As a Shlucha I have often been presented with questions and stories from professionals who are not accustomed to dealing with observant women and their husbands during the process of childbirth. These people have been trained to treat their patients with compassion and understanding while dispensing their medical expertise. To that end they seek the knowledge to understand their patients so that they may accommodate them accordingly.
This article represents the mainstream Orthodox halachic (Jewish Law) view on the issues of giving birth. Please understand that this is a brief overview for the purpose of providing clarification to medical personnel who find themselves dealing with these couples and wish to be sensitive to their needs. There are Rabbis who are experts in these areas (much as a doctor who specializes in Gynecology and/or Obstetrics) and there are times when a situation arises wherein such a Rabbi needs to be consulted.
TORAH
First of all, let me explain that Jewish Law is determined by Torah. What is Torah? It is often translated to mean Bible, however this translation conjures images of some antiquated history book telling us stories of the past. In actuality, the more accurate translation of Torah would be to look at the root source of the word itself horaah meaning instruction or guide. It is interesting to note that the word for parents in Hebrew is horim plural for guides or instructors indeed parents are the childs primary guide and teacher throughout their lives.
The Torah is our instruction manual, our guide to life. It is not a history book of ancient stories, but a very contemporary book that teaches us how to live our lives today, right here, right now no matter the century. We believe that the Torah is a Divine code, every letter meaningful and precious and as such is truth that is forever, a truth that does not change but withstands the test of time. We are observing the same Torah in the same way since it was given to us on Mount Sinai over 3000 years ago. It is as relevant and essential today, and every day, as it was then.
G-d created all life and what is childbirth if not the creation of life? It is certainly appropriate that we use G-ds manual so to speak and follow His directive of behavior at this time.
JUDAISM AND INTIMACY
Lets start from the beginning the Jewish marriage.
The Hebrew word for marriage is Kiddushin which comes from the Hebrew root word kadosh which means HOLY. Holy in Hebrew means separate, special, set aside and set apart, belonging to only one. This is the Jewish idea of marriage.
We believe that the letters of the Hebrew alphabet contain the secrets of the world, the very essence of creation, G-d used those letters to create every single thing in our universe.
The Hebrew name for man is Ish Alef, Yud, Shin. The Hebrew name for woman is Isha Alef, Shin, Hey. Each of these names contain the Hebrew word for fire within them Aish Alef, Shin. The two remaining letters of these names are Yud and Hey letters of G-ds holy name. Together they are Aish Hashem the fire of G-d.
G-d created man and woman as physical beings. These physical beings have physical needs and a physical passion fire - for one another. When man and woman come together according to the Torah way marrying and attempting to build a family, their physical passion is not just good, it is holy. By following His laws in their relationship, they make G-d the third Partner of their marriage, acknowledging Him as their Father the Creator of everything - Who will bring blessing to their home and their family.
History gave man many different theories about physical intimacy. The ancient Greeks glorified the body, its desires and needs, perfecting it as an end result of its own. Then came religions that considered the physical body and its needs a necessary evil forcing celibacy upon their highest clergy.
Judaism, however, does not say intimacy is good or evil, rather it emphasizes that, done right, intimacy is HOLY! Not just holy, but the holiest act we can be part of! Why? Because when man and woman come together they have the ability to produce a child, a child with a holy soul, a neshama. That soul comes directly from G-d Who allow us to participate in an act that is as G-dlike as possible, since only G-d can create something from nothing, yet here we have the potential to join Him in creating a child!
So how do we make this act a holy act? We follow the Torahs instruction. The Torah tells us who should be intimate, namely a married couple, and when we should be intimate. The Torah gives us times when we should abstain from intimacy, then immerse in a Mikvah following a protocol dictated by Jewish law halacha then resume our intimate relationship.
Sadly, some people think that the purpose of Mikvah is to remove some kind of dirtiness that is associated with the menstrual period. This comes from the association of the two words used regarding Mikvah immersion. One immerses in Mikvah to change ones spiritual status from Tuma to Taharah simplistically translated to Impure and Pure. The truth of the matter is that Mikvah is used to change spiritual status. This has nothing to do with physical cleanliness.
The Kohen Gadol, High Priest, immersed prior to his service in the Bet Hamikdosh the Holy Temple in Jerusalem. The convert to Judaism immerses to signify the change in his status from non-Jew to Jew. One who attends a funeral or visits a cemetery washes their hands upon leaving the cemetery. According to Judaism, the spirit of death, a form of impurity, rests upon our fingernails. We dont see it; it is not a physical thing, but a spiritual issue. The same is true of the menstrual cycle. The blood shed during the menses is the loss of potential life, a pregnancy that could have occurred but did not. That potential for life is lost, dead if you will. This spirit of death needs to be removed, the woman restored to her holy, life giving status with the potential to be part of the creation of a new life. By following the proscribed protocol and immersing in the Mikvah, she removes all spirit of death, and allows the transition from connection to death, to the source of life water is the source of life. Just as a fetus is contained in the water of the womb and emerges as a new life, so a woman emerges from the Mikvah as a new entity, undergoing a spiritual rebirth to reunite with her husband and again be part of the holy union that has the potential to be part of creation.
Torah has three different types
of mitzvot (commandments):
- Chukim Statues Commandments that have no visible rationalization i.e. do not mix milk and meat, the whole issue of Kosher and non-Kosher foods, etc
- Edot Testimonies Commandments that remind us of certain events and ideals i.e. Shabbat, the Festivals, Mezuzah, Tzitzit, etc
- Mishpatim Judgements Commandments that govern the relationships of human beings i.e. do not steal, do not kill, do not lie, etc
According to Chassidus every mitzvah actually contains elements of all three of these categories. While Mikvah falls into the Chok (singular for Chukim) category, we are still able to see many possible benefits from its observance.
The entire concept of Mikvah, the intimate separation of a couple from each other and the reunion they have after the Mikvah immersion provide advantages on the practical, spiritual and psychological levels.
Absence makes the heart grow fonder - There is no question that a separation only heightens the excitement of a reunion. Abstaining from all physical touch creates a newness that the couple can experience when they come together again. That sense of renewal stands them in good stead throughout the years of their marriage, keeping that newness and excitement alive and well even into the later years of life.
Communication A couple who observe Mikvah find themselves learning to communicate with one another on many different levels from the very beginning of their marriage. When the physical option is removed a couple must learn to use their words, their eyes, their very expressions they cannot fight and make up in the bedroom!
Respect and Individuality - Two beds and physical space give rise to respect for the person, their personal space and individual needs. Boundaries are set and adhered to and the result is an enduring respect for one another.
Medical Advantages Observance of the laws of Mikvah give a woman a deeper and clearer understanding of her body and its functions. Women are taught to learn their individual bodies and be comfortable with themselves. They are able to discern possibly unhealthy situations that may occur, often far earlier than their non-observant counterparts.
Menstruation is the shedding of the uterine lining that has built up to accommodate and nourish a possible pregnancy. Once that lining is shed it takes seven days to regenerate. Some physicians have discovered that intimate relations during that time can be unhealthy until that lining has completely regenerated. The vagina is naturally acidic, thereby repelling germs. During menstruation, however, it becomes alkaline and more receptive to germs, less able to repel them. It takes seven days for it to revert to its naturally acidic and protective state. Emotionally as well, women are more receptive to intimacy and all it entails about seven days after the period has ended, often coinciding with a womans most fertile time of the month when she is by nature at the peak of her physical desire.
Spiritual Meaning - Mikvah is a mitzvah given to us by G-d, the Creator of all life. We live this life in this world, we look to G-d, its Creator to guide us and give us direction on how to live this life. We stand in the Mikvah waters where the gates of heaven are open to our prayers and we pray for all we need, all we desire. We emerge from the Mikvah spiritually renewed, ready to unite with our husbands in holiness.
PRACTICAL APPLICATION
We have discussed the issue of Mikvah and the spiritual transition immersion in Mikvah brings. So how does this all work? How does this affect an observant woman during childbirth?
Menstruation brings a woman into the status of Nidah literal translation separation practically speaking, the time that a woman separates physically from her husband until the Mikvah immersion changes her spiritual status to non-Nidah Tahor. This Nidah status and its accompanying physical separation comes not only from actual menstruation, but from any uterine bleeding, including the blood associated with birth bleeding, mucous plug, bloody show, etc.
What does this physical separation entail?
Not only must an observant couple refrain from actual relations during the time the wife in the nidah status, but there are also restrictions of any physical contact, including hugging, kissing, touching, passing or throwing things directly to one another. At that time a husband is only permitted to see his wife in a modestly dressed fashion. All parts of her body that are covered for the general public, are to be covered in his presence as well.
Of course the reasons for this are rather obvious, once you know that intimate relations are forbidden to the couple at this time. It only makes sense that anything that may lead to arousal or pique physical interest would be forbidden as well, truly as an aid to the couple to help them keep the critical observance of forbidden intimacies at this time. So while intimacy between husband and wife is of the utmost holiness at the proper time, it is strictly prohibited at the incorrect time.
In terms of childbirth, a nurse or doctor who sees a husband who does not hold his wifes hand in comfort or kiss her in jubilation may think: What kind of relationship does this couple have?? What kind of parents will they be if they cannot show affection to one another at such an emotional time?
The laws of Tzniut modesty are to be carefully observed as well. This means that the husband leaves the room, or at least stands behind the curtains during vaginal exams and during the actual birth or at least at a distance or angle, where his wifes modesty can be maintained. By giving him notice of these exams, you can ease the situation tremendously. Helping a laboring woman, who may not always be in full control of what is going on around her, maintaining her head covering and keeping her elbows, knees and everything in between as covered as possible, will ensure her comfort in often uncomfortable circumstances.
Observant couples not only love each other, but they share a devout commitment to one another and to their Torah observance. They will impart these strong values to their children as they raise them in the true spirit of Torah and belief in G-d.
How does the Torah view a new mother? For the first 72 hours post birth a woman is considered to be in the category of someone who is seriously ill. Anything that needs to be done for her is permissible for example she is permitted to eat on the holiest of holy days Yom Kippur (the Day of Atonement where Jews fast for 25 hours). Even the Shabbat (Sabbath) may be desecrated if there is no other way to meet her needs during that time. However, a woman who is observant will of course try her utmost to maintain the laws of Shabbat and the holidays. In this respect, the non-Jewish hospital staff can help by doing these things for her, adjusting her bed, turning lights off or on, etc as needed to ensure her comfort so she can get the rest she needs to regain her strength and recover.
KASHRUT
Another issue that arises while an observant woman is confined to the hospital is keeping Kosher. Many are aware of the prohibition against pork and its byproducts, however, the laws of Kosher are more complex than the prohibition of pork. Kosher means that we may eat only meat from certain animals, and that meat needs to be ritually slaughtered according to Torah law. Not all fish are kosher, only those who have both fins and scales are permitted.
When we eat kosher, it means that we not only follow very specific laws of not mixing milk and meat, it is also means that we wait six hours after eating any meat foods before we may eat dairy foods. We eat only foods that have been prepared under strict rabbinical supervision and have that rabbinical certification on the package. This includes all prepared fruits, vegetables and grains. We also recite a prayer both before and after we eat, blessing and thanking G-d for providing us with this food, asking Him to allow this food to give us the strength and well being to continue to perform His commandments.
There are also many who observe Cholov Yisrael, dairy products that have been supervised by a Jewish person from the very moment of milking to the final prepared product. This too requires a symbol of rabbinical supervision, to allow consumption by an observant woman.
The laws of kosher, kashrut, are detailed and complex and while it may be difficult to comprehend, the understanding and respect given by hospital staff can only help the observant patient feel comfortable in her surroundings and enable her to focus her energies on getting strong and well.
Observance of the laws of kashrut, the laws of nidah, the laws of tzniut and all the commandments of the Torah bring spirituality to this physical world. We believe that the entire universe was created to bring the glory of G-d and His will from the highest heavens down to the mundane world we live in, thereby giving all things physical, a spiritual significance.
SHABBAT AND JEWISH HOLIDAYS
Another important situation for the observant woman in hospital is the observance of Shabbat and Jewish Holidays. Shabbat is the day of rest that we observe each week beginning at sundown on Friday afternoon and ending at nightfall on Saturday, a total of about 25 hours. G-d rested from His creation of the world on the seventh day which, according to Torah, is Saturday. On the Shabbat we refrain from doing many things you probably would not consider work, but they are prohibited nonetheless. Use of electricity in any form is prohibited; in terms of a hospital stay this has numerous implications:
A. Call button
B. Lights
C. Phone
D. Automatic doors
E. Television
F. Automatic bed adjustment
Also prohibited is writing and the handling of money including credit cards - thus no forms can be completed and discharge must be delayed until after Shabbat or the holiday. The observant woman will wish to light the Shabbat and holiday candles, if she is physically capable of doing so. If at all possible, provide an area where this can be done safely.
The holiday of Passover will have your observant patient eating nothing but whole, raw fruits or vegetables from the meal trays, most waiting for family members to provide their food for them. The holiday of Rosh Hashana will include a visit by some member of friend or family to blow the Shofar, the rams horn, and Succot will bring round a visitor bearing the palm frond and citron to be blessed.
BRIT MILAH/BABY NAMING
Completion of the birth certificate is a huge issue when you take into account that Jewish girls are named only on Mondays, Thursdays or Shabbat the days the Torah is read during the prayers. Baby boys are named only at the brit milah circumcision ceremony performed on the eighth day from birth. Once you are aware of this fact you can easily understand that the observant couple anticipated their childs birth with joy and most certainly thought long and hard about just the right name for their baby they just cant make it official yet! The birth certificate is often sent to the parents with just Baby Boy/Baby Girl in place of the name and parents then submit the name at a later date and have it added to the legal papers.
BIRTH CONTROL
Todays society is accustomed to the concept of birth control, however, observant women consider a large family to be the biggest blessing! The commandment to be Fruitful and Multiply is one we take literally. While Torah certainly has provision for those whose health or circumstance requires a break, it is the exception rather than the rule. An observant woman may be very uncomfortable with the concept. If necessary, this is something to be discussed privately with her husband, her doctor and then her rabbi, it does not have to be discussed by those tending her in hospital during her recovery time.
IN CONCLUSION
Other things to keep in mind would be the Shir Hamalos cards that Jewish women of all levels of observance may wish to place in the babys bassinet. These cards contain Kabbalistic letters and words of protection for mother and child. Some women may even wish to have these cards enclosed in envelopes for modesty during their labor. Many women will place a sacred prayer book, the book of Psalms or pictures of holy rabbis in the crib as well, in keeping with the philosophy of surrounding the child with holy items from the moment of birth.
Any religious icons or symbols, frequently found in hospitals, would be uncomfortable for Jewish patients. If at all possible, either cover or temporarily remove those items during their stay.
One other important fact that is frequently misunderstood, observant men and women do not shake hands or physically touch a member of the opposite gender who is not a close blood relative. So do not feel rebuffed if he/she declines shaking hands, it is nothing personal, just another aspect of the laws of modesty. It is most comfortable for all to simply be aware of this and refrain from extending your hand in greeting or casual touch.
The main requirement is understanding, respect and compassion for actions and beliefs that you have never heard of and may not understand. In this way you have taken your job as a caregiver to the next level and you can be sure that the nurturing you provide will be appreciated by all.
This article was edited and revised by Chaya M. Klein, editor and administrator of mikvah.org, from a lecture given by Dvora Green.