Laws and Customs of Pregnancy and Birth - Rabbi Dov Tverdovitz shlita

00:02 Speaker 1 You’re listening to “Lema’an Yishme’u,” a podcast of the Machon Halacha Chabad.

00:09 Speaker 2 Let’s mention a few Chabad customs concerning childbirth. First, let’s mention the Alter Rebbe’s approach. A woman who has given birth on Yom Kippur, for example, who is required by halacha to eat during the first three days, should still eat in measured amounts. Depending on the different opinions, that might mean eating up to thirty cubic centimeters every eight minutes or so, and another forty cubic centimeters, and so on, in measured amounts. Even when there is a danger to life, this applies. Similarly, in the laws of Shabbos, whenever there is a critically ill person, including a woman giving birth, whatever can be done in an unusual manner should be done that way. A simple example: suppose she arrives at a hospital to give birth, and the ward is on a certain floor. To reach it, she has to take the elevator. She no longer has the strength to walk up, say, or time is pressing. Then, if possible—and usually it is—one can press the button in an unusual manner, using the side of a fingernail. That already counts as doing it in an unusual manner, because Shabbos desecration must be minimized as much as possible. What cannot be avoided cannot be avoided, of course. For example, a driver taking a woman in labor or a critically ill person on Shabbos must clearly drive normally, observing all the ordinary traffic laws. Besides, if he tried to drive differently, he might make mistakes and so on. Here we can mention a few more questions about childbirth on Shabbos. First, who should preferably drive? According to Shemiras Shabbos Kehilchasah—and this does seem reasonable—the first choice, if a non-Jew is readily available and can be called to drive, is to have him do so. That way we avoid any concern about a Torah prohibition. But if there is doubt that he will arrive in time or handle things properly when care is needed, then a Jew should drive. Now, which Jew? According to Shemiras Shabbos Kehilchasah, a Jew who observes mitzvos is preferable, because he will not do more than halacha requires. An ambulance, by contrast, generally

02:44 Speaker 2 comes from a particular location and returns there, involving much more Shabbos desecration. The crew also generally writes down the details, at least in some form, and that too is prohibited. So a private driver is preferable, whether it is the husband or someone else. Here we need to pay attention to how he turns off the car. According to halacha, he may turn it off in an unusual manner. What does that mean? He should remove the key or turn it off using the sides of his fingernails. Why is that permitted? First, there is a principle that a shvus of a shvus is permitted in a case of substantial loss or great need. Shvus means a rabbinic prohibition, an activity the Sages said to refrain from. A shvus of a shvus means it is rabbinic on two counts. In our case, even the non-Jew—sorry, even extinguishing itself is rabbinic, because according to halacha, extinguishing is prohibited by Torah law only when one makes a coal. What does it mean to make a coal? In earlier times, people would take a burning piece of wood and smother the fire with water or by depriving it of oxygen. It would go out, and then they would dry it again and use it as charcoal that catches fire quickly. In that case, the extinguishing serves to preserve the means of lighting a fire later. But simply turning something off, such as a car, is considered an act whose result is not needed for its own sake: from his point of view, it would be better if there were more fuel right now. He does not need the object in which the extinguishing takes place. This is called a melacha she’eina tzricha legufah, for which one is exempt from Torah liability. If he also does it in an unusual manner, it becomes a shvus of a shvus—rabbinic on two counts—and is permitted for a great need or to avoid substantial loss. So if, say, a husband drives his wife to give birth, when he reaches the hospital or its parking lot, he should turn off the car in an unusual manner, or have a non-Jew do it if one is available. What is certainly forbidden is to leave the car running, also because of the danger that an undesirable person or a teenager might take control of it and, G-d forbid, cause an accident.

05:06 Speaker 2 So that is forbidden, while turning it off in an unusual manner, as we said, really is permitted, as is having a non-Jew do it. One question nowadays concerns the plastic band hospitals put on the father to show that he is the child’s father and can enter the ward. What is the halacha on Shabbos? May he wear it where there is no eruv? The straightforward halacha is that it is forbidden. Why? Because it is not clothing; it is made for just one purpose, to show that he is allowed in. Some nevertheless want to permit it if he uses it as part of his clothing—for example, if he rolls up his sleeve and uses the band to hold it in place so it will not fall down. Some also offer this argument: nowadays, most young fathers are proud of it. They come to shul and want everyone to see the band showing that they have had a child. So perhaps there is some basis for considering it a kind of ornament too. In any case, ask a rav. It may be possible to permit it in such a situation. What one should certainly not do is tear it off for no reason on Shabbos, or fasten it unnecessarily. But the main question is whether one may wear it while walking outside on Shabbos. Now, if one arrives at a hospital on Shabbos with a woman in labor or a sick person and the staff asks for details, it is permitted to provide them. Nowadays, the information is generally all on the computer and linked to the person’s ID, so they can easily check the medical record, blood type, and so forth, which is very important. As for the hospital, its staff really do need to ask and check. There are hospitals today that operate according to halacha and do try, wherever possible, to have a non-Jew do what is needed, or, if something must be written, to use ink that fades on its own after

07:18 Speaker 2 a few days, which is less severe in this situation. The same principle applies throughout: wherever it is possible to use a less severe method, one should. In halachic terms, Shabbos is overridden in cases of danger to life. In other words, there are two opinions in the Gemara and among the halachic authorities. According to one opinion, Shabbos restrictions are completely set aside. What does that mean? According to that opinion, there is no need to avoid violating Shabbos. Suppose, for example, a patient can receive a treatment requiring Shabbos desecration either on Shabbos or after Shabbos, with equal effectiveness. According to the more lenient opinion, it can be done on Shabbos; there is no need to wait. In practice, according to the Alter Rebbe and most halachic authorities, no: Shabbos is overridden, meaning that a violation is permitted only when there is no alternative. If there is an alternative, it should be done after Shabbos. They tell a story about Rabbi Auerbach z”l. There was a patient who apparently had an infection and needed surgery. Medically, it was possible to wait, say, two hours. I’m speaking generally, because I haven’t checked the exact details of the case. He said to operate immediately. They asked him: medically, the bacteria—or whatever it was—could wait another two hours. He replied, “Do the bacteria know about that clock, about those two hours?” In other words, even if the doctors say it is not so urgent, every moment the condition continues, it becomes more dangerous; the bacteria gain strength. So he said there was no reason to wait. But as I say, each case must be considered on its own. In principle, this is correct. Another thing to know is that halacha says we do not violate Shabbos for a non-Jew, except for a rabbinic prohibition for the sake of peaceful relations. What has become accepted in recent years is that we do violate Shabbos for a non-Jew, even when a Torah prohibition is involved. Why? Because failing to do so might—or certainly would, G-d forbid—endanger Jews. Suppose it became public knowledge that a non-Jew was injured in an accident and Jews did not come to his aid,

09:35 Speaker 2 Another time, it could be the other way around, G-d forbid. Or sometimes it could even stir up unrest against Jews. They tell of Rabbi Auerbach z"l that a woman who had converted approached him. Her non-Jewish father was hospitalized, and on Shabbos he needed treatments that involved violating Shabbos. She asked him privately whether perhaps she should not have them done for him, since he was not Jewish, and said she would not tell anyone. The rabbi told her, “Do them.” He understood very well that it would not remain a secret. There are no secrets, especially in situations like these. His ruling would become public immediately, and it was clear what that would stir up. Yes. Along these lines, let’s mention another question, though it is not specifically about Shabbos. With a woman in labor, there is a dispute about when she is considered ritually impure. According to some halachic authorities, it is from the moment bleeding begins, and so on. Rabbi Ovadia Yosef rules this way too. The stricter opinions hold that from the moment she cannot walk without help, when she can no longer stand, she is already considered ritually impure, at least because of a doubt. If that happens to a woman in labor on Shabbos and she needs to be taken to a hospital, and a Magen David Adom team arrives, who should help her onto the stretcher or into the chair? Halachically, someone other than her husband is preferable. Because the husband and wife are close to one another, there is greater concern that they might come to do something prohibited. In practice, I think, first, that if it is necessary, the husband clearly must help. And it also seems to me that if the team members are people they know and the like, it is better that they not touch a woman they know. In other words, if the alternatives are her husband or someone else—say, a neighbor who might see her without clothes or something—it is better for her husband to do it. That is what I think; all things considered, it is preferable. On the other hand, of course, it is a great mitzvah to help, even to deliver the baby if necessary. They tell of the holy brothers, Rabbi Zusha and Rabbi

11:45 Speaker 2 Elimelech, that they once stayed somewhere on Shabbos, and during Shabbos they heard the innkeeper groaning. One brother said to the other, “This is no time to rest. She has gone into labor; we need to help her.” And the holy brothers delivered her baby. So of course, if there is a need, one must do whatever is necessary. But in principle, it is clear that if possible, an unrelated person should do it. As for Shabbos, we also said that, in principle, whatever can be done in an unusual manner should be done that way. And what is the order of preference for traveling to the hospital? Halachically, the very best option is an available non-Jew, if he is genuinely careful and quick—say, someone from a rescue service or one of the organizations abroad. That is best, provided they are quick, capable, and available. If not, a Shabbos-observant Jew is preferable. If there is no medical need for an ambulance, Shemiras Shabbos Kehilchasah says that a Shabbos-observant Jew is preferable, whether it is the husband or someone else, because he will violate Shabbos less. With an ambulance, there is a lot of driving from place to place; afterward, the crew generally also writes things down and speaks over the radio. If there is a medical reason to use an ambulance, clearly one should take one. But if not, the husband or someone else is preferable. On the other hand, Shemiras Shabbos Kehilchasah says that if, for example, a neighbor has a car and the husband cannot drive her because he has no car, the neighbor may say, “I don’t want to be stuck at the hospital all Shabbos. Would you? Call a taxi; call an ambulance.” He cannot be compelled. It would indeed be an especially pious thing for him to drive in order to reduce Shabbos violations, but he cannot be compelled to do so. In principle, though, a Shabbos-observant person is definitely preferable. Of course, whenever no such person is available, or in any urgent situation, do not wait even a moment. Nowadays, if there is

13:51 Speaker 2 Especially since nowadays, in most places, the rescue services and Magen David Adom are generally all connected, so they are usually very quick. If you call Magen David Adom, for example, they generally send whoever is closest. This is very, very important, and one must not delay. When a life may be at risk, one must not delay. I would say that this applies to anything that raises a concern of danger to life, not just to a woman in labor. On Shabbos as on a weekday. Let me mention something: many years ago in Kfar Chabad there was a doctor, Dr. Dubkin, who was very G-d-fearing. He once told me that a neighbor, I think, was feeling unwell, and in his opinion she needed to go to the hospital. It was Yom Tov or Shabbos. They did not hurry. They waited until morning, and by then it was too late. Perhaps she reached the hospital and... But one must not try to be smarter than the doctor. If the Torah says to violate Shabbos, and the doctor—especially a G-d-fearing doctor, though in principle this applies to any doctor—says to go, then at the very least it is a case of halachic doubt. Certainly, when a G-d-fearing doctor says to go, one must not delay. It is a matter of life and death. This is not about feeling uncomfortable interrupting Yom Tov or Shabbos. The same applies in any other case, yes. All right, let’s close with a saying of the Rebbe. The Rebbe said, as a play on the words “Bereishis bara Elokim”—“In the beginning, G-d created”—“Bereishis, bari”: first comes health. And returning to the earlier topic, there are three main things: children, life, and sustenance. “Children” means children; “life” means life and health; and then there is livelihood. The Rebbe says that, nevertheless, the most important of them all is children. That is, even if a person were not entirely healthy, G-d forbid, if he has children, he has a family, and that is more important. There are several stories from the Baal Shem Tov, or stories of people who did not have

15:56 Speaker 2 the merit to receive everything. They wanted to exchange one thing for another, and often agreed to give something up in return for having children. So let’s indeed conclude on this point. As the Rebbe said, the younger one is, the more possible it is—first of all, there is more physical and emotional strength—to have more children. And indeed, as the Rebbe said, through all the souls in the treasury of souls being born, may we merit the complete Geulah very soon, amen. One more thing: let’s mention some of the Rebbe’s instructions concerning a woman giving birth. First, a Shir Hamaalos should be present during the birth, wrapped twice, and so on. Second, the husband should not be present during the birth, nor in the labor room. Simply put, from the moment the woman removes her regular clothes and puts on a gown in preparation for giving birth, the husband should not be there. If it takes a long time, ask a rabbi; or she can come out to him, which is probably preferable. Let me mention this: some halachic authorities permit the husband to be present during the birth, provided he does not see the area, and so on. But in the Rebbe’s view, one should not get into such questions, because he might see it after all, and so on. And remember, some years ago there was no possibility at all for the husband to be present during the birth, and baruch Hashem, everyone was born without it too. So there is no need to permit it. Another instruction of the Rebbe concerning the birth of a daughter is to give her a name as early as possible. Of course, that is if the husband and wife have agreed. If there is some discussion or disagreement between them, the Rebbe says that the usual arrangement is to alternate: one name chosen by the husband, one by the wife, and so on. Now let’s mention a little about a child who has already been born. We spoke about the instructions for a daughter: to name her promptly. As for a son, one of the halachos according to the Alter Rebbe is that if he is a firstborn son, his pidyon haben should not be delayed even a day once the time has arrived. According to the Alter Rebbe in his Siddur, it is an obligation every single day. That is to say, it is not something to do once in a lifetime and leave it at that. The mitzvah itself is indeed performed once in a lifetime, but one should do it as soon as possible. As for a bris, the Rebbe’s approach is well known: to be stringent where there is danger, in the words of the Rambam, because a life cannot be restored, whereas a bris can be postponed. So if there is a concern of danger and the like, it should be postponed. What is distinctive about the Rebbe’s words is that one should be especially careful. That is why there are differing opinions among rabbis. If the baby had jaundice, jaundice that developed following the birth or around the time of the birth, how far must the level come down? Some rabbis rule that a bris should always be performed when it is below ten, but if it had risen above fifteen, one must wait seven days from when it dropped below fifteen. Each rabbi follows his own approach. Yes, another thing the Rebbe says is that milah and periah should be performed separately; that is a matter for the mohelim. Of course, there is also the giving of the name: the name draws down life-force, and through it life-force reaches the newborn. They tell of a woman who once passed by the Rebbe and asked for a blessing to have a son like the Rebbe. The Rebbe answered her, “If you are like my mother, you have a chance of having a child like the Rebbe.” In other words, it really depends a great deal on the parents’ holiness, and so on. Another of the Rebbe’s instructions regarding pregnancy is not to publicize it until the fifth month. Simply understood, the fifth month is counted from the night of immersion, not according to the doctors’ calculation. And the Frierdiker Rebbe writes that there is an inner reason for this. Alongside that, it may also have to do with the evil eye—in other words, not drawing attention before the time. There was one case, or two cases, that I know of. A woman in early pregnancy was absent

18:18 Speaker 2 To delay it even a day, if the time has already arrived. According to the Alter Rebbe in the Siddur, there is an obligation every single day. In other words, it is not something you do once in a lifetime and that’s it. The mitzvah itself is once in a lifetime, but it should be done as soon as possible. As for a bris, the Rebbe’s approach of being stringent where there is a risk of danger is well known. As the Rambam puts it, a life cannot be restored, whereas a bris can be postponed. So if there is a concern about danger or the like, it should be postponed. What is distinctive in the Rebbe’s words is that we should, in fact, be even more careful. That is why there are differing opinions among the rabbis. If there was jaundice—jaundice that developed following the birth or around the time of the birth—how far does the level have to come down? Some rabbis rule that the bris should always be performed when it is below ten, but if it had gone above fifteen, you have to wait a full week from the time it dropped below fifteen. Each rabbi follows his approach. Yes, another thing the Rebbe says is that the cutting and the peri’ah should be done separately; that is already a matter for the mohels. And, of course, the naming: the name draws down a person’s life-force, and through it the life-force reaches the newborn. They tell of a woman who once passed by the Rebbe and asked for a blessing that she should have a son like the Rebbe. The Rebbe replied, “If you are like my mother, you have a chance of having a child like the Rebbe.” In other words, a great deal really depends on the parents’ sanctification of themselves, and so on. Now, another of the Rebbe’s instructions regarding pregnancy is not to publicize it until the fifth month. The fifth month, in the straightforward sense, is counted from the night of immersion—not according to the doctors, but from the night of immersion. And the Frierdiker Rebbe writes that there is an inner reason for this. At the same time, it may also be because of the evil eye—that is, not to draw attention to oneself too early. There was one case, or two cases, that I know of. A woman who was in the early stages of pregnancy was absent

20:33 Speaker 2 From work, and they asked her whether it might be because she was pregnant. She said yes, she really was pregnant, and so on. And because of that—I have to say this—she miscarried immediately afterward, a day or two later. There was another case, too. It says that you may tell your closest relatives, so they told the parents. The parents told the extended family, which included dozens of people, and the next day the pregnancy ended. From this we see that there is also an element of the evil eye here. Halachah says that a person should not walk through his friend’s field when it is full of grain, lest he harm it through the evil eye. This shows how careful we need to be: to keep things private, to see things only through holiness, and not to let them be exposed to an unfavorable eye, and so on. Medical tests: the routine tests common today—urine, blood, blood sugar—pose no problem. As for ultrasound, the Rebbe’s view was to limit it. So many rabbis hold that an ultrasound should be done around week eleven, to know that everything is all right and, especially, to establish the gestational age. Sometimes the birth is delayed and people become anxious, so this test is very important. That reminds me: some time ago, someone called me and asked whether his wife, who was already past week forty-three, should have labor induced. At first glance, it seemed that in a situation like that, at forty-three-plus weeks, it might very much be needed. But then he added, “No, the doctors found that the pregnancy began two weeks later. Forty-three weeks is counted from her last period; she’s actually only at week forty-one.” So is there any reason to be so anxious? That’s why this is very important. Then, in the middle of the pregnancy, around week twenty-one or twenty-two, it may also be advisable to have an ultrasound to check that everything is all right. Some rabbis also favor additional tests, such as an anatomical scan and so on. Every woman

22:44 Speaker 2 should ask her rabbi. Of course, an ultrasound should be done as the birth approaches, around week thirty-four or thirty-five, to see the baby’s position and size, and so on. And here we should mention why, in the Rebbe’s view, it is advisable to avoid ultrasound. First of all, because it involves radiation, and radiation can cause harm. It was found some time ago that boys born after frequent ultrasound monitoring were more likely to be left-handed. Why? Because, plainly, it affected the brain in some way and led to greater use of the left hand. So that indicates that there is some kind of problem. They do claim that ultrasound today involves much less radiation than it used to, and the amount is apparently continuing to decrease. Still, it would seem best to avoid it without a particular reason. Another guideline on this subject: if possible, avoid a vaginal examination, an internal examination. An internal ultrasound is considered somewhat risky, and one should try to avoid it. If there is no choice, then there is no choice. And of course, in any urgent case, one should certainly have it done, and so on. Now, regarding an epidural injection: years ago, Chabad people in the Holy Land asked the Rebbe, and the Rebbe said that each case should be brought to a rabbi qualified to rule on halachah. That also makes sense, because there is a small risk, albeit a small one, that it could cause paralysis or other problems. So one should ask a rabbi. And the significance of asking a rabbi is not only to know the Torah’s view, but also that, through this, he actually changes the reality. This was said about Rabbi Shlomo Zalman Auerbach: he said he appreciated it when the Rebbe sometimes referred people to him, or when people came to him because the Rebbe had told them to ask a rabbi. Most questions are about what is permitted, what is advisable, and what is forbidden. But with the Rebbe, it came out differently. It was something more: having a rabbi issue a halachic ruling, and that

25:10 Speaker 2 changes the reality. I was at a class where a woman told us that she had given birth to several children and had asked a rabbi each time whether to have an epidural. She was always told it was fine; she had one, and everything went well. The next time, she already knew that rabbis approved it, so she went ahead without asking. That time there was a complication with the epidural. What does that mean? That a rabbi does not merely instruct us whether something is permitted or forbidden. He is also given the power from Above to rule and to change the parameters of the world. It is well known how strongly the Rebbe called for halachic rulings against giving back territories and the like. A rabbi changes the reality of the world. Now, going in order through pregnancy tests, first of all it seems advisable to have an ultrasound around week eleven. That is, first and foremost, to establish the gestational age, as well as to check development. Sometimes, toward the end, people get anxious and want to induce labor or even, at times, have surgery, only to discover afterward that it was unnecessary because the pregnancy began later than they thought. I encountered such a case—I mentioned one in which the pregnancy appeared to be past week forty-three, but it turned out that she was only at week forty-one, because the pregnancy had begun a little later. So this is very important. In this connection, let’s also mention the medical school of thought that is quite widely accepted today, which places great importance on ovulation. Ovulation is when the egg passes from the ovary toward the uterus and is in the fallopian tube. According to some opinions, that is the time when conception can occur—for twenty-four hours or thereabouts, and so on. The Rebbe cites two views brought in the Gemara. One view is that a woman conceives close to the time she immerses in the mikveh, which may correspond to the time of ovulation. The other view is that she conceives specifically close to the onset of her next period, toward the end of the cycle. And the Rebbe says, in reference to the view that everything depends on ovulation,

27:32 Speaker 2 that this is not necessarily always so. From what I understand medically today, there certainly are doctors who say that it can happen as the Gemara says, close to the next period. What is more, one doctor explained to me that, according to that school of thought, most women—or many women—can conceive at any time up until their period, as long as the egg is in the uterus. But some women really are dependent on the timing of ovulation. Those are the women who come for medical tests and monitoring. Women who do not have that problem conceive on their own and do not need any ovulation-related treatment. I was also at a class where a woman who was no longer so young spoke about her own story. In those years, her father traveled to the Rebbe and returned at the end of Tishrei or after Tishrei. By their calculation, her mother had only one night of taharah left before her next period. Nevertheless, she immersed in the mikveh. They were together, and the woman said of herself, “I’m the result.” In other words, as mentioned earlier, there are cases where a woman conceives close to her period. This was also relevant once when someone asked me a question, which I of course referred to a doctor. It concerned a woman for whom becoming pregnant posed a real medical risk, and we won’t go into the details. She was using temporary contraception, not permanent contraception. Her husband then thought that perhaps they could be together if they delayed relations—delayed her mikveh immersion—by a week or more. I referred the question to a doctor, and that particular doctor did permit it. He relied on the likelihood that, once several days had passed, she would not conceive. There, too, the risk was real. As far as I understand, not every doctor agrees with that.

29:46 Speaker 2 And each person according to their circumstances. But let’s move on. Regarding the detailed ultrasound scan, in the past it was customary not to have one. Why? Because even if a scan finds a defect, there is usually nothing to do to treat it, and under halachah, terminating a pregnancy is almost never an option. If it is something very extreme, then one should certainly ask a rabbi. Or if it could affect the woman severely, causing depression or the like, that too is a question for a rabbi. But generally, the scan was not considered useful. Some also raised another idea: Hakadosh Boruch Hu does not usually perform openly visible miracles, but a hidden miracle presents no particular difficulty. So as long as the scan has not been done, perhaps the fetus is in one condition or another, perhaps not fully healthy, and through prayer we can bring about that everything will be all right. But if a scan has already been done and a defect or problem has been seen on the ultrasound, bringing about a change is much harder. Today there are rabbis—and I say this depends on each case—who hold that it is advisable to have a later detailed scan, in week twenty-two. That is because in recent years there have sometimes been treatments that can be given during pregnancy and may help; some are even covered by the health system now. All the more so, knowing about a problem can sometimes allow people to prepare for it. For example, if it is known that the child will need oxygen immediately at birth because of a lung problem or something similar, they can prepare and thereby save the child. So there are rabbis who favor the scan. I would say: each case on its own merits. It is especially important to ask about tests that carry some risk, such as an amniocentesis. That carries a certain risk: sometimes the procedure itself causes a defect or

31:58 Speaker 2 a miscarriage. So ask a rabbi. Generally it is not strongly recommended, but still, if a woman has some particular problem, each case must be considered on its own. There is also the basic principle, perhaps accepted by all opinions, not to induce labor without a medical reason. Here I’ll mention this: according to Rabbi Feinstein, inducing labor without a medical reason is actually prohibited because of the obligation to safeguard life and health. In other words, every birth carries a risk. When it happens as Hakadosh Boruch Hu has established in His world, He has commanded it and will see to it that everything is all right. But a woman must not put herself in danger—that is, enter labor—if it was not meant to happen then. Rabbi Shlomo Zalman Auerbach, however, argued: No, that is not a reason, because she is going to give birth in any event, so no additional risk is being introduced. According to Rabbi Feinstein, bringing the risk forward is itself considered prohibited. In addition, there is the well-known teaching that people cite, which Rabbi Ovadia Yosef also cites, from the Arizal. The Arizal says this: A child born before his time—that is, whose birth was brought forward—may either die before his time or lack good fortune because he was not born under the proper mazal. Again, if it is medically necessary, then that is his situation; this is his time and his mazal. But if there is no medical reason—for example, this is more common among the nonreligious public—people want the birth to be on a particular date, say the ninth of the ninth. It sometimes happens; a lot of people want that sort of thing. Say it was the year eleven, and many people wanted weddings or births on 11/11/11, so that the whole date would match. Reasons of that kind certainly do not justify doing something prohibited under halachah.

34:06 Speaker 2 Along these lines, there was a question someone once asked me. The grandmother had come from abroad for a limited time, and they thought the birth and the bris would all take place while she was there. In the end, the birth was delayed. Was it permissible to induce labor so that the grandmother could attend the bris? That does not seem to me to be a reason to permit it. All the more so, one should not have a cesarean section for that reason. Surgery is, of course, even more problematic if there is no reason requiring it. Another thing worth mentioning: today, under Health Ministry guidelines, if the child is in a breech position—meaning the head is not down, whether the feet are down or whatever it may be—if the child is not in the usual position, a cesarean is performed. Nevertheless, if this is known a little in advance, one should certainly try going to a doctor who specializes in turning the baby. Most of the time it succeeds. Sometimes there is concern that the baby will return to the previous, undesirable position, and then they try to induce labor. That may be appropriate; ask a rabbi. It may also make sense. But in any case, the turning generally succeeds. It reminds me of something that happened a few years ago. A young married man asked me about a cesarean for their first birth. I don’t remember exactly what his question was. I asked him, “Why a cesarean?” He told me the baby was breech, or the feet were down rather than the head. I said, “Have you tried having the baby turned?” He said no. Why not? The doctor at the health clinic had said there was no chance and it wasn’t worth it; his wife would just suffer through it for nothing. I told him that, as far as I knew, everyone agreed they should try. He also checked with other clinics and the like, and they said yes. They went to a doctor, who turned the baby within a minute, avoiding a cesarean. Of course, because of that there was a pidyon haben, and the bris took place on time. First and foremost, avoid surgery when possible. Surgery is no small matter. Under halachah, a person may not cause harm to his body without a reason, G-d forbid. Yes.

36:18 Speaker 2 On the other hand, one must not go to extremes in trying to avoid a cesarean either. Sometimes it really is necessary. These are matters to discuss with doctors and rabbis who understand them. There are certainly emergencies in which a cesarean is needed. Yes. The same applies to inducing labor. For example, if they see that the baby’s heart rate is dropping—and again, each case must be considered on its own—but broadly speaking, that is a situation requiring induction or some other way of delivering the baby. If it becomes severe, an immediate cesarean is sometimes needed. But even if it is not severe, it is, in principle, a medical reason. There can be other medical reasons too. Again, if the baby is large, then according to what is commonly accepted today in most places, if the baby is expected to weigh more than four and a half kilos, some schools of thought consider that a reason for a cesarean. In that case, perhaps it is preferable to induce labor before the baby reaches that weight. Or, say, if the woman also has diabetes, then at around four kilos there are places that would plan a cesarean; perhaps in such a case it would be better to induce labor beforehand. Boruch Hashem, today there are rabbis and organizations that specialize in all these situations. The Rebbe’s general instruction is to consult two doctors—that is, about any significant matter. I’m not talking about someone with a slight cough, but for any significant matter, ask two doctors. If they disagree, a third should decide between them. Of course, I’m not talking about an extremely urgent case. For example, if the umbilical cord tears during labor, that is a very dangerous situation. In such a case, there is generally no time to deliberate at length. At most, another doctor on the ward can agree that an immediate cesarean or some other intervention is necessary. In these matters, one must listen to the doctors, obviously. There is another case, another thing worth discussing. Today there are places that favor

38:27 Speaker 2 Natural childbirth. So natural childbirth with proper medical supervision may be all right, but natural childbirth at home without a doctor is, in my opinion, not appropriate at all. If any serious complication arises, it is very hard to deal with; you do not have all the equipment and everything else at home. I also understand that in some European countries, where there really are many of what they call home births, they happen only after screening. In other words, they first check that the birth is expected to be straightforward and uncomplicated. There is also a mobile team that can come if help is needed. In Israel, it would seem that this is not advisable. If a woman specifically wants it, she should ask a rabbi, but she must really make sure that everything is well organized and no problems are anticipated. This reminds me of a question a woman from abroad asked me a few years ago. They asked me about the idea of natural childbirth, and I did not really agree. They gave birth in a hospital. As it turned out, the umbilical cord became wrapped around the baby, creating a very dangerous situation. The nurse-midwife could barely summon additional help, because she also had to hold the baby. She could barely call for help. Baruch Hashem, the midwife was there and everything turned out all right, but in the natural course of things, somewhere without further medical help, it would not have ended well. Since we have touched on medical matters in general, it was also reported that Rabbi Shlomo Zalman Auerbach was asked what to do when natural medicine and conventional medicine have differing views. He said conventional medicine takes precedence because it has more funding, has been researched more extensively, and so on. On the other hand, that does not rule out looking into other treatments if conventional medicine has nothing that can help, or if there is something tried and tested. There are also several letters from the Rebbe along these lines. In one letter, the Rebbe asks why someone would turn to, as it were,

40:32 Speaker 2 nonconventional medicine. On the other hand, someone wrote to the Rebbe that natural medicine had helped a woman, and the Rebbe said: If it worked, why not continue in that direction? That seems to me to be more or less the approach. Today, many people also combine the two, something the Rebbe actually mentions as well. Everyone today knows how closely connected the body and mind are. This is very, very important for fertility too. One of the things that is advisable when trying to become pregnant, for example, is for the woman to be relaxed during intimacy. That is from a medical standpoint, conventional medicine, and it is also important for physical health in general. It is highly desirable, very important, for a person to be happy and not sad. I remember something that happened a few years ago. My brother-in-law passed away young, Hashem should protect us, and a little while afterward I had a cold. Just an ordinary cold. I went to the clinic. The doctor heard about his passing too. She said: “You caught the cold because you took his passing to heart. Your body was weakened, so it could not overcome the viruses.” So this is very important, and I think it is well known too. It seems that one of the studies found that people who have faith live longer, naturally speaking. This is part of the reason. First of all, when a believing Jew grows old, he still has things to do in life. He goes to shul, davens, has a supportive family and community, attends classes or gives classes. And it is well known that quite a few people, once they stopped working, retired, and ceased their activities, developed all kinds of illnesses. That is very well known. So, first, the Rebbe always said that he was against the idea of resting, of retirement. If someone is retired from his job, he should increase his service of Hashem and increase his activities. He must not rest. “Man was born to toil.” Along these lines, when it comes to children there is also this idea

42:50 Speaker 2 that people cite: “Man was born to toil.” The Rebbe addressed this in connection with spreading Judaism too. A person might think: I work so hard spreading Judaism, going places and organizing things. Otherwise, I could be sitting at home, resting; perhaps all this effort is a shame. So he is told: First of all, this is a person’s shlichus, and he has to do it. But the Rebbe also says: It is not as you think. “Man was born to toil.” A certain amount of toil is allotted to every person. The only choice is whether that toil will be spent on good things or on things that are not good. Here I will tell a story that has been published. There was a mashpia, Rabbi Reuven Dunin, a"h. This was many years ago. He earned his living operating a tractor, and in the evenings he would give classes. Things were not like they are today. He would drive some old car from place to place. He did not have a driver to take him, and he also had a family—Baruch Hashem, a large family. In short, one day he thought to himself that he needed a little rest, so he canceled his classes and activities. On that very day when he took time off, one of his daughters, Hashem should protect us, was injured in an accident. He spent two weeks with her in the hospital, and then he understood the message. Better to be busy spreading Judaism and have a healthy family than, Heaven forbid, the other way around. The same idea is also brought up in connection with children. A person might think that if he had fewer children, he would have a more peaceful life, and so on. He is told: No. A certain amount of toil is decreed for every person. Better that the toil be connected with children. The Rebbe also mentions that we can see plainly that families with many children have hardly any medical problems. Those are the Rebbe’s words. In other words, if a person plans, Heaven forbid, to have few children, then that same toil may, Heaven forbid, come in the form of medical problems.

45:04 Speaker 2 And the Rebbe explicitly said that everyone should see to it that they have at least ten children, a minyan of their own. Later, the Rebbe added: There are twelve tribes; once you reach twelve, add more. But to begin with, it was ten children. And the Rebbe spoke about this in many ways. The Rebbe said it adds to harmony in the home and increases livelihood—not only for oneself but for others as well. I encountered an example of this about three or four years ago. I happened to travel with a young married man who told me he had only a few children and was preventing further pregnancies because of financial concerns. I told him what the Rebbe said: On the contrary, having children brings more livelihood. I saw him again a year or two ago. He said that he had indeed stopped preventing it, another daughter had been born, and since then he really had seen an increase in his livelihood. So it is just the opposite. But here is the thing: Some people ask, quite reasonably, that there are all sorts of segulos for livelihood, including serving as a sandek and, of course, giving tzedakah, yet some say they do not always see the results. One possible explanation is that there are also things that specifically obstruct livelihood. There is a saying: “One dispute drives away a hundred livelihoods,” and some people are not careful enough about this. There is also a saying: “One bit of mockery drives away a hundred rebukes”—and a hundred livelihoods too. The mashpia Reb Mendel Futerfas used to ask: Why does one bit of mockery drive away a hundred rebukes? They are not even comparable. He would say: It means mocking the mashpia. In other words, if people say, “Who is he to speak to us? What is he worth, anyway?” then everything he said goes to waste. That is what it means that one bit of mockery drives away a hundred rebukes. In any case, the Rebbe really spoke a great deal about this subject. Bringing children into the world adds to harmony in the home, quite simply because there is more that the couple creates together. [unclear]

47:19 Speaker 2 They say there’s no time to argue; they’re busy with this. I’ll finish with something I came across a few years ago. There was a couple—I won’t go into details. They said they had arranged to meet with one of the mashpi’im to reconcile and restore peace in their home. But before they could speak with him, that mashpia passed away. A few months later, I met the husband. “What happened with the peace at home?” I asked. He told me, “He saw there was no one to rely on, so we worked it out ourselves.” So that does happen. Another time, a couple had an argument after the wife had immersed in the mikveh, and the husband called me. Perhaps they shouldn’t be together while they were in the middle of an argument, and so on. I asked the wife what she thought. She said, “What are you talking about? Why should all my effort have been for nothing?” So the halachic ruling was that they had to make up and be together. They followed the ruling and thanked me afterward. So we’ll finish this subject with that. Truly, Hakadosh Boruch Hu found no vessel capable of holding blessing other than peace. We should avoid every kind of dispute, both within the family and around us. As we said, one dispute drives away a hundred sources of livelihood. Someone said that just as we work hard to earn a living, this too is one of the hard things: to overcome our own tendencies and achieve peace, love, and unity. Let’s continue with medical matters, or pills and the like, relating to fertility. First of all, it is generally permitted to take medication to regulate menstruation, which can, of course, sometimes also help with fertility. Even when someone takes medication to prevent pregnancy on a rabbi’s instruction—and I stress, on a rabbi’s instruction—it is permitted to take it on Shabbos, and certainly medication to regulate menstruation. There is a question whether a man may take something on Shabbos to improve his potency. Many permit it, but nowadays, generally—

49:39 Speaker 2 As I understand it, there are medications, taken on a doctor’s advice, that can be taken before Shabbos. So why take them on Shabbos if they can be taken beforehand? As for a pregnant woman: first of all, any risk to a pregnancy is considered a matter of saving a life, including during the first forty days. If there is a reason, one goes to the hospital even on Shabbos. In principle, when it comes to childbirth or pregnancy, Shabbos is like a weekday. Here I’ll mention a distressing story that happened a few years ago. A pregnant woman was nearing her due date, and on Shabbos she felt that the baby’s movements were decreasing. It was Shabbos, and she couldn’t call a rabbi. She waited and waited, until by morning the situation was no longer good. She got to the hospital, and it turned out she may have been just a few hours too late. The baby had died. In the natural course of things, if she had gone a little earlier, when the movements first began to decrease, she could have saved the baby. We need to know all these things. A weekday is like Shabbos—sorry, Shabbos is like a weekday. That means that if the doctor’s instruction is to go to the hospital when the baby’s movements decrease—after doing what women are instructed to do, such as lying on the left side, having something sweet, and checking for movement—then she should go. This is especially true of a woman who has, say, a problem in this area or has rapid deliveries, and whose doctor has told her to come in when contractions begin, even before they reach the usual point at which one must come in. Since her labor progresses quickly, there is no difference between Shabbos and a weekday. And let’s mention here the two reasons given in halachah. First, saving a life overrides Shabbos. There is also the principle, “Desecrate one Shabbos for his sake so that he may observe many Shabbosos.” In other words, there is another aspect here that actually serves the continued observance of Shabbos. Now, regarding problems during pregnancy or breastfeeding. So, first of all—

51:55 Speaker 2 A woman who has a breast infection may, of course, take antibiotics and whatever else she needs, because she is certainly considered bedridden by illness. According to the Alter Rebbe, most halachic authorities hold that in such a case it is permitted—and necessary—to take medication. In addition, if she needs to pump milk with an electric pump, that too is permitted if done in an unusual manner. Even if we say that this starts a motor and thus involves a Torah prohibition, according to the Alter Rebbe it is permitted to perform an act prohibited by the Torah in an unusual manner for someone bedridden by illness, even if her life is not in danger. Besides, according to most opinions, using electricity without kindling a flame or making metal incandescent is only prohibited by rabbinic law. But according to the Alter Rebbe, that distinction doesn’t affect this question, because it is permitted to do it in an unusual manner. On the other hand, whatever can be done in an unusual manner should indeed be done that way. A simple example: a woman in labor arrives at the hospital, and there is an elevator up to the floor with the delivery rooms. Clearly, she can press the elevator button in an unusual manner, with the side of her fingernail. By contrast, when driving a car, one should obviously drive normally. There is no distinction to make there, and one shouldn’t even get into all sorts of fine points, because that would confuse the driver. Don’t tell him, “Don’t turn on your signal when you turn...” Do everything as usual. Unrelated to this, I would say that in Israel especially, one needs to be careful. Some drivers signal left when they want to turn right, whether deliberately or by mistake, and one has to watch out for things like that. I would also tell pedestrians to be careful, even at a crosswalk and even at a traffic light. Pay attention, because some drivers speed through crosswalks, and I’ve also encountered drivers going through a red light several times. As for vitamins during pregnancy, there are two questions here: Shabbos and kashrus. In principle, the accepted practice is to take any medication a doctor prescribes without checking its kashrus, especially a tasteless medication. When it has no taste, checking its kashrus is a matter of hiddur, though that should not be dismissed. But if it is needed, it is needed.

54:13 Speaker 2 This is especially so if there is no alternative. Someone who takes vitamins without any particular reason should choose vitamins with kashrus certification, since today almost all vitamins are available with certification. But if there is a medical reason, especially when they have no taste, there is no particular problem. As for Shabbos, I would make the following distinction. If it is necessary for a woman to take them on Shabbos too, she certainly should. The same applies to someone considered bedridden by illness. For example, someone with severe anemia may need to take a large amount of iron; without it, he becomes very weak. Clearly, he may take it on Shabbos if it is necessary. But in many cases it isn’t necessary. It can be taken before or after Shabbos; it isn’t urgent. In that case, one should not take it on Shabbos. In places where people ordinarily take vitamins every day, perhaps they are considered food. But even according to those opinions, here in Israel, I think most people today do not take vitamins regularly. Only those who need them do. So one may not take them on Shabbos unless there is a genuine reason. On the other hand, people with various illnesses who are considered bedridden by illness—or even, in the Alter Rebbe’s words, someone who is not bedridden only because he pushes himself, but really needs rest—may take them. All the more so if the condition could worsen until he becomes bedridden, and certainly if it could become dangerous. Take an example, if we’re still in the COVID period. This is clear: I think someone who feels weak with COVID should take any medication or anything else that may strengthen him. And, of course, he should not fast on fast days. That’s clear. Someone who feels well but has COVID and a fast day comes around should ask a rabbi, but in principle—

56:18 Speaker 2 Let’s take another example. Someone has a headache, an earache, or something similar. If it is not caused by an actual illness or cold, it depends on whether his condition is defined as being bedridden by illness. That means he basically cannot function normally; it doesn’t mean he cannot move. If he cannot function normally, he may take medicine to relieve the pain and so on. So it really depends quite a bit on how severe the pain is. Sometimes the pain is mild and a person can ignore it; then it is not advisable to take medicine on Shabbos, and perhaps it is prohibited. But if it is real pain, whatever kind it may be, he may take medicine. In fact, perhaps he should take it so that, G-d forbid, he will not suffer on Shabbos. We are more lenient with young children. The rule is that for a child, any need—a medical need or a need for food—is treated as illness that confines him to bed. A young child, according to the various opinions, certainly up to a few years old—two or three, or older—simply cannot endure it. Even something very minor causes him great distress. So it is treated like being bedridden by illness. According to Rabbi Noy[unclear], as long as a child needs special food and it was not prepared before Shabbos, one may ask a non-Jew to prepare it for him. Why? Because for the child it is like being bedridden by illness. The child cannot bear being without the special food he needs.