Reb Elchanon (Kovetz Hearos 23) discusses whether it is permitted for a person to put themselves into a situation where they will have to use the permissibility of pikuach nefesh (they are in mortal danger) to permit what otherwise would have been regarded as a prohibition.
Reb Avi Lebovitz (Hearos on the Daf/) explains Reb Elchonon: He proves from the Ba'al Hameor who forbids leaving on a ship within three days of Shabbos because it is likely that you will find yourself in a situation of pikuach nefesh and have to be desecrate the Shabbos, that it is only a Rabbinical prohibition, but not Biblical (if it would be an Biblical, it should not matter if it is within three days or more than three days). Once it is only a Rabbinical prohibition, we can permit it for shalom bayis purposes. Therefore, one would be allowed to have relations with a woman for whom it is dangerous to become pregnant, even though after relations she will use a 'moch' to prevent pregnancy (I am not sure about the statistical success rate associated with this form of birth control).
This explanation would be necessary if we learn the Gemora to be speaking about a moch (wad) after relations (Tosfos in the name of Rabbeinu Tam) and would be forbidden if not for pikuach nefesh. But, according to Tosfos who explains that these three women must use a moch, which implies that others also are allowed to because there is no prohibition for her to remove the shichvas zerah (semen) with a moch after engaging in relations, we don't need to come onto the permissibility of pikuach nefesh.
Reb Elchonon second guesses his proof, that perhaps there is a Biblical prohibition to put oneself into a situation where pikuach nefesh will have to override the prohibition and no proof can be brought from the Ba'al Hameor because he may hold that Shabbos specifically is "hutrah," (completely permitted) for pikuach nefesh (but other prohibitions which are only "dechuya," (overridden), there would be a Biblical prohibition to out rightly put oneself into a situation where they will have to rely on the license of pikuach nefesh.
At the end he cites a Magen Avrohom (O.C. 248) who questions whether one, who intentionally put themselves into a situation of pikuach nefesh should rely on it to override Shabbos. Reb Elchonon explains that by not relying on this permissibility, it comes out retroactively that he did not do a prohibition by placing himself in that situation. Reb Moshe has a teshuva where he adamantly disagrees and says that one must use the permissibility of pikuach nefesh to override Shabbos and save their life.
Reb Avi Lebovitz (Hearos on the Daf/) explains Reb Elchonon: He proves from the Ba'al Hameor who forbids leaving on a ship within three days of Shabbos because it is likely that you will find yourself in a situation of pikuach nefesh and have to be desecrate the Shabbos, that it is only a Rabbinical prohibition, but not Biblical (if it would be an Biblical, it should not matter if it is within three days or more than three days). Once it is only a Rabbinical prohibition, we can permit it for shalom bayis purposes. Therefore, one would be allowed to have relations with a woman for whom it is dangerous to become pregnant, even though after relations she will use a 'moch' to prevent pregnancy (I am not sure about the statistical success rate associated with this form of birth control).
This explanation would be necessary if we learn the Gemora to be speaking about a moch (wad) after relations (Tosfos in the name of Rabbeinu Tam) and would be forbidden if not for pikuach nefesh. But, according to Tosfos who explains that these three women must use a moch, which implies that others also are allowed to because there is no prohibition for her to remove the shichvas zerah (semen) with a moch after engaging in relations, we don't need to come onto the permissibility of pikuach nefesh.
Reb Elchonon second guesses his proof, that perhaps there is a Biblical prohibition to put oneself into a situation where pikuach nefesh will have to override the prohibition and no proof can be brought from the Ba'al Hameor because he may hold that Shabbos specifically is "hutrah," (completely permitted) for pikuach nefesh (but other prohibitions which are only "dechuya," (overridden), there would be a Biblical prohibition to out rightly put oneself into a situation where they will have to rely on the license of pikuach nefesh.
At the end he cites a Magen Avrohom (O.C. 248) who questions whether one, who intentionally put themselves into a situation of pikuach nefesh should rely on it to override Shabbos. Reb Elchonon explains that by not relying on this permissibility, it comes out retroactively that he did not do a prohibition by placing himself in that situation. Reb Moshe has a teshuva where he adamantly disagrees and says that one must use the permissibility of pikuach nefesh to override Shabbos and save their life.
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