Welcome to the third session of "THE BIBLICAL PERSPECTIVE ON CHILD DEVELOPMENT". Following our review of the Biblical perspective on conception, we are ready to delve into the wondrous process of birth. The process of prenatal development and birth holds the key to our understanding of the central role of the child in the Jewish family and the importance attributed in Biblical ethics and law to life itself.

PRENATAL DEVELOPMENT

The mysteries of prenatal development fascinated the Jewish sages, and they succeeded in unraveling many unknown aspects of the creation of a human being long before modern science attempted to do so.

The Midrash states that the embryo is created when fertilization succeeds and the white drop (the ovum) fuses with the semen. The embryo then develops in the uterus, which is full of blood.(Yalkut, Job 905) The ban on destroying seed in Biblical law (Niddah 13a) is based on the knowledge that the male sperm is the essential element in conception. In modern scientific history, the human ovum was discovered by Baer in l827, while the existence of the spermatozoa was discovered by Hamm and Leeuwenhoek in 1677 (W.M. Feldman, "The Jewish Child" 1918, pg. 120-121).

In many cases, statements on embryology in the Talmud are a blend of philosophical speculation and insights that have been restated as scientific facts in our times. Consider, for instance, the following passage:

"Our sages learned: There are three partners in the creation of man: the Almighty, his father and his mother. The father contributes through his seed the white subtanceout of which are formed the bones, sinews, the nails, the brain and the white of the eye. The mother contributes through her ovum the pigmented portions: i.e., the skin, the flesh, blood, hair, and the black of the eye. The Almighty contributes the spirit, the soul, the beauty of the features, eyesight, the power of hearing, ability to speak and walk, and cognition. When the child dies, the Almighty takes His Portion to Himself and leaves the remainder to the parents. Rav Papa said: This is the meaning of the saying: Remove the salt and the flesh is fit for the dogs. As Rashi comments, this means that the soul is like salt which preserves the body - when the soul departs, the body decomposes".(Niddah 31).

The description of the parts of the body attributed to the seed of the mother and father may be considered as an antecedent of the theory of germinal predetermination and the chromosomes which was considered to be a breakthrough in modern science.

The miracle of fetal development is further described in following passages:

" What is taught in the verse, I will give thanks unto Thee for I am wonderfully made; wonderful are Thv works and that my soul knows right well". " Take note of the difference between the Almighty and man! A man puts different seeds together in the soil and each grows in the manner of its own species; whereas the Almighty places the embryo in the mother' womb, with the result that both the father's seed and the mother's seed grow into one and the same human being."

"Compare the clothes-dyer puts several dyes in the vat and all unite to form one color, whereas the Almighty places the embryo in the womb so that each element of the parent's seed develops in it own natural way" (Niddah 31).

The wonder of the metamorphoses by which these "elements of the parent's seed" develop into a human being is further unraveled when we note Rabbi Eliezer's statement that "a fetus inside the womb is like a nut placed inside a bladder of water. If you press your finger on the bladder, the nut recedes."(Niddah 31) This is an obvious reference to the amniotic sac surrounding the baby. Moreover, during the prenatal development period:

"The fetal mouth is closed and its umbilicus is open; it eats and drinks everything that its mother eats and drinks…. but, as soon as it comes into the world, everything which had been closed opens, and that which was open closes, otherwise the child could not exist for a single hour. (Niddah 31b)

This is a remarkable description of the life-support system formed by the placenta, to which the baby is connected by the umbilical cord. The baby receives all its nutrients and hormones from the mother by way of the placenta, and also excretes its wastes through the placenta.

Among the Jewish sages were some experienced observers, such as Mar Samuel (a famous embryologist), Abba Saul, and Rav Abbahu. According to some of them, the primary center of formation of the human being was the head, while according to Abba Saul it was the umbilical vesicle, from which the parts of the embryo develop in different directions. (Yoma 85a) These rabbinical observers actually examined embryos based their statements on scientific methods of observation. In the Talmud, we find instructions for examining the embryo - not in water but in oil, and only in the sunlight. (Niddah, 25a/b)

For this reason, we find astonishing descriptions of the developing baby at different stages of prenatal development. The following description of the forty-day embryo by Rav Abbahu is supported by modern scientific findings:

"Its size is that of the locust; its eyes are like two specks at some distance from each other; its two nostrils have the same appearance as the eyes of a fly, and they are very close to each other; its mouth has the same appearance as a strand of hair. Sex can be distinguished, but it is not possible to differentiate between the upper and lower extremities. The arms and legs are not sharply defined. And it is for this stage of development that we find the saying in the Kabbalah: "Hast thou not poured me out as milk, and curdled me like cheese? Thou hast clothed me with skin and flesh, and hast fenced me with bones and sinews. Thou hast granted me life and favor, and Thy visitation hath preserved my spirit" (Niddah 25)

Thus, we find the distinction between the embryo and the fetus. At a further stage of development, the fetus resembles " a ledger folded and laid to rest. Its hands rest on its two temples, its two elbows and two legs and two heels against its buttocks, its head lies between its knees; its mouth is closed and its naval is open." (Niddah 30)

According to the Talmud, no time a person spends is better than the time he spends in the womb, (Niddah 30), and for good reason…. The child in the womb is taught the entire Torah, but when it is time to be born, an angel comes and strikes him/her on the mouth, causing the child to forget what he/she has learned. Moreover, before entering the world, the child must vow to be righteous and not wicked, and even if the entire world may someday proclaim that he is righteous, the child must still consider himself wicked (so that he/she may yet improve his/her character]. (Niddah 30) This beautiful legend, claiming that man attains his highest level of spiritual life while in womb, may explain the great amount of care and devotion for the unborn child that is evident in the laws regarding the status of the fetus and the Halakhah (Biblical law) relating to abortion..

Halakhah stipulates that a fetus disqualifies its mother (if she is a priest's daughter married to an ordinary Israelite) from eating the terumah (gifts of food given to the priests], for if woman is pregnant (even if her husband dies), it is considered as if he has left behind a descendant. On the other hand, if an Israelite woman married to a kohen (priest) becomes pregnant, the fact that she is carrying his child does not entitle her to the terumah (Yevamot 83). This point is important, for in the former case the fetus is regarded as an individual in its own right, a concept which has great implications in rulings on abortion. In addition, Halakhah stipulates that a fetus inherits from its father (if he dies) but does not cause the first-born to take less of the inheritance than the double portion allotted before the child is born (Bava Kamma 142b). Again, in the former section of this law, we find that the fetus is regarded as an individual who attains his rights at the suitable time.

Finally, a very important concept, which forms the basis for rulings relating to the status of the fetus, is the viewpoint that even during the first forty days after conception, the embryo (which develops into a fetus) possesses a soul. An authorized Rabbi must be consulted concerning cases of medical emergencies regarding a decision to save the embryo or the mother (Seridei Esh 3:96. Refuah Leor Hahalakha, Institute for Medical Research According to Halakha; J-m 1980). This is indeed remarkable, for it raises the status of the unborn child to that of a "life" and thus entitles the developing fetus to maximum care and protection so that it may become a healthy individual.

BIRTH

Nothing in life is more wondrous than the process of birth. The Halakhah concerning women in labor and the historical descriptions of the birth process in Jewish literature determine the special significance of the exciting moment of delivery.

At the very beginning of creation, the Almighty ordained to the parturient Woman, "You will bear children with sorrow" (Eruvin 100) This the eternal punishment for the sin committed by Eve when she ate a fruit from the tree of knowledge. In essence, it was most fitting retribution, for it is a constant reminder that all of creation is a blend of pain and ecstasy, just as the life that follows is filled with happiness and sorrow

In the Biblical descriptions of birth, we find women who suffered from contractions and those who had painless deliveries. In biblical times, it was thought that labor with a male child was more difficult than with a female, as in the case of Rachel: "And it came to pass, as she was hard in labor, that the midwife told her, "Fear not, thou shalt have this son also."(Genesis 25:17) Rachel actually died during or immediately after childbirth.

A woman giving birth is described by Isaiah as "bending over with pain for the contractions have overcome her." (Isaiah 4:9) In Psalms, we find the association of extreme pain with labor contractions: "they were seized with pain like a woman in labor."(Psalms 48:7) The prophet Micha expresses himself in a similar manner: "Be in pain and labor, 0 daughter of Zion, like a woman during childbirth." (Micha 14:10)

The Talmud notes that three voices are heard from one corner of the earth to the other, and one of them is the cry of a woman giving birth to a child. (Yoma 20). The Talmud also offers an explanation for death during childbirth: "Women die during childbirth f'or having committed three sins: If they have not been careful to fulfill the mitzvot of niddah [purification], challah, and lighting the Sabbath candles." Rabbah explains that the woman's misconduct is accumulated and she is punished all at once at a time when she is most vulnerable." On the other hand, we learn that Sarah had no "trouble" during her pregnancy or delivery. (Genesis 21:1) The Talmud gives the example of Jochebed, whose pregnancy and labor were painless, and concludes from this that righteous women are exempt from the verdict passed on Eve." (Sotah 12)

It was known that the primapara had longer and more severe contractions: "For 1 have heard a voice of a woman in labor, and the anguish of her that bringeth forth her first child." (Jeremiah 4:31)

The mechanics of the labor process are explained in the Talmud as follows: "In the first three months, the embryo dwells in the bottom section; in the middle three, it dwells in the middle; and in the last three months, in the top section. When the time comes for it to be born, it turns over and comes out into the world."(Niddah 31) It is explained that a muscular force dilates the mouth of the uterus so that the baby can pass into the birth canal and finally into the outside world. Labor pains are first felt in the loins (Jeremiah 30:6, Isaiah 21:31). Moreover. a common sign of labor, the "bloody show" is mentioned in the Talmud. (Shabbat 129a)

According to the descriptions in the Bible, women in the process of childbirth either kneeled or sat on someone's knees.(Genesis 30:3). A woman in labor flexed her thighs against her groin in the effort to expel the baby.(Yevamot 103). An important sign of childbirth is the fact that the woman's groin becomes as cold as stone (Sotah 12). This sign is mentioned as critical in the deliveries assisted by the midwife Puah in Egypt. As Puah's role in the process was to "call out" to the mother, this might be a reference to natural-childbirth techniques similar to the modern Lamaze method of breathing exercises, which are known to have a numbing effect on the muscles and the groin (and thus provide evidence that the delivery is progressing well).

In addition to normal deliveries, we find evidence of obstetrical operations such as the Caesarean section carried of difficult labor (Niddah 40a). A child born in this manner ("yotze dofan" - through unnatural conditions) does not render his mother impure. According to Maimonides, a woman who gives birth through Caesarean section cannot have another child (Rambam, commentary on Berachot 47a), but according to Rabbenu Gershom the Caesarean section does not prevent another pregnancy (Rabbenu Gershom, commentary on Berakhot 47a).

A description of the operation is given by Rabbi Yochananh, who states that the incision was carried out in the "fifth place on the right side of the abdomen (Sanhedrin 49a). According to a talmudic commentary, the term Caesarean was applied to the operation because the first Roman emperor was born in that manner (Tosafot, Avodah Zarah 10b). The Caesarean section was most commonly performed in effort to save the child when woman died during childbirth. In fact, according to Mar Samuel, it is permitted to perform this operation even on the Sabbath in order to save the child (Arakhin 7a).

In addition to the Caesarean section, the Talmud discusses the breech birth which occurs in abnormal deliveries (Niddah 28a). The delivery process in which the midwife or doctor grasps the child in the uterus and turns it upside down in order to assure a normal delivery (if the baby presents itself abnormally) is mentioned in the biblical account of the delivery of Tamar's twins.

Halakhah affords all possible conditions for a delivery that is safe and normal for both mother and child. If a woman begins labor on the Sabbath, it is permitted to desecrate the holy day for her sake by calling for a midwife, and the midwife may cut the navel on the Sabbath. Since a woman in labor is considered to have similar but not identical legal status as a sick person in mortal danger, all her needs must be attended to even on the Sabbath. The Talmud states that it is even permitted to light a candle for a blind woman in the process of delivery if this will soothe her (she will be relieved to know that assisting her have light). However, in all cases, if it is possible, the manner of performing such acts should be changed, in honor of the Sabbath (Shabbat 128b). The parturient woman attains this status soon as she sits on the birth stool, or when she has a bloody show, or when her friends carry her. If any of these circumstances exists, one may desecrate the Sabbath on her behalf. (Shabbat 128b).

A woman who has given birth (a yoledet) is considered to have a similar status as a sick person in mortal danger. (Shabbat 128-129b; Shulkhan Arukh, Orach Hayim 203) As long her womb is open (which is for the first three days after birth). one may desecrate the Sabbath for her sake if she requires something, whether she asks for it or not. Once her womb closes, this no longer applies. From the fourth to the seventh day after birth, one may desecrate the Sabbath for her sake only if she specifically asks for it; if she states that she does not require it, one must not desecrate the Sabbath for her sake. From the eighth day up to the thirtieth day after birth , she is consider a sick person who is not in mortal danger, and one must not desecrate the Sabbath for her sake.

A woman who gives birth on the seventh day of Tishrei. (i.e. three days before the Yom Kippur fast) may not be compelled to eat on Kippur, for she is then considered to have the status of a sick person who is not in mortal danger. The period during which she is considered to be in mortal danger is three days including the first day of delivery. As far as this ruling is concerned, it is the number of days that is considered and not the exact time of birth (Terumat ha-Deshen pt A, siman 148) so that most sages rule that she is required to fast.

If a woman had difficult labor, it was the custom to bring a Torah scroll to the doorstep of her home, but bringing the Bible scroll into the house was not permitted. The Torah's presence was to maintain a watch over her, but this was not to be considered a good-luck symbol. (Responsa Chinnukh Bet Yehuda 71)

Certain customs have developed to provide psychological support during childbirth. In some communities it was the custom to hang posters with relevant portions from the Psalms and the names of the Biblical forefathers around the bed of the woman in labor. Verse 121 of Psalms is considered appropriate for the occasion. Special prayers are recited in the synagogue for a safe delivery and the mother's healthy recovery. The prayers are recited before the reading of the Bible portion on the Sabbath (Mi sheberakh)

The midwife (called " meyaledet;" in the Bible and chakhamah, "wise one" in the Talmud) played an important role in childbirth. She carried out medical functions, as we noted in the birth of Benjamin, and even perrformed obstetrical operations, as in the case of the twins born to Tamar. She also had the function of caring for the child immediately after delivery. Sotah 11b) The Bible mentions two midwives during the period of bondage in Egypt, Shiphrah and Puah. According to the Talmud and Midrash they assisted in the delivery and cared for the neonates. (Exodus 1:15, Sotah 11b, Ecclesiastes Rabbah 7:1) As we have seen, Puah would call out the mother's name, thus assisting in the delivery, while Shiphrah would sooth and cleanse the newborn. The function fulfilled by Shiphrah is especially interesting for it would seem to imply that special care was taken to spare the newborn any unnecessary trauma and to make the entrance into the new world as pleasant as possible (perhaps an antecedent to the modern Leboyer method).

Another role specifically designated to the midwife was to serve as one of the three persons entitled to decide in cases of doubt concerning the identification of the firstborn, especially when twins were born. (Kiddushin 74a)

THE NEONATE

The care of the neonate immediately after birth consisted cutting the umbilical cord, bathing the infant, rubbing it salt, and swaddling it (Ezekiel 16:4) The salt was applied to the baby's skin to make it harden. (Rabbi A.I. Sperling: Sefer Taamei ha-Minhagim, J-m: Eshkol 1957, pg. 30). ) All these procedures must be done even on the Sabbath (Shabbat 129a). The baby was swaddled to straighten out its limbs which had been somewhat deformed during delivery (Rashi, commentary on Shabbat 66b). Similarly, the baby's head was manipulated in order to bring it back to its proper shape following any elongating which occurred during delivery. Hillel comments that the Babylonians had round heads because midwives were not competent enough to manipulate the head to its proper shape.

The entrance of a new individual into the world marks a link in the continuing chain of human development, with all the hope and promise accorded by a new life. The cycle of development in the framework of Judaic thought is summed up in the following statement: "Man enters the world with closed hands, as if to say, "The world is mine." He departs with open hands, as if to say, "Behold, 1 take nothing with me" (Ecclesiastes Rabbah 5: 21).

NONVIOLENT BIRTH

According to several Biblical sources, the birth process was carried out as smoothly as possible and with the least amount of trauma to the newborn. The midwives had an important role in the "nonviolent birth", as we noted above. The midwife Shiphrah was given that name (derived from the Hebrew le-shaper, "to cleanse and appease") because it was her duty to cleanse, soothe, and appease the neonate immediately following birth.

While the Jews were in Egypt, the women gave birth in natural surroundings, under an apple tree (to assure their safety and provide a calm atmosphere for the momentous occasion). Although there were special circumstances during the period of exile in Egypt (Sotah 11b), it is quite probable that this principle and the calm treatment of the neonate were similar throughout the biblical period and in later Jewish history, for we find in the Pesikta de Rav Kahana (IX, 77b) that the neonate was kissed and cuddled even though he was still covered with blood and mucous. This was an antecedent of the modern Leboyer method of nonviolent childbirth. We even find reference in the Bible that the father was present at birth and was presented with the newborn (Genesis 30:3,2:23) although the father is not permitted to view the actual birth. An authorized Rabbi should be consulted regarding the halakha concerning the father's presence during the actual birth.

As we have seen, the occasion of childbirth warrants the desecration of the Sabbath if necessary to save the mother or the child. The Responsa literature considers conditions of birth which warrant such an allowance (Shabbat 135a) "If the hair and nails are found as they should be in a full-term baby, then the infant is viable even if born during the eighth month." In fact, the Talmud notes that even an infant born to a mother after six-and-one-half-months of pregnancy can survive (Yevamot 42a).This must have entailed sophisticated techniques for the care of a premature child.

It is interesting to note that the Midrash gives the average length of a neonate as a little over an "ammah kedumah", about 18 inches, corresponding to the average length of the newborn in our times (about 20 inches).(Genesis Rabbah 12:6)

POSTPARTUM CONVALESCENCE

Following delivery, the mother begins her period of recovery, determined by Halakhah as from three to thirty days. As have seen, the cycle of development is closely linked with the concepts of purity based on the principle of partnership between the Almighty and man in the act of creation. It is fitting, therefore, that the period of recovery is characterized by laws regulating this cycle. The law is stipulated in the Bible as follows woman who has given birth to a male child is considered a "niddah" (impure) for seven days and she is to count another thirty-three days of purification. A woman who has given birth to a girl is considered a "niddah" for fourteen days and she must count sixty-six days of purification. Following this period of purification, the woman was to bring certain required sacrifices to the Temple (Leviticus 12). The Talmud explains that the woman is required to bring sacrifices because it is probable that during labor, she vowed never to have relations with her husband again, and since this is a vow she will regret later on, she must bring a sacrifice.(Niddah 31b)

In accordance with the Code of Jewish Law, a woman remains impure as a result of childbirth for seven days after giving birth to a boy and fourteen days after the birth of a girl, assuming there is no blood flow. Following this period, she must count seven days and then immerse herself in the mikvah (ritual pool). Some communities follow the more strict formula of waiting forty days following the birth of a boy and eighty days following the birth of a girl before immersion in the mikveh. (Kitzur Shulkhan Arukh 154)

It is interesting to note that according to modern medical knowledge, it takes about six weeks of rest for the reproductive tract to return to its normal state as it was before the pregnancy (Alan F. Guttmacher, "Pregnancy, Birth and Family Planning". N.Y: New American Library, 1973, pg. 264)

The Halakhah concerning the puerperium (yoledet) assure the young mother the maximum conditions for rest after childbirth, thus completing the cycle of development in which man is a partner to the Creator in the most wondrous of all of life's events. The Biblical laws and customs also assure maximum conditions for a new cycle of life to commence.

EXERCISES:

In our next session we will consider the Biblical philosophy, laws and customs for welcoming the newborn. Until then the following exercises will help round out this session on birth:

1) Review your standard books and magazine articles on conception birth.
   a) Compare the contemporary concepts and legal status of the embryo and fetus with the biblical perspective.
   b) How does the biblical perspective differ from or compare with the contemporary view?
   c) What implications does this have for the survival and well-being of the embryo/fetus?

2) What insight does the biblical perspective on childbirth offer mothers-to-be today and in the future:
   a) regarding the meaning and essence of life?
   b) concerning the cycle of life?

 

 

 

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28 Aug 2005 / 23 Av 5765 0