that they do want more children. Finances may stand in the way. Even if surgically reversed, scar tissue may have formed to block the fallopian tubes in a woman and the vas deferens in a man; the decision to reverse might come at a point when the individual is no longer fertile. The point is that such sterility procedures may then dictate against future desires. Many couples have regretted having such a procedure and feel mastered by the original decision to permanently avoid pregnancy.

Related back to the passage in 1 Corinthians 7, I’m concerned because I pick up in some of the anti-contraceptives material I’ve read, “Sexual pleasure is fleshly and worldly, and should be avoided—reproduction is the godly purpose for sex.” Well, any purpose created by God is godly, isn’t it? Sex and sexual pleasure were not created by Satan, Playboy, Hollywood, HBO, rock musicians, the Internet, or some pervert lurking in the shadows of a porno shop. Sex was created by the holy God of heaven, where purity reigns.

God made sex physically desirable by creating us with sex drives, without which sex wouldn’t exist and neither would people. God’s Word speaks openly of the pleasure of sex (Proverbs 5:18,19; Song of Solomon 4:5; 7:1, 6-9). We shouldn’t be ashamed to enjoy what God wasn’t ashamed to create—provided we enjoy it in the context of his intentions and requirements, not the world’s.

Is Genesis 1:28 a command to Christians today? “Be fruitful and multiply and fill the earth and subdue it.” This was a critical command to Adam and Eve, but does it apply equally to all mankind today? Does it apply to a poor Christian couple in Pakistan who have twelve children? Does it mean they would be wrong to use a nonabortive contraceptive? What about if they had six children? Five? Four? How does God define “too many”?

Not every command given to every individual in the Bible applies today or to all people today; we are not to build an ark because Noah did, or wade into the Jordan fully clothed because the priests did. Neither are we to stone adulterers. The Old Testament was fulfilled in Christ. Several passages that relate are Romans 7:6, Galatians 3:23-25, and Hebrews 9:15-17. While the Old Testament is still pertinent, and Genesis 1:28 was not just Hebrew law but given to the parents of all races, is there a sense in which it applied more directly to those living in an empty world than to us? Or more to those living in a world with high infant mortality, where bearing ten children might result in three to five surviving children? But are we to assume God wants us to exercise judgment about how many children we have in a way parallel to how many acres or boots or horses we might have?  Then again, is it not wrong to equate children created in his image and likeness to leather and animal herds? They are not the same. In fact, it is precisely that children are created by God in his own image that the issue of reproductive behaviors cause us so much anxiety.

God plainly teaches, in 1 Corinthians 7 that a husband and wife should fulfill one another’s sexual needs. This necessitates regular marital relations. Abstinence can bring with it pressure toward adultery. Does God expect us to use our wits and available resources to accomplish this without necessarily having children from most of our sexual relations?

Statistically, if no precautions are not taken, a fertile couple having sex 2-3 times a week will normally have about one child a year. Will this create other problems Scripture addresses? Paul says in I Timothy 5:8, “If a man provide not for those of his own house, he has denied the faith and is worse than an infidel.” Can we have so many children that we can’t provide for their needs? In some cultures, yes. In ours? That would be a lot of children—maybe we would be failing to provide for their emotional needs before their physical ones, I’m not sure.

Some say, “Look, we’re constantly interfering with God-ordained natural processes—like every time we cut our hair or fingernails; so why not use contraceptives?” I guess I see a special sanctity on the reproductive process where the analogy breaks down. God is never said to be the one who determines fingernail length, but he is said to be the one who opens and closes the womb. Hence, if we become too aggressive in our attempts to close the womb (and perhaps even to open it, as in the case of fertility treatments, artificial insemination, etc.), we may be usurping the prerogatives of God. Yet, at what point do you move away from the mystical miraculous aspects of God creating children and say that for us, we will get pregnant every time we stop using contraceptives (like Nanci and I did immediately the only two times we didn’t use them?) Conception is a miracle in one sense, of course, but in another sense is it not a biological reality as predictable as other bodily functions we don’t hesitate to control, such as hair length?

After Nanci’s two hard pregnancies we decided to have a tubal ligation. If we were in our childbearing years today, what would we do? I’m not positive, but I suspect we would exercise natural family planning and be more prayerful, more prone to search the Scriptures, and open to more children than we were before. On the other hand, I don’t believe we would rule out considerations about spacing children (as is normally part of natural family planning), and in that sense we would not be rule-driven and indiscriminate in considering issues of family well-being that might affect certain decisions. Certainly, we would take it to the Lord and seek godly counsel, as you have.

Specifically, I think I would do what you’re doing, talk it over with my wife, and seek God’s face about the possibility of the vasectomy reversal. I don’t know what conclusion I’d come to, and I would certainly pray too about the possibility of adopting children. While you made your decision about “permanent” birth control when you weren’t fully informed, God can override our decisions and open our hearts to something he wanted us to do but we wouldn’t have otherwise, such as adoption, which I believe is very close to his heart. So I don’t know what I would actually do, but I do know for sure I’d be very open to the Lord, very prayerful, and search the Scriptures and ask him for guidance.

If you had a reversal, would that mean that you would never use contraceptives, use them sparingly, or that you would practice natural family planning or what? It would seem a bit contradictory to go to the trouble of reversing a vasectomy just to use contraceptives or other means to accomplish the same purpose as the vasectomy, namely, not having more biological children. Or maybe if you didn’t use contraceptives now and God chose to give you more children, you would come to a point down the line where you would use natural family planning or contraceptives?

In my mind, if contraceptive use is an issue with some red flags, permanent contraception would be even moreso, so I can understand your desire to revisit this issue, and if I were in your place, knowing what I know now, I would be doing the same thing. Frankly, if we had it to do over again, I doubt we would have had Nanci’s tubes tied, though remembering the amount of pain she went through in both pregnancies, especially the second, I wrestle with that too. As you can see, I go back and forth on this. I know that God is pro-child and we should affirm his sovereignty. And I’m honestly not sure the degree to which, and the means by which, it is appropriate for us to exercise our wisdom in family planning in the same way we do in almost every other area of our lives (e.g. financial planning and time management). 

As for passing on this perspective to others, I’d suggest it be done carefully and humbly (and I know that’s how you’d do it of course), as I’ve noticed some have made their main life’s agenda to be anti-contraceptive crusaders in a way that overpowers others and raises defenses unnecessarily. I certainly think it should be fair game for discussion, and we should all feel free to share our perspectives.

Above all, no matter where we stand on this issue, it is an absolute certainty that the body of Christ should be pro-children and pro-family and never demean or roll our eyes at those God has blessed with many children, but rejoice with them and help them as we’re able. (I think we should also get over our aversion to crying infants in a church service—the way we turn our heads and stare and frown if a mother with a crying child doesn’t head for the exit in the first five seconds. I think this is symptomatic of our view of children as hindrances to what we want to accomplish.)

Ironically, while undercutting the value of children on the one hand, we pamper and spoil them on the other. Perhaps that’s one of the results of decreased family size—more spoiled children who get everything they want (as they couldn’t with more siblings) and have no responsibilities (as they would with no siblings). 

I appreciate so much your thoughtfulness, and your desire to please the Audience of One above all others. I pray that God will help you and your wife as you wrestle with this issue, and lead you to do what is right and brings most glory to Him.

Photo by Tim Foster on Unsplash

Randy Alcorn (@randyalcorn) is the author of over sixty books and the founder and director of Eternal Perspective Ministries