Is it our understanding that we are to propagate children as long and as frequently as the human body will permit? Is there not any kind of “gospel family-planning,” for lack of a better way to say it?

Dr. Homer Ellsworth, gynecologist and former member of the Melchizedek Priesthood General Committee I hear this type of question frequently from active and committed Latter-day Saint women who often ask questions that are outside my professional responsibilities. Here are some of the principles and attitudes I believe apply to this fundamental question, a question most couples ask themselves many times during their child-bearing years.

I rejoice in our basic understanding of the plan of salvation, which teaches us that we come to earth for growth and maturity, and for testing. In that process we may marry and provide temporal bodies for our Heavenly Father’s spirit children. That’s basic, it seems to me. In contemplating this truth, I also take great delight in the Church’s affirmative position that it is our blessing and joy, and our spiritual obligation, to bear children and to have a family. It impresses me that the positive is stressed as our goal.

I rejoice in our understanding that one of the most fundamental principles in the plan of salvation is free agency. The opportunity to make free agency choices is so important that our Heavenly Father was willing to withhold additional opportunities from a third of his children rather than deprive them of their right of choice. This principle of free agency is vital to the success of our probation. Many of the decisions we make involve the application of principles where precise yes-and-no answers are just not available in Church handbooks, meetings, or even the scriptures.

Our growth process, then, results from weighing the alternatives, studying the matter carefully, and seeking inspiration from the Lord. This, it seems to me, is at the heart of the gospel plan. It has always given me great joy and confidence to observe that in their administration of God’s teachings, our inspired prophets do not seek to violate this general plan of individual agency, but operate within broad guidelines that provide considerable individual flexibility.

I recall a President of the Church, now deceased, who visited his daughter in the hospital following a miscarriage.

She was the mother of eight children and was in her early forties. She asked, “Father, may I quit now?” His response was, “Don’t ask me. That decision is between you, your husband, and your Father in Heaven. If you two can face him with a good conscience and can say you have done the best you could, that you have really tried, then you may quit. But, that is between you and him. I have enough problems of my own to talk over with him when we meet!” So it is clear to me that the decisions regarding our children, when to have them, their number, and all related matters and questions can only be made after real discussion between the marriage partners and after prayer.

In this process of learning what is right for you at any particular time, I have always found it helpful to use a basic measuring stick: Is it selfish? I have concluded that most of our sins are really sins of selfishness. If you don’t pay your tithing, selfishness is at the heart of it. If you commit adultery, selfishness is at the heart of it. If you are dishonest, selfishness is at the heart of it. I have noted that many times in the scriptures we observe the Lord chastising people because of their selfishness. Thus, on the family questions, if we limit our families because we are self-centered or materialistic, we will surely develop a character based on selfishness. As the scriptures make clear, that is not a description of a celestial character. I have found that we really have to analyze ourselves to discover our motives. Sometimes superficial motivations and excuses show up when we do that.

But, on the other hand, we need not be afraid of studying the question from important angles—the physical or mental health of the mother and father, the parents’ capacity to provide basic necessities, and so on. If for certain personal reasons a couple prayerfully decides that having another child immediately is unwise, the method of spacing children—discounting possible medical or physical effects—makes little difference. Abstinence, of course, is also a form of contraception, and like any other method it has side effects, some of which are harmful to the marriage relationship.

As a physician I am often required to treat social-emotional symptoms related to various aspects of living. In doing so I have always been impressed that our prophets past and present have never stipulated that bearing children was the sole function of the marriage relationship. Prophets have taught that physical intimacy is a strong force in strengthening the love bond in marriage, enhancing and reinforcing marital unity. Indeed, it is the rightful gift of God to the married. As the Apostle Paul says,

“The wife hath not power of her own body, but the husband; and likewise also the husband hath not power of his own body, but the wife.” Paul continues, “Depart ye not one from the other, except it be with consent for a time, that ye may give yourselves to fasting and prayer; and come together again, that Satan tempt you not for your incontinency.” (JST, 1 Cor. 7:4–5). Abstinence in marriage, Paul says, can cause unnecessary temptations and tensions, which are certainly harmful side effects.

So, as to the number and spacing of children, and other related questions on this subject, such decisions are to be made by husband and wife righteously and empathetically communicating together and seeking the inspiration of the Lord. I believe that the prophets have given wise counsel when they advise couples to be considerate and plan carefully so that the mother’s health will not be impaired. When this recommendation of the First Presidency is ignored or unknown or misinterpreted, heartache can result.

I know a couple who had seven children. The wife, who was afflicted with high blood pressure, had been advised by her physician that additional pregnancy was fraught with grave danger and should not be attempted. But the couple interpreted the teachings of their local priesthood leaders to mean that they should consider no contraceptive measures under any circumstances. She died from a stroke during the delivery of her eighth child.

As I meet other people and learn of their circumstances, I am continually inspired by the counsel of the First Presidency in the General Handbook of Instructions that the health of the mother and the well-being of the family should be considered. Thirty-four years as a practicing gynecologist and as an observer of Latter-day Saint families have taught me that not only the physical well-being but the emotional well-being must also be considered. Some parents are less subject to mood swings and depression and can more easily cope with the pressures of many children. Some parents have more help from their families and friends. Some are more effective parents than others, even when their desire and motivation are the same. In addition, parents do owe their children the necessities of life. The desire for luxuries, of course, would not be an appropriate determinant of family size; luxuries are just not a legitimate consideration. I think every inspired human heart can quickly determine what is a luxury and what is not.

In summary, it is clear to me that couples should not let the things that matter most be at the mercy of those that matter least. In searching for what is most important, I believe that we are accountable not only for what we do but for why we do it. Thus, regarding family size, spacing of children, and attendant questions, we should desire to multiply and replenish the earth as the Lord commands us. In that process, Heavenly Father intends that we use the free agency he has given in charting a wise course for ourselves and our families. We gain the wisdom to chart that wise course through study, prayer, and listening to the still small voice within us.