2011-05-25

Hasidic Childbirth Customs

Hasidic Childbirth Customs

This entry describes Hasidic Childbirth Customs: the beliefs and practices of Hasidic Orthodox Jews with respect to childbearing. Strict observance of Jewish law (‘‘halacha’’) is central to the way of life of Haredi (ultra-Orthodox) communities. Many Hasidic groups share similar views towards sex, pregnancy, birth and motherhood.

Most Haredi Jews today live in Israel and North America, in communities that resist the influence of secular society, but which engage with secular society to varying degrees, in accordance with religious law. Rabbis counsel women and men in their health care decisions and mediate the application of religious rules to modern-day family situations. Haredi Jews have selectively embraced secular biomedical technologies where those have enabled them to fulfill their religious obligations, including the obligation to “be fruitful and multiply” (Genesis 1:28).

Much of the information that follows is specific to the Hasidic communities of Brooklyn, New York since World War II.

Background

United States Jewish population estimates

The demography of Haredi populations has been understudied apart from the overall Jewish population, from which Haredi Jews are culturally distinct. A recent study of the national Hasidic population used Yiddish language spoken at home and young age profile of communities to estimate the total national population at between 137,000 and 145,000 for the year 2000, a smaller number than previous estimates. Hasidic Jews represent the fastest-growing segment of the Jewish population. (Comenetz 2006)

In 2010, the total Jewish population of the United States was estimated to be 6,544,000. The Northeast region represented only 18% of the total U.S. population, but 44% of the Jewish population. Of approximately 1.6 million Jews in New York state, about 1.4 million were counted in the New York metropolitan area in 2002, including New York City and Nassau, Suffolk and Westchester counties. Of the five boroughs of New York City, Brooklyn was home to the most Jewish people, with 456,000. (Mandell L. Berman Institute North American Jewish Data Bank 2010)

According to the National Jewish Population Survey, 10% of American Jews considered themselves Orthodox in 2000-01. Compared with the overall Jewish population, Orthodox Jews were younger and had lower rates of intermarriage with non-Jews: more than half of Orthodox adults were age 44 or younger, and the intermarriage rate was 5% versus 47% for all Jews. (United Jewish Communities 2004)

The Jewish Community Study of New York: 2002 found that Brooklyn’s Jewish population includes a higher proportion of Orthodox Jews, and is younger and poorer on average, compared to the eight-county New York metro area as a whole. In the metro area, Jews were most likely to identify as Reform or Conservative (29 and 25% of respondents, respectively), whereas in Brooklyn, the largest proportion, 37%, described themselves as Orthodox. (Brooklyn also had higher percentages of self-described Non-Denominational and Secular/Non-religious Jews than the eight-county average.) (UJA-Federation 2004)

Over the same ten-year period that the proportion of Orthodox Jews rose from 13% to 19% of all Jews in New York City (from 1991–2002), the percentage of Jewish households earning less than 150% of the federal poverty threshold doubled to 21%. Analysts attributed this increase in poverty to increases in the proportion of elderly, Russian-immigrant, and Orthodox Jews. Hasidic communities have large family sizes and, on the whole, lack the educational preparation for professional jobs for ideological reasons. (Treiman 2003)

Physical environment of Hasidic communities

Hasidic Jews, unlike other ultra-religious cultural groups in America, occupy an urban environment, concentrated as they are in the New York City metro area. They accept modern conveniences insofar as their use does not contradict religious law and spiritual values. Residential communities are tightly clustered to accommodate walking to synagogue on the Sabbath and living within walking distance of the Rebbe, who is the leading religious authority and defines distinct Hasidic groups such as the and Lubavitchers. (Comenetz 2006)

There are several suburban satellite communities outside of New York, including the Hasidic-controlled municipalities of Kiryas Joel in Orange County and New Square in Rockland County, which are almost 100% Jewish. (Mandell L. Berman Institute North American Jewish Data Bank 2010).

The Satmar Rebbe Joel Teitelbaum established Kiryas Joel in the 1970s in the hopes that the community would grow protected from impious influences. (Gutwirth 2005) Today, the village has a young population profile owing to large family size, with almost six people in the average family and a median age under 12. In the 2010 U.S. Census, Kiryas Joel had the highest proportion of people living in households earning less than the federal poverty threshold (71%) of any place larger than 10,000 residents. About half of residents receive food stamps and one-third receive Medicaid benefits and federal housing vouchers, but the community is well-organized. Crime is virtually nonexistent. (Roberts 2011)

Hasidic history

Hasidic Judaism emerged in the mid-eighteenth century in the Carpatho-Russian mountains, in Galicia on the Polish-Romanian border and the Volhynia region of present-day Ukraine. There, Rabbi Israel Ben Eliezer (1700–1760), known as Baal Shem Tov or “Master of the Good Name,” started a movement as a reaction against the rigid forms of worship and formal, ascetic rabbinical leadership of Judaism at the time. He emphasized joyous religious experience and the importance of serving God in all aspects of life. The rebbes that came after formed dynastic courts throughout Eastern and Central Europe. Communities were defined by the personality and philosophy of the rebbe, who was considered to have divine knowledge and to mediate between God and the people. (Shaffir 1996)

The Holocaust decimated the Hasidic centers of eastern Europe, and the rebbes who survived settled in Jerusalem and [Bnei Brak|B’Nai Brak] in the new Israel, and in Brooklyn and Montreal. They brought with them the name of their geographic place of origin – Lubavitch, , Belz, Satmar, and Bobbov – as well as loyal followers. The Hungarian Satmar Rebbe. Joel Teitelbaum, settled in Williamsburg, Brooklyn in 1947. The Russian Lubavitch Rebbe, Yosef Yitzchok Schneersohn, settled in the Crown Heights area. (Kranzler 1993)

Hasidic Jews in Brooklyn today are concentrated in the neighborhoods of Williamsburg (Satmar), Crown Heights (Chabad-Lubavitch), and Boro Park, which is home to Hasidic as well as other Orthodox Jewish communities and shows the fastest rate of population growth (UJA-Federation 2004). Although the Satmar was the largest Hasidic sect in 2000, the Lubavitchers are most well-known because of their outreach to the broader non-Hasidic and non-Orthodox Jewish population. (Comenetz 2006) By contrast, the Satmar Hasidim shun outsiders and are staunchly anti-Zionist. (Shaffir 1996)

Economic activity

Hasidic men pursue work that allows them to structure their time around religious activities and obligations, often learning a trade or joining the family business during or after yeshiva studies. 25% of Hasidic men living in Williamsburg are self-employed in such industries as jewelry (particularly as diamond brokers and traders), silverware, and electronics. (Gutwirth 2005) (B&H Photo Video in Midtown Manhattan is owned and operated by Satmar Hasidic Jews, and is closed on Saturdays.) Others are public-sector employees, skilled workers such as carpenters and electricians, insurance brokers, estate agents, securities brokers, teachers and administrators in Hasidic schools, scribes of religious documents, and supervisors or ritual slaughterers in the ‘‘kashrut’’ food industry. (Gutwirth 2005)(Shaffir 1996)

The Hasidic women of Williamsburg have worked, when childcare demands permitted, in textiles and as teachers in religious schools. In recent years they have been more likely to work in offices or run their own shops selling wigs and modest clothing to Orthodox women. Women are active in community service activities. (Gutwirth 2005)

Few people raised in Hasidic families pursue secular higher education, so the professional class is small and earning potential is limited. Hasidic professionals may be newly Orthodox Jews that affiliated with the Lubavitchers after their education. (Shaffir 1996) Health care providers for Hasidic communities are, more often than not, non-Hasidic.

In 1984, the U.S. Department of Commerce declared the Hasidim a disadvantaged minority, expanding their access to federal aid. (Kranzler 1993)

Hasidic birth rates

The commandment to “be fruitful and multiply” still exerts strong influence on the reproductive practices of Haredi communities, as reflected by high fertility rates compared to Modern Orthodox and non-Orthodox populations.

By one estimate, the birth rate for the Hasidic population in the United States was 7.8, versus 3.3 for Modern Orthodox and less for the non-Orthodox population (Teman Ivry Bernhardt 2011). A more conservative estimate puts the number at 5-6 children per household. (Comenetz 2006)

Religious precepts

Haredi Jews meticulously observe Jewish law (‘‘halacha’’) as set out in the Five Books of Moses (Torah or Pentateuch), the Talmud, post-Talmudic codes and commentaries, and the rabbinical rulings on legal questions known as the responsa literature. The 613 Mitzvot are fundamental commandments for acts of commission and omission.

In the Orthodox tradition, religious obligations must be observed, regardless of the reason behind them, and regardless of one’s personal attribution of meaning to the practice. In many instances, no reason is given by the source in Jewish law, and various rabbinical authorities have interpreted the meaning of the words differently. Attributions have evolved over time and in different places, but practices have remained comparatively stable. (Hartman & Marmon 2004)

In Judaism, marriage represents the completion of each human being in a spiritual and bodily sense. Sexual intercourse is an essential part of marriage, being both pleasurable and productive of children. For Haredi Jews, sex is pure so long as a couple observes the laws of family purity, or ‘‘tahirat hamishpacha’’. (Bodo & Gibson 1999) According to these laws, a woman is a ‘‘Niddah’’ whenever she experiences bleeding from her womb. She must maintain separation from her husband for a period of ritual impurity that begins with menstruation or uterine bleeding, and ends with immersion in a purifying ritual bath (‘‘mikveh’’). (Lubavitch Haredim explain that menstrual blood is a source of pollution because it is associated with the destruction of a life-creating force, such as an unfertilized ovum.) (Levy 1975)

A husband is required to provide his wife with sexual pleasure by the mitzvah of sexual visitation (‘‘onah’’). Sexual intercourse must follow his wife’s ‘‘mikveh’’ immersion. She is considered pure, having immersed herself in the water naked, with nothing between her body and the water, in an enactment of rebirth into purity; the ‘‘mikveh’’ is poetically conceptualized as a womb. Women are encouraged to communicate the completion of the ritual bath, and have the right to express their physical desires to their husband during this sexual phase. (Hartman & Marmon 2004)

The rules of ritual separation are specific. For at least five menstrual days and for seven “white” days of no bleeding, husband and wife may not touch, share a bed, or have sexual intercourse, and a husband cannot receive anything from his wife’s hands. (Bodo & Gibson 1999) Customarily, women check for residual uterine bleeding at specified times on each of the seven days by inserting a special cloth into the vagina. If any color appears on the checking cloth, she should bring it to a rabbi for inspection. If he determines that the mark is blood of uterine origin, she must wait for her checks to be bloodless, and then begin to count the seven clean days over again. (Hartman & Marmon 2004)

At the beginning of pregnancy, a woman’s separation behavior depends on the regularity of her menstrual cycle prior to becoming pregnant: if her menses occurred at regular intervals, she should observe the same 12-day separation pattern for three months; but if her menses occurred irregularly, she observes ritual separation for one month only. (Finkelstein & Finkelstein 1993)

While it is a halachic commandment for men to procreate, women are not obligated to bear children because pregnancy has the potential to threaten a woman’s life (Bodo & Gibson 1999). Throughout pregnancy, labor and birth, her life takes priority over other religious obligations such as observing Shabbos and fasting on holy days.

Having a large family is a mitzvah (good deed). Although one male and one female child is sufficient to fulfill the commandment to “be fruitful and multiply and replenish the earth,” a couple should welcome those children that God provides. (Bodo & Gibson 1999).

Social structure and organization

The sexes are segregated except in the context of immediate family. (Kranzler 1995) In Orthodox synagogues, a divider (‘‘mechitza’’) sections the congregation into male and female. Physical contact between men and women is limited to the marital relationship in part because a woman’s niddah status cannot be determined by her appearance. (Levy 1975) Also, women and men are required to maintain modesty, or ‘‘Tznius’’. Women wear long-sleeved blouses and long skirts, or high-necked dresses, and cover their hair or wear wigs, depending on the Haredi group.

Young people usually marry at the age of 18-20. Marriage is arranged by friends, family or community members who act as the marriage broker (‘‘Shadchan’’). (Shaffir 1996) Typically, a courting couple will meet several times and discuss feelings and life goals without physical contact. (Levy 1975) Courtship meetings may take place in the living room of the woman’s family. Lubavitchers may meet in public or go for a drive. (Shaffir 1996)

In the Lubovitch tradition, women attend bridal classes (‘‘kallah’’) to learn the laws of family purity before marriage, while husbands spend the first 1-2 years of marriage in full-time ‘‘kollel’’ classes, during which time their wives work to support them. (Levy 1975) Although endogamy is preferred, a Lubovitch man may gain approval to marry a non-Lubovitch woman provided she is Jewish and commits to practising the home rituals expected of a Lubovitcher. The reverse situation – a Lubovitch woman marrying a convert – is considered inappropriate, because a woman follows her husband’s customs and beliefs and she should not become less righteous in this way. (Levy 1975)

Education

Boys and girls undergo separate educational experiences that train them for distinct roles: men supervise religious matters and are eligible for rabbinical degrees, whereas, traditionally, women have been charged with maintaining the home and ensuring that their children live by religious and ethical principles. Hasidim do not generally pursue secular higher education. They run their own religious schools, with the minimum secular curriculum to comply with state requirements. Non-academic subjects like music and physical education are excluded, and textbooks may be censored. Secular studies end at 16 for both boys and girls. (Shaffir 1996)

Yiddish is spoken in most Hasidic households, and instruction by Hasidic teachers is conducted in Yiddish. Boys learn Torah, including the Pentateuch and the Babylonian Talmud, until 16 or 17, when they move on to advanced religious study in Yeshiva. Girls are forbidden to learn Torah, and instead receive instruction in morals, customs and prayers. Women receive more secular education, and are more likely attend secular college, but spend less time learning overall. (Shaffir 1996) Historically, many Lubovitch women attended seminary to become teachers in Hebrew day schools, but did not pursue the accreditation to be able to teach in a state-certified school. (Levy 1975)

Community solidarity

The many Hasidic social service organizations active in New York City, Israel and elsewhere reflect the traditional importance of giving to others less fortunate (‘‘tzedoke’’). (Gutwirth 2005) Helping others is a ‘‘mitzvah’’ that serves an important function in communities with large families and low incomes. In Kiryas Joel, New York, organizations offer interest-free loans and wealthier individuals help their poor fellows. (Roberts 2011)

Individuals and community groups, in the tradition of ‘‘hahnosses kale’’ or “leading the bride,” raise funds for young women from poor Hasidic families, so that they can marry. (Gutwirth 2005). ‘‘Kimpatorin Aid’’ sends female volunteers to the homes of childbearing women to help them with household chores before and after giving birth and to offer emotional support (‘‘kimpatorin’’ means “woman in childbirth” in Yiddish). (Kranzler 1995) ‘‘Bikur cholim’’ visitors of all denominations – organized at the individual, synagogue, and city level – comfort the sick in New York City hospitals and homes by bringing kosher meals and offering spiritual support.

The Hasidic communities of Brooklyn, and villages such as Kiryas Joel, have constituted powerful voting blocs to which city and state politicians have catered. Clashes between the Satmar and the Lubavitch, and between Hasidim and members of other ethnic groups, have occurred in part owing to the perception that the Hasidic communities organize for themselves and compete for limited resources. (Gutwirth 2005)

Health and illness

Although they believe that God has ultimate control over the fate of each individual, Haredi Jews have an obligation to take care of their health to the best of their ability. This “obligatory effort” is known as ‘‘hishtadlus’’. (Kahn 2003)

Suffering may be seen as a challenge to endure the hardship that God has a reason for imposing: “Hashem would not give me more than I can handle” is a common line of reasoning.

The notion that spiritual status impacts physical health justifies the involvement of a rabbi in the treatment of illness of all kinds. In the Hasidic tradition, the Rebbe has the divine understanding to read the religious meaning of human suffering. (Coleman-Brueckheimer & Dein 2011) Religious authorities offer spiritual healing, make referrals to medical professionals, and are involved in treatment decisions. If a person comes to a rabbi in distress, he may encourage increased observance of religious duties that have been neglected. An ill person who receives medical treatment and spiritual healing may attribute an improvement in health to spiritual, medical, or both kinds of interventions.

The endorsement of a treatment plan by a rabbi may lead to better compliance with that treatment because it is seen as the action that accords with God’s will. This process – of personal and rabbinical interpretation of the illness, and action-taking in response – imbues both the affliction and the treatment with religious meaning. (Coleman-Brueckheimer & Dein 2011) Sometimes the religious explanatory model can have a detrimental effect on believers, when suffering is unrelieved and the ill person associates disease with God’s anger. (Coleman-Brueckheimer & Dein 2011)

Pregnancy beliefs and behaviors

Conceptualizations of pregnancy and birth

Talmudic sages imagined that the fetus exists in a blissful state of enlightenment and understanding, and sees both ends of the world by a light that shines above its head. The soul, brought down to the mother’s flesh by God, resists incorporation into the base bodily fluids of conception, and resists its delivery from the womb. Angels show the fetus the Garden of Eden and then take it to Gehanna, where the wicked are punished. At birth, an angel extinguishes the light and the baby forgets his or her special knowledge, and cries. (Klein 1998)

Motherhood is a way of life for many Haredi women, who tend to grow up in large families and have large families of their own. Pregnancy, when it happens, is considered to be part of God’s plan for the pregnant woman. In giving birth, she brings light into the world and practices loving kindness. God and her husband are her partners in this endeavor. It is written in the Gemara that only God holds the key of birth (the other two keys he holds, of rain and the resurrection of the dead, may be given to a messenger). (Finkelstein & Finkelstein, p. 134) No soul comes into the world without God’s willing it, but parents play an active role and are obligated to ensure the best outcome through their actions during marriage, pregnancy, birth and childrearing.

Infertility

For a majority of women, observance of the ‘‘niddah’’ laws allows for procreative sex coinciding with ovulation. Ritual abstinence may lead to diminished fertility for women with shorter menstrual cycles lasting 21-25 days, or an estimated 22% of menstrual cycles. (Haimov-Kochman & Hochner-Celinkier 2007) A couple may consult with a rabbi about the possibility of shortening the separation, if they suspect this is the case.

Infertility may be an especially difficult experience for couples in the Hasidic culture. Procreation is simultaneously a way of honoring God and a sign of God’s blessing. Although rarely applied now, Haredi couples had a traditional obligation to divorce after ten years of childless marriage. It is still a widely-held belief that infertility creates marital strife. (Kahn 2006)

Hashem is considered the third partner in every pregnancy. The principle of ‘‘’’ requires couples to make their best effort at pregnancy, even if the outcome is ultimately in God’s hands. Consequently, rabbis have overwhelmingly embraced Assisted reproductive technology, reasoning that it helps couples fulfill the commandment to “be fruitful and multiply,” relieves suffering, and preserves the integrity of the family. Case-by-case rulings on the use of ART incorporate ‘‘halachic’’ principles. Some rabbis have ruled in favor of sperm donation in the case of severe male infertility, so long as the donor is a non-Jew (because ejaculation that is not vaginally contained is forbidden). Female gestational carriers should be Jewish to ensure that the child is a Jew, as Jewish identity is determined through matrilineal descent, i.e., the religion of the womb is what counts. (Kahn 2006)

Abortion and contraception

In Jewish law and tradition, the life of a pregnant woman takes priority over the fetus, which is not considered a separate life until the head has emerged. Abortion is not considered murder. However, Jewish law values the fetus as a potential life. The status of the fetus changes as pregnancy progresses so that elective abortion may be more strongly forbidden after the first 40 days. Traditionally, the fetus is conceptualized as water for the first 40 days, and then as an extension of the mother, like one of her limbs, not to be desecrated by amputation. (Lewis 2003) If the pregnancy would endanger a woman’s life, a rabbi will sanction abortion, but elective abortion is generally unacceptable without significant physical or mental distress. (Shulevitz 2000).

Prevention of pregnancy is discouraged by religious authorities: the continuation of the Jewish faith depends on procreation and procreation is an obligation of Jews (Lewis 2003). The withdrawal method (coitus interruptus) is unacceptable because of the Jewish law requirement that ejaculation be vaginally contained. Barrier methods are not preferable because it is important that sexual contact allows for husband and wife to “become as one flesh” as stated in Genesis; however, use of a diaphragm or cervical cap may be more acceptable than a condom. Vasectomy is seen as castration, which is prohibited, but tubal ligation may be permissible. (Haimov-Kochman & Hochner-Celinkier 2007)

Haredi women are more likely to use contraception to lengthen the interval between pregnancies, depending on their physical and emotional needs, than they are to use contraception to prevent pregnancy in the first place. Methods that may be more acceptable to women include delaying the ritual bath, which can be done discreetly, if purposefully. Women may extend breastfeeding because they believe it will help delay the next pregnancy. (Haimov-Kochman & Hochner-Celinkier 2007)

Routine prenatal care

Female health care providers are preferred because of the importance of maintaining modesty, but a trusted male provider may be acceptable. In the latter case, the door to the exam room should be unlocked, with someone who cares about the woman within hearing range. (Bodo & Gibson 1999)

Genetic testing and prenatal diagnosis

Dor Yeshorim provides genetic screening to about half of Haredi couples before marriage. (Teman Ivry & Bernhardt 2011) Testing determines their carrier status for recessive genetic diseases such as Tay-Sachs disease and Cystic fibrosis. Ashkenazi Jews are at increased risk for many genetic diseases due to historically high rates of endogamy. Haredi communities are even more susceptible due to the preference for marriage within the sect. Religious leaders such as the Satmar Rebbe have endorsed Dor Yeshorim as a way of safeguarding the future of their communities. (Kranzler 1995)

Orthodox women and communities embrace routine prenatal care along with other medical services. However, Haredi groups have shown low uptake of amniocentesis, chorionic villus sampling and maternal serum screening – optional procedures that screen for congenital anomalies in the fetus. (Teman Ivry & Bernhardt 2011) Haredi women may decline these tests as a proclamation of faith in God’s plan for them. (Teman Ivry & Bernhardt 2011)

Women in the community who accept the challenge of raising disabled children are exemplars of faith and the feminine virtue of caring. In this cultural context, individual women may experience pregnancy complications as a test of faith (‘‘nisayon’’) for which God selects them, and feel anxiety and guilt for considering termination of an abnormal fetus. (Teman Ivry & Bernhardt 2011)

Certain prenatal tests that increase risk for miscarriage, such as amniocentesis to assess for chromosomal abnormalities like Downs syndrome, require consultation with a rabbi because rabbis disagree as to whether Jewish law would allow them in a given situation. If amniocentesis were medically indicated, for example to evaluate fetal lung maturity before premature delivery, the test would be acceptable because it would guide decisions about medical treatment, to protect mother and baby. (Finkelstein & Finkelstein 1993)

Preparation for birth

Pregnant women have a responsibility to maintain their health during pregnancy. This imperative overrides other ritual requirements, such as fasting on Yom Kippur, and minor fast days. An expectant mother may fulfill her obligation to fast if she feels strong enough and there is no danger of complications such as weakness, fainting or premature labor. If there is such a risk, as determined by a health care provider or the woman herself, she has the status of an ill person in danger. Her portions may be the amounts permitted to sick people on fast days, or a larger amount, as necessary for her health. A rabbi is often involved in these decisions. Each Jewish holy day bears special consideration (Finkelstein & Finkelstein 1993)

Halacha directs women to eat a kosher diet, and not gaze at non-kosher animals or impure things during pregnancy, as these actions may harm the fetus. (Citron 2011) Sages interpreted the messages of biblical stories and gave concrete dietary and behavioral instructions to pregnant women. Eating certain foods, and speaking proper or improper words, were thought to influence fetal development and the baby’s future character, often in a very literal way. (Finkelstein & Finkelstein 1993)

One of the more stable pregnancy principles in Jewish tradition, passed along by rabbis and midwives through the ages, was that a woman’s cravings should be satisfied, no matter how eccentric, to prevent harm to the fetus in the form of miscarriage, birthmarks or deformity. The baby was believed to express its character in utero. (Klein 1998)

According to the Talmud, a pregnant woman should pray for a healthy baby, modifying her prayers to influence the most significant changes occurring at different stages of fetal development. For the first three days after conception, she should pray that pregnancy be accepted by the body. From three to 40 days, she should pray for the sex of the child (sex was thought to be influenced by prayers, and determined by the fortieth day). From 40 days to three months, she should pray that the child not suffer from deformity. From three to six months, she should pray that she not suffer a miscarriage. Finally, from six to nine months, she should pray for a safe delivery. (Finkelstein & Finkelstein 1993)

It is common for Haredi women not to prepare formally for birth. (Bodo & Gibson 1999). Some may attend women-only childbirth classes, with an instructor that understands their customs and the need to preserve modesty. (Finkelstein & Finkelstein 1993) There are books written for an Orthodox Jewish audience that blend current medical understanding with explanations of Jewish law pertaining to pregnancy, labor and birth (Finkelstein & Finkelstein 1993).

Expectant Haredi couples tend to keep a new pregnancy to themselves for the first three months, and only inform close friends and family in the fourth month, to ward off the Evil Eye. Baby showers are not common. They may only acquire immediately necessary baby supplies in advance, or might not bring purchased items into the house until after the baby is safely delivered. (Citron)(Lewis 2003)

Orthodox Jewish husbands are likely to support pregnant wives spiritually, though their prayers. Women continue their physical domestic chores – including parenting other children – as they are able to do safely. Interdependence of siblings is a feature of many large Haredi families. Older sisters help busy mothers by caring for their baby siblings from a young age. (Kranzler 1995)

Labor

Beliefs

In the context of Hasidic culture, a woman’s most sacred role is that of mother. Labor and birth thus signify an important transition in a woman’s social status.

Labor can have deeply personal or mystical significance for many Hasidic women: they believe that God is directly involved in the process of childbirth, and may feel his presence more strongly than at other times. The Gemara describes the settling-down of the divine presence beside a woman in childbirth using the feminine word for this presence, ‘‘Shechinah’’, which also has special meaning for Hasidic Jews where it appears in the mystical ‘‘Zohar’’ of Kabbalah. (Finkelstein & Finkelstein 1993)

Many women strive to maintain a state of mindfulness, and may wish to avoid numbing medications. Biblical stories of motherhood provide rich sources of metaphor for meditation. Some may believe that Hashem makes labor more or less painful for them individually, but this does not mean that women are conditioned to go into labor in a passive mind-state, necessarily. Some women may practice now-mainstream non-pharmacologic coping techniques like Lamaze breathing and HypnoBirth that help to relax the body and achieve an altered state of consciousness.

There have not been studies on Hasidic women’s experience of labor specifically (more attention has been paid to menstruation, sex, prenatal testing and infertility treatment), but many Orthodox women share their stories via online forums.

Halachic considerations

Haredi women are likely to want to know how to behave in accordance with ‘‘halacha’’, especially the laws of family purity, if they are experiencing labor for the first time. A woman becomes a niddah whenever she has bleeding of uterine origin. There is no clear agreement as to what labor signals are definitive for this transition. With leakage of amniotic fluid, there may or may not be some blood. Contractions that cause cervical dilatation affect purity status more than contractions before rupture of membranes or in early labor before progressive cervical changes. Based on this reasoning, a religious advisor will definitely instruct a woman to abstain from physical contact with her husband when she notices bloody discharge, but may also suggest that they separate when she experiences rupture of membranes, or when she is no longer able to move or behave normally because of painful contractions. (Finkelstein & Finkelstein 1993) (Bodo & Gibson 1999)

Labor on the Sabbath

In ancient times, childbirth was a dangerous time for women, and Jewish law reflects a cautious, serious view of labor and delivery. As a woman progresses to active labor, the danger to her health increases. Because the woman’s health overrides other religious obligations, she or other Jews are permitted to break Shabbos rules as necessary to protect her life, and are obligated to help her. It may be preferable for a non-Jew to drive her to the hospital on the Sabbath, but if her husband is the only one available, he must do so. (Lewis 2003) Activities prohibited on Shabbat may be done a slightly different way, with a modification, such as signing a consent form with one’s non-dominant hand or pushing the buttons on the phone with an object instead of one’s fingers.

Women in labor and their family members will attempt to observe Shabbos commandments as closely as possible. They may bring few belongings with them, as transporting objects from private to public spaces is prohibited unless there is an ‘‘Eruv’’, a physical-symbolic boundary that designates an area as not having property lines in some sense. (There are several eruvim established by Haredi Jews in New York City, with municipal cooperation.) Turning electrical devices (including lights) on or off, touching money, writing, and ripping paper are prohibited, while ritual remembrances such as lighting Shabbos candles, dressing festively, and blessing and drinking from the Kiddush cup are required. (Noble et al. 2009) Some New York City hospitals have special labor and delivery rooms for Orthodox women and families who do not wish to be discharged home on Shabbos. Sabbath elevators stop on every floor so that Orthodox Jews do not have to push the buttons.

Attendants

In addition to refraining from physical contact with her, the woman’s husband may not look at parts of her that are normally covered, in order to maintain ‘‘Tznius’’. He will not watch the birth, although he may be nearby, in the corner of the birthing room or in the next room. (Noble et al. 2009) Female attendants traditionally provided physical support and comfort to Jewish women during childbirth. Some Rebbes believe that the husband does not belong at the birth. (Klein 1998)

Two heroic midwives from the Bible, Shiphrah and Puah, are the paragons of social support, feminine strength, and courage for childbearing Hasidic women. They disobeyed the Pharaoh’s command to kill the infant sons of the Israelite women, including Moses. By Rabbinic tradition, these women were actually Jochebed (Moses’ mother) and Miriam. The name Shiphrah may be derived from the Hebrew for cleaning or swaddling a baby or being fruitful (Klein), or from the verb ‘‘leshaper’’ (“to make better”). (Finkelstein & Finkelstein) Puah’s name comes from the Hebrew verb for “to cry out,” for midwives would calm screaming women by their soothing words and prayers. (Klein 1998)

In ancient times, Jewish midwives may have offered women back support as they squatted. They used oil, both to massage the abdomen and to help the baby’s passage through the vagina. They applied pressure to the perineum to prevent tearing. (Klein 1998)

Pain and its management

In the Judeo-Christian tradition, women’s pain in childbirth was the consequence of Eve’s original sin as described in Genesis. Over centuries, Talmudic sages interpreted biblical metaphors likening distress and punishment to the pain of childbirth, and Jewish mystics elaborated on imagery of a snake that bites to cause labor pain in sinful women. (Klein 1998)

Rabbinical advice for easing delivery was based on the idea that failure to observe religious duties increased the pain and the risk of death in childbirth. They argued that the most righteous matriarchs, such as Jochebed, had painless births, and that women should emulate them in their daily lives. “In pain shall you bear children” was interpreted broadly to mean that the whole process of producing and raising children involves suffering. (Klein 1998)

The ritual duties of Jewish women include the three mitzvahs of separating challah (removing a piece of the bread dough before it is braided, which refers back to priestly tithes), observing the laws of family purity (sexual separation when she has uterine bleeding, which makes her a niddah), and lighting the candles on the Sabbath (Finkelstein & Finkelstein, p. 124). Some of the prayers women recited during childbirth mention Hannah because the initial letters of these feminine mitzvahs in Hebrew spell her name. (Klein 1998)

A Haredi woman today may pray for childless friends during early labor – as it is considered righteous to plead for others before oneself – and then receive prayers from her mother, spoken in her ear, when she cannot continue. (Klein 1998)

The various prayers her husband may recite on her behalf while she is laboring include (but are not limited to) the Shema, psalms, and verses from the Prophets. The more people who pray for her, the more powerful the prayers. If labor is long or complicated, a rabbi or other holier person may be asked to pray for her. (Klein 1998)

Haredi women may fear childbirth because they perceive that labor is ultimately beyond their control in a spiritual as well as a physiological way. It is ultimately God that unlocks the womb to release the baby, with the key that only he possesses. (Klein 1998) (Finkelstein & Finkelstein 1993)

Supportive behavior

A woman’s husband may offer her spiritual support with his prayers and emotional support with his presence, but physical comfort measures such as soothing touch, massage, application of hot or cold packs, etc. is performed exclusively by women.

Birth

Birth attendant and assistants

Hasidic women in New York typically deliver with the assistance of a skilled birth attendant, either a Certified Nurse-Midwife, a professional midwife or an obstetrician. To be licensed in the state, midwives must complete a midwifery program that meets certain specifications and pass the qualifying American Midwifery Certification Board (AMCB) exam.

The health care provider is unlikely to be a Hasidic Jew herself, but many providers who work in Brooklyn are familiar with the cultural requirements of the Hasidic population. Female care providers are strongly preferred. (Bodo & Gibson 1999)

Women are likely to receive both physical and emotional support from other women. Non-clinical support people may include a doula. Doulas may be paid for their services or volunteer. There is no requirement that the doula be Hasidic herself. Women may ask a close relative or friend to be with them.

Birth position

The position a woman assumes for giving birth likely depends on the setting in which the birth takes place, as well as the individual woman’s preferences based on previous experience or the advice she receives from female attendants. A literature search found no studies. In the hospital, semi-sitting is a common position. The growing acceptance of midwife-attended home birth as a safe option for low-risk women is likely to increase its prevalence. Cost may be a barrier.

Delivery of the placenta

Ancient Jews regarded the placenta as an extension of the baby. Many buried the placenta to prevent strangers from gaining control over him or her. Before 1900, the Jews of Palestine buried girls’ placentas near the hearth to anchor them in the home. Magical practices of midwives included allowing a barren woman to sit on a placenta to encourage fertility, or rubbing the placenta on an infant’s chest to stimulate breathing. (Klein 1998)

Haredi Jews in the U.S. are unlikely to attribute such powers to the afterbirth. The placenta does not receive much attention in pregnancy and childbirth discussions on Jewish websites. In the hospital, it is likely to be disposed of as medical waste.

Use of technology

It is important that parents cooperate with health care providers, as well as their rabbi, to do everything possible to protect the health of mother and fetus/newborn. Interventions such as emergency cesarean are acceptable when they are necessary to prevent injury.

Induction of labor is only permitted when it would be dangerous to continue the pregnancy, because God keeps track of when individuals come into and leave the world, and labor carries risks to mother and baby that should not be brought on purposefully. Furthermore, the Gemara suggests that one’s time in the womb is a blissful – if not the best – time of life and should not be cut short prematurely (Finkelstein & Finkelstein 1993)

If a primigravida’s firstborn son, the child who “opens her womb,” is born by cesarean section, no Pidyon haben will be performed. (Finkelstein & Finkelstein 1993)

Postpartum

Halachic considerations

‘‘Halacha’’ considers the postpartum woman to have the same status as a sick person in danger for the first seven days after birth. From the eight to the thirtieth day after birth, she is no longer in danger but still has special needs, like a sick person, and the rabbi should be consulted where meeting those needs might interfere with religious customs.

Medical advice is to be followed in the first 72 hours, even if this requires overriding another religious requirement. For the first week, others must respect the mother’s physical and emotional needs and meet her requests. Any danger to her health after the first week postpartum puts her back in the category of a sick person in danger. (Finkelstein & Finkelstein 1993)

When she is feeling strong – and not before the first seven days postpartum – the mother should recite the Birchat HaGomel, a prayer that is said in thanksgiving for deliverance after a serious illness (or after dangerous travel, release from prison, or surviving an earthquake). This recitation should take place in the presence of a minyan (quorum) of ten men. In the past, some Rebbes have ruled that it violates a woman’s modesty to recite the HaGomel in front of men, and the husband has done the recitation on her behalf, in the synagogue. (Klein 1998)

Ritual impurity

A woman is ‘‘niddah’’ for one week following the birth of a baby boy, and two weeks following the birth of a girl (there is no explanation given for this rule but it must be accepted). If there is bleeding beyond that time, she remains ‘‘niddah’’ until seven days after the bleeding ends, once she has been to the mikveh. Couples also take the advice of their care provider seriously. (Finkelstein & Finkelstein 1993)

Kimpeturin heim

It is customary among Haredi Jews to meet all of a woman’s needs while she recovers from birth. Convalescent homes for postpartum mothers (‘‘kimpeturin heim’’), staffed by nurses but separate from hospitals, offer a respite from household and childcare duties. There are four such facilities in the New York area: the Seagate heim in Coney Island, two in Rockland County, and one in Lakewood, New Jersey. (Cohen 2011)

The newest, the Mothers’ Relief Center or ‘‘Aishes Chalil’’ in Kiryas Joel, was completed in 2008. Satmar arsonists burned down the previous postpartum home in 1996 during a period of religious and political infighting set off by a dispute over the succession of the Rebbe. $10.5 million of the $11.4 million cost for the new project came from state and federal grants, provoking controversy about pork-barrel spending. (McKenna 2008) The price for mothers to stay at the Mothers’ Relief Center (called ‘‘Aishes Chali) is not covered by Medicaid, but wealthier community members often subsidize the cost for poor women.

The newborn

Rites of passage

When the baby is born, welcoming rituals connect the child to his or her ancestors and seal his or her membership in a covenant. (Klein 1998) These rituals are different for boys and girls, reflecting their different innate qualities and spiritual status.

After the birth, but before circumcision (for a boy), children too young to have sinned visit the newborn to recite the ‘‘Shema’’ to protect him or her from spiritual harm. (Finkelstein & Finkelstein 1993)

The parents recite blessings once the baby is born, according to Jewish laws. For a boy, the father should thank God by reciting the HaTov VeHameitiv, upon hearing the news of the birth. For a girl, he should recite the Shehecheyanu, only upon seeing the baby. (Citron)

Boys: circumcision

Circumcision is considered to be one of the most important and most joyful of the ‘‘mitzvot’’. The requirement comes from Genesis, wherein God makes the covenant with Abraham to circumcise his descendents on the eighth day after birth. Any uncircumcised male who remains that way shall be cut off from God and kin. (Lewis 2003)

It is the responsibility of a boy’s father to organize his ‘‘Brit milah’’. This ritual circumcision ceremony is conducted by a Mohel and takes place before sundown, usually in the morning. Playing one of the ceremonial roles is an honor, especially for the man who acts as the ‘‘Sandek’’ and holds the baby. The ‘‘sandek’’ may be the grandfather, great-grandfather, or an important man in the community.

Traditionally, the ritual begins outside the room, where a chosen female guest takes the baby from his mother and passes him to another guest (her husband). He, in turn, crosses the threshold and gives the baby to the ‘‘sandek’’. The ‘‘mohel’’ and the father both say blessings. After the ‘‘mohel’’ has cut the foreskin, the baby receives a drop of wine from the Kiddush cup, and he receives his name. The brit milah is followed by the ‘‘Seudat mitzvah’’, the requisite celebratory feast.

Rabbis have offered many reasons for God’s requirement of circumcision. Some contend that the act of removal of the foreskin represents man’s contribution to God’s creation: the person is incomplete until the mohel performs this action, and this symbolizes the ongoing requirement for man to perfect himself spiritually. Removing the foreskin reduces sexual pleasure, and marks him a member of the tribe of Abraham. (Lewis 2003)

Girls

A girl typically receives her name when her parents bring her to synagogue the week after her birth. The Sephardic ‘‘Zeved habat’’ is an elaborate naming ceremony.

Jewish law does not require a welcoming ceremony for girls, as it requires the ‘‘brit’’ for boys; a girl’s birth was celebrated simply with the shehecheyanu blessing, and there were no public ceremonies. In Ashkenazi tradition, a girl is welcomed with a more personalized celebration called ‘‘simchat bat’’ (“rejoicings over the daughter”), which may take place at any time, in the synagogue or the home, so long as her mother feels strong enough to participate. It may take place at eight, fourteen or thirty days, coinciding with brit milah, the end of the mother’s ritual impurity after the birth of a girl, or the pidyon haben for a first-born son, respectively. (Breger 2000)

Parents, siblings and guests may speak of the baby’s namesake and/or biblical figures with the same name. Particular verses welcome her into a covenant and recall the virtues of the matriarchs. The baby girl may be passed among the female guests, signifying her entrance into the community of women. Some families plant a pine tree, as the Talmud suggests should be done upon the birth of a daughter. The girl’s mother may recite the ‘‘Birchat HaGomel’’ at this ceremony. (Breger 2000)

Breastfeeding

Historically, breastfeeding was universal among the Satmar and continues to be the most common feeding practice. Women may extend lactation in order to prolong the interval between pregnancies without using other contraception. (Rubin 1972) Breastfeeding in public violates the modesty requirement, and if a woman must breastfeed in public, she will cover her breast and all parts normally covered.

Ingestion of non-kosher foods by a breastfeeding mother was thought to negatively affect the baby’s development. (Finkelstein & Finkelstein 1993)

References

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W. Bennett (Ed.), The new ethnicity: Perspectives from ethnology (25-50). St. Paul, Minn.: West Publishing Co. As seen in eHRAF World Cultures on April 25, 2011.]

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