“Be fruitful and multiply”

Hundreds of religious texts serve as a backdrop in the office of Moroccan ultra-Orthodox rabbi Daniel Bitton, at the Hamaor Institute in Jerusalem, Israel. Steam rises from a coffeemaker and the interview begins. He starts at the beginning, which is his position on family planning: “I can’t explain something that doesn’t exist. There is no such thing as family planning for us. We don’t decide anything. God plans everything and decides everything.”

From denial to prohibition, the rabbi is not alone in his position. The three main monotheistic religions have the same starting point: sex is only permitted within marriage and its ultimate goal is reproduction. That leaves little room for contraceptives. Promoting their use might encourage promiscuity and sin.

Many things have changed in these religions, among their clergy and especially among believers. Not all of them interpret religious texts in the same way, nor do they follow their leader’s rules to the letter. But religion continues to be a barrier to birth control. Sometimes it is so intertwined in people’s values that it’s almost invisible.

Pope Francis criticises the concept of ‘safe sex’, saying, “As if an eventual child were an enemy to be protected against.”

Pope Paul VI wrote in the Encyclical Humanae Vitae, that contraceptive use leads to selfish enjoyment, disrespect and abuse of women. Sterilisation or anything that interferes with procreation is prohibited, too. Pope Francis, in his Amoris Laetitia, took a step toward removing the aura of sin on sex between spouses, at least. But in the same text he criticises “coercive” government family planning campaigns for having a dangerous “anti-birth mentality.” He also attacks the concept of safe sex, writing, “such expressions convey a negative attitude towards the natural procreative finality of sexuality, as if an eventual child were an enemy to be protected against”.

Some 5,600 kilometres from Jerusalem and 4,140 km from The Vatican, in Thiès, Senegal, dozens of women sit in plastic chairs in the sand beneath an awning. Most hold small children in their arms. Older children run around nearby. The audience listens and laughs, sometimes with embarrassment and sometimes in loud peals, to a class on birth control given by Coumba Dieng, of Marie Stopes International. There are less than a dozen men present, including the sound technician, some Marie Stopes members, and the imam and his companions.* The presence of the imam is very important to gain acceptance by the women and especially their husbands.

A few days before, neighbouring The Gambia, an overwhelmingly Muslim-majority country, hosted a three-day conference on Islam, family well-being, and traditional practices. Members of the government, religious leaders, and representatives from the United Nations Population Fund (UNFPA) and United Nations Children’s Fund (UNICEF) sat down to talk about eradicating female genital mutilation and child marriage. They also talked about contraceptives. “It is vital to orient religious leaders so that they spread family planning messages in their sermons, at prayers, and after prayers,” says Momodou Njie of the Gambia Family Planning Association, a non-governmental organisation in Banjul that has decades of experience helping women get family planning services.

Religious bans on contraceptives affect more than just believers. They affect sweeping policies, such as Trump’s gag rule on groups that practice or promote abortion. They also affect smaller everyday behaviours, such as the moralistic barriers people impose on one another. Not so long ago, the Guadalajara pharmacy chain in Mexico, one of the most biggest in the country, did not sell condoms, says Patricia Ortega, of The Network for Sexual and Reproductive Rights in Mexico (DDSER). Today the Catholic owners still do not sell the morning-after pill.

Ortega has her work cut out for her: Guadalajara is one of the most religious states in Mexico. Catholic schools there have organised massive demonstrations against birth control and abortion. The ex-cardinal Juan Sandoval Íñiguez said that the rise in murders of women is due to their own “imprudence” in getting into stranger’s cars. Few political candidates in his state can make it through an electoral campaign without a photo opportunity with him. The ex-cardinal is clear about his position on contraceptives: no. In a video titled roughly “Duo of death: contraception and euthanasia”, he says: “The UN is committed to reducing the population of the world […] It promotes organisations that help in this devil’s work.”

One of the organisations he mentions is the UNPFA. Alieu Jammeh, an UNPFA official in The Gambia says, “All the work you’ve done in three, four, five years, the imam can undo in five minutes.”

Every sperm is sacred

“And Onan knew that the seed should not be his; and it came to pass, when he went in unto his brother’s wife, that he spilled [it] on the ground, lest that he should give seed to his brother. And the thing which he did displeased the LORD: wherefore he slew him also.”

Men and women’s first duty in Judaism is to multiply. They should have as many children as possible or, according to some interpretations, a son and a daughter. Jewish tradition holds that sperm contains the breath of life necessary for conception. That makes it sacred and imperative. So, for the strictest believers, the rule is clear: wasting sperm is a sin. They call the improper emission of semen hash-hatat zera.

For Rabi Mira Raz of Mishkenot Ruth Daniel community centre in Jaffa, Israel, the biblical focus on the man’s semen opens a door for women to use contraceptives. For progressive religious reformers like her, contraceptives such as the pill or the IUD are permissible, but not barrier methods. And beyond theory, she says, “I’m not God’s policeman.”

Rabbi Joseph Höffner, of the Ma’ayanei Hayeshua hospital in Bnei Brak, an ultra-Orthodox community of Tel Aviv, agrees with her: “Anything the man has to wear is prohibited and almost all of the other things are permitted.”

Yair Hass is director of Hillel, a Jerusalem organisation dedicated to helping adults who choose to abandon the restrictive world of ultra-Orthodox Judaism. Birth control in Israel, he says, is a “controversial” topic because some people want the population of Jews to “get back to the pre-Holocaust number.” What’s more, birth rates are a matter of state in Israel: Jews need to outnumber Palestinians and the people of neighbouring countries. Those ingredients mean that in 2017 Israel’s population pyramid is shaped just like Spain’s in the 1960s baby boom, though with different religious backgrounds. The haredim, or ultra-Orthodox Jews, who are also the most fertile, now make up 10% of Israel’s population. By 2059 they will be 35% of the population, according to one estimate.

For Islam, it is also a question of numbers. It’s a synonym for wealth: the more children, the better. Many Muslims also share the Jewish interpretation of sperm. “They argue against using condoms by saying that they trap children in this world and in the next. So when you die and go before Allah, those children you trapped will push you back down. They make it very scary,” says Jammeh, the UNPFA official. But in Islam the pull-out method is permitted and even appears in the Koran. “We ask them, if you use the pull-out method, where do you ejaculate? On the floor? On the bed? If you leave it in a nice place, like a condom, and gently throw it in the rubbish bin, rather than on the floor, don’t you think that is better and more hygienic? They feel very confused when we say that,” Jammeh says. In 1982 during a visit to Madrid, Pope John Paul II told thousands of the faithful that “each and every marriage act must remain open to the transmission of life.” It’s the same sense of avoiding waste as in Islam and Judaism, and the same as in Pope Francis’ Amoris: “Hence no genital act of husband and wife can refuse this meaning”.

Permission granted –sometimes– for health reasons

“Do not kill your children for fear of poverty. We will provide for them and you”.

“It is never lawful, even for the gravest reasons, to do evil that good may come of it”, states the Humanae Vitae encyclical. So do the most die-hard believers believe there is no place at all for birth control? The Humanae Vitae encyclical also says that, “If therefore there are well-grounded reasons for spacing births, arising from the physical or psychological condition of husband or wife, or from external circumstances, the Church teaches that married people may then take advantage of the natural cycles immanent in the reproductive system.” It also discusses the rhythm method of birth control for couples who have already had children, in the interest of “less prolific” fertility.

So, no contraceptives, but using the calendar to avoid sex on fertile days is ok. Ultra-Orthodox Judaism has a similar tradition: men may not touch menstruating women because she is impure. After seven days, she bathes, which purifies her. She may then have relations again. “We know that that day, after they bathe, women can get pregnant. Well they should just not have relations that day,” says Bitton, the ultra-Orthodox rabbi. But the female cycle is not precise like clockwork. What happens if someone gets pregnant on a day other than the bath day? “That’s what God wants,” Bitton says.

The Koran implies using breastfeeding as a form of birth control. It states that a mother should breastfeed at least two years. “Nine months of pregnancy plus another twenty-four…in Islam we think that’s a reasonable time for the mother and the baby,” says Ousman M. Had, president of the Hajj Commission and a member of the Supreme Islamic Council in The Gambia.

All three religions leave a loophole for cases in which the mother’s health is at risk.

In 2016, malnutrition threatened the lives of nearly 52 million children under five worldwide, according to Unicef.

But even that acceptance of medical advice isn’t absolute. “Sometimes we don’t trust certain experts, because they are influenced by ideologies, movements, activism”, Had says. “Years ago, some of our mothers had ten children, or even more, without no problem,” he says. At the time, the childbirth mortality rate was 288 per 100,000 births, much higher than today’s 216 per 100,000 births. After four births, the risk of death rises for mothers, according to the World Health Organisation.

Höffner, the Bnei Brak hospital rabbi, also treats health and financial reasons differently: “Family planning for reasons of money is unacceptable, but if it’s done for emotional reasons or health reasons, then it is acceptable.” That’s assuming you’ve already had at least one boy and one girl.

Gabriel Oelsner is Head of Gynecology at Bnei Brak and has been working hand in hand with the rabbi for 14 years. He needs the rabbi’s sign-off for any intervention, including tubal ligation or inserting an IUD. “If there is a health problem, such as when a woman has had many caesarean sections already, I explain it and he accepts it,” he says. “The doctor makes a recommendation and the woman asks the rabbi for permission,” Höffner says.

So it’s yes to birth control, with conditions, if there are health problems or risks. And it’s no if it’s money worries. And don’t even mention another reason: the personal choice of the woman, which is relegated to the background and which needs the consent of the husband and the rabbi.

Control over women’s sexuality via morality increases men’s power in the family and relegates women to the domestic sphere, reinforcing the patriarchy, according to Coming of age in the classroom: religious and cultural barriers to comprehensive sexuality education, a report by international network of non-governmental organisations The Observatory on the Universality of Rights (OURs).

Educating against contraceptives

“We must encourage educators to create a favourable climate for chastity.”

The OURs report also states that “religion plays a fundamental role in producing and reproducing moral arguments against sex education.” In Guatemala, Nómada reports that conservative officials in the Ministry of Education, as well as Catholic and evangelical influence on the school curriculum, have kept sexual education out of classrooms.

In 2009 José Ignacio Munilla, then the bishop of Palencia, Spain, compared the Unesco Sexuality Education Guide with the crowd-pleasing ‘bread and circus’ of the Roman Empire. In 2015, then the bishop of San Sebastian, Spain, Munilla wrote in Sex with Soul and Body that most sex education classes in the Spanish public school network “do not offer a sexual education but a mere teaching of the genital practice. “ In 2004, Juan Antonio Reig Pla, then bishop of Segorbe-Castellón, in Spain, stated that sexual education in classrooms was reduced to “exalting homosexuality.” But in religion classes in public schools in Spain teachers can speak–or not–about sexuality on their own terms, since it is the Spanish Episcopal Conference that sets the curriculum.

And that lack of sex education has consequences. Yair Hass, from Hillel, talks about its users: “They know absolutely nothing, it’s a taboo subject. On their wedding day, one of them did not know how a child was conceived or the differences between a man and a woman.”

Sarah Reich, an ex-ultra-Orthodox volunteer at Hillel, says that, although she received the “extraordinary” permission of her rabbi to use contraceptives, nobody taught her “how to avoid having children”. Two months after getting married she was pregnant. To avoid a second pregnancy, she got out of bed after having sex and “jumped up and down, jumped a lot, I jumped hundreds of times.”

Who’s word of God?

But not all religious leaders apply the rules the same way nor do all believers follow them the same way. In Mexico, the women’s group Catholics for the right to decide has been promoting another perspective for years. Its animated series, Catolicadas, now in its ninth season, confronts issues such as abortion, sexual education and contraceptives, among many others.

In one episode, the main character, Sister Juana, confronts her alter ego, Father Berto, a grumpy old-fashioned type, and argues that women can also be priests and give mass.

Things have evolved for the better, says Mijal Prince, who researches sexuality among religious women in Tel Aviv: “Now, seven years after I began my research, the world has changed, women have changed, they speak out and they write. I write a weekly sex column in a magazine for religious women that has a circulation of 40,000. It’s crazy.”

Fanta Jatta, head of the women’s rights program at Action Aid International in Banjul, The Gambia, says that contraceptives are not prohibited by Islamic scriptures. “The important thing is understanding the texts and how the people interpret them and, unfortunately, there are more men with religious educations than women. So, the interpretation is done mainly by men.”

Ronit Irshai, a gender studies professor at Bar-Ilan University in Jerusalem, agrees. She says the key is “not to depend on men and to be able to learn the sources and interpret Jewish law so that it respects women”. Irshai says, “the revolution has begun.”