The prohibition of sterilization applies to women as well as men, but sterilizing a woman is a rabbinic prohibition rather than a Torah one. The Torah prohibits male castration, as it says, “You shall not offer to the Lord anything [with its testes] bruised or crushed or torn or cut. You shall have no such practices in your land” (Vayikra 22:24). All these actions damage the male reproductive organs, which are external, and not the female reproductive organs, which are internal. Similarly, the prohibition of a saris to marry applies only to a man who has been sterilized, as the verse states, “No one whose testes are crushed or whose penis is cut off shall be admitted into the congregation of the Lord” (Devarim 23:2). Clearly, this refers to a man. In contrast, a woman who has been sterilized is allowed to marry freely. Nevertheless, from the standpoint of the mitzva of procreation, a man who has not yet fulfilled his obligation may not marry an infertile woman.
The rabbinic prohibition of female sterilization is limited to cases where this is done directly, either through physical trauma or surgery. However, indirect sterilization, such as by drinking an infertility potion, is permitted. Even this indirect sterilization, though, is permitted only when truly necessary to sterilize her, such as if she has extremely difficult labor, or if her children turned out poorly and she is afraid to bring more children into the world, and accepted methods of birth control are not viable options for her (above, 5:17-19). However, when there is no particular reason, infertility may not be caused even indirectly, as there is a general prohibition on wantonly destroying anything in God’s world (bal tashḥit; Devarim 20:19). Certainly, then, one may not destroy a woman’s ability to have children.
Permission for a woman to undergo sterilization is also contingent upon her husband’s consent, because in agreeing to marry him she committed to be his full partner in the mitzva of procreation (Ḥatam Sofer, EH §20; above 5:14; see also 5:6).
In recent years, the issue has arisen of sterilizing a woman by tubal ligation, a procedure, colloquially called “getting one’s tubes tied,” in which the fallopian tubes (through which the egg travels from the ovaries to the uterus, where it can be fertilized) are cut, tied, or blocked, preventing the eggs from reaching the uterus, making pregnancy impossible. The question is whether a woman who experiences difficult pregnancies and does not want any more children may ask her doctor to sterilize her via tubal ligation. Some say that tubal ligation is like drinking a sterility potion, since the sterilization is not visible externally (Si’aḥ Naḥum §100). Additionally, this type of sterilization is not irreversible; sometimes the tubes can be surgically repaired. Even if the reversal procedure does not work, it is still possible to extract an egg from the ovary and do IVF. Others say that since ligation is an act of sterilization performed on the reproductive organs themselves, it is rabbinically prohibited. Thus, as long as it is possible for a woman to take birth control pills or have an IUD inserted, tubal ligation is prohibited (Igrot Moshe EH 4:33-34 and 4:32:1). Today there is a procedure that blocks the fallopian tubes indirectly. This is permitted even according to the stringent opinion.
There are two possible explanations for the majority opinion that the Torah prohibition of sterilization applies to men and not to women. First, the Torah prohibition is limited to injuries to reproductive organs that are external, not internal. Second, a man is obligated in the mitzva of procreation, while a woman is not (even though she is performing a mitzva). Therefore, the prohibition of female sterilization is only rabbinic, and indirect sterilization is permitted.
At first glance, there seems to be a disagreement about the indirect sterilization of a woman as well. According to Beit Shmuel 5:14 and most poskim, a woman may drink an infertility potion even when there is no need. In contrast, Baḥ and Yam Shel Shlomo permit drinking an infertility potion only when there is a specific need. It seems that all poskim would agree that without any need at all, such an act is forbidden, because of the prohibition on wasteful destruction. The disagreement, then, is about how great the need must be. Must it be a case of great need, or does ordinary need suffice?
. We can infer from Responsa Devar Yehoshua, EH 3:7, that if the ligation is reversible, the procedure is not considered total sterilization. In contrast, Igrot Moshe, EH 4:32:1, rules stringently, since reversing the ligation requires surgical intervention. In practice, since the disagreement is about a rabbinic prohibition, under pressing circumstances, the lenient opinion may be relied upon. However, nowadays this is unnecessary, because a new method for indirectly blocking the fallopian tubes has been found. The blockage is achieved by inserting a coil into the fallopian tube. Within a few weeks, scar tissue forms around the coil, blocking the tube. Since the sterilization is indirect, it is like drinking a sterility potion, which is permitted when there is a great need. (This is based on an article by R. Yoel and Dr. Chana Katan, “Ḥasima Hafikha shel Ha-ḥatzotrot,” in R. Mordechai Halperin, ed., Metzi’ut U-refu’a Be-Seder Nashim, pp. 290-292.) Though some challenge this, claiming that this is direct, not indirect sterilization, it seems clear that the act is considered grama (indirect), especially considering that some maintain that even tubal ligation is not considered halakhic sterilization (Si’aḥ Naḥum §100).