CONCEPTION

The relevant commandment regarding conception in the Bible is stated in form of a blessing: " And the Almighty blessed them and said, 'Be fruitful and multiply "'(Genesis, 1:22) This is a most important commandment; because of it all other commandments in the world are fulfilled. In light of its nature, it was given to human beings and not to the angels. (Sefer Hachinnuch, pg. 1a) Rabbi Yochanan ben Beroka points out that the commandment "be fruitful and multiply" (peru urevu) was directed to both man and woman (Shabbat 3) but the sages in the Talmud maintain that it is the man and not the woman who is responsible for the fulfillment of the commandment (Yevamot 61a) The latter viewpoint is determined as the Halakhah (Jewish law) in the Code of Jewish Law (145a).

The Talmud emphasized the sanctity attributed to conception in the following passage: "Our Rabbis taught: There are three partners in man: The Holy One, blessed be he, the father and the mother. The father supplies the semen, the white substance, out of which are formed the child's bones, the sinews, the nails, the brain and the white of the eye. The mother supplies semen, the red substance, out of which are formed the skin, flesh, hair, blood and the black of the eye. The Almighty provides the spirit, the soul, the beauty of the features, eyesight, the power of hearing, ability to speak and walk, understanding and intelligence." (Talmud, Nidda, 30a)

From the beginning of Jewish history to this day, women who did not conceive suffered great mental anguish as a result their infertility. Our ancestors Sarah, Rebecca and Rachel exemplify the desperation of women who were infertile and redeemed when the Almighty blessed them with a child. Failure to bear children involves more than just personal frustration; a person who chooses not to have children diminishes the image of the Almighty. The sages taught that when even one person in the nation choses not to fulfill the mitzvah of procreation, this was reason enough for the Shekhinah (spirit of the Almighty) to remove itself from the people Israel. (Bereishit Rabbah, 34:20)

In Judaism, the very purpose of marriage is to fulfill the commandment peru urevu (Yevamot,61b).Indeed, the Code of Jewish Law states that "marital relations should not be carried out with the object of satisfying one's animal passions, but for the goal of establishing a family which should serve the Almighty and be useful mankind". (Even Haezer 25:2; Sotah 12) According to the Biblical commentator Rashi, one should have as many children as possible, for it is written, "Be fruitful and multiply" (Genesis 1,22) The word "multiply" indicates that one should have many children (Gen. 1:22). The sages stipulate that the commandment is fulfilled when one has a boy and a girl (according to the school of Hillel or two boys (according to the school of Shammai). (Yevamot 61b)

Judaism places such a great emphasis on building a family that if a man died before he had a son, his widow was to marry his brother so that her firstborn would carry the name of the deceased and thus ensure that his name not be "removed from Israel". (Deut.25:5~6). The alternative ceremony of chalitzah enables the brother to forfeit his duty and his right to marry the widow while maintaining the principle intact.

Infertility, whether due to the woman or the man (Deut. 7:14),is considered a great curse, for a "man without children is considered like the blind, the pauper, and the leper-as a dead man ."(Nedarim 64b) The Bab.Talmud notes, however, that one who raises an orphan or who teaches a chiId Torah, is like a parent. The Talmud mentions some natural remedies for the treatment of infertility and impotence, such as Rabbi Yochanan's potion consisting of "three measures of kartemi pounded and boiled and mixed with wine" (wine was also considered an aphrodisiac) or eating garlic and fish.(Gittin 70a, Bab Kamma 8). The Talmud recognized psychological causes of impotence, and on one occasion Rabbi Huna treated such a case by inviting the husband and wife together for a meal in order to help them overcome the psychological barriers.(J-m Talmud, Nedarim 11:12) The Bible mentions the use of the fruit duda'im as a love potion which supposedly increased fertility (Genesis 30:14). The sages were aware of a wide spectrum of life situations that could cause impotence and on one occasion Rabbi Judah diagnosed that the social conditions of hunger and poverty were the cause of the failure to bear children. In treating the men involved, the sage ordered that they be bathed and fed well. This cured them of impotence (Kettubot 10a)

Both the wife's failure to bear children after ten years of marriage and the husband's impotence are possible grounds for divorce (indeed, the latter is also a reason to prevent marriage) (Nedarim 90b) In light of the grave consequences of infertility, the Responsa literature discusses various fertility treatments for women, even examination of the semen after the woman has been thorougly checked and found fertile. (Abraham Steinberg, Hilkhot Refuah Verofim, J-m: Mossad Harav Kook, 1978, pg. 150) As a result of the many complexities involved a Rabbi must be consulted in all cases of infertility. For this reason, contemporary IVF treatments which involve complicated medical procedures must be implemented according to Biblical Law and should at all times be conducted only in clinics with authorized Rabbinical consultants on the staff to assure adherence to "Halakaha" (Biblical law) in all stages of IVF treatment.

FERTILITY TREATMENT

One of the outstanding characteristics of Biblical law is its pragmatic attitude towards advances in medicine . Nevertheless, the new and sophisticated techniques of IVF which have created possibilities for conception in an artificial manner involve many legal and moral complexities.

The subject is discussed in the Responsa of various authorized Rabbis especially in light of the questionable legal of a child born under such circumstances (Responsa Minchat Yitzhak, IV, 5). (see related web sites). If a couple has been married for ten years and is still childless, and the doctors conclude without a doubt that there is no hope for normal conception, an authorized Rabbi should be consulted concerning the procedure for IVF treatment (Steinberg, pg. 150-151)

Rabbinical rulings are in line with the Biblical ethical framework and offer a flexible and pragmatic solution to a powerful dilemma. Beyond the need for rabbinical and medical consultation, the most important cure for infertility according to the Bible, is prayer. According to the Talmud, the Matriarchs, Sarah, Rachel, and Hannah were at first unable to bear children because the Almighty desires the prayers of the pious (Yevamot 64a).

PREGNANCY

"At the beginning of a human being's existence, the Creator appointed the mother's body to serve as shelter for the fetus so that it might abide in a safe place, a strongly guarded fortress, as it were, where no hand can touch it, where it cannot be affected by heat and cold. but it is shielded and sheltered and where its food is ready for it. Here it continues to grow and develop and even becomes capable of moving and turning. It receives its nourishment without any effort or exertion. This nourishment is provided for it in a place where no one else can in any way reach it, and is increased as the fetus develops until a defined period. Then it emerges without any contrivance or help on its part, but solely - by the power of the wise, merciful, and gracious One who shows compassion to His creatures" (Duties of the Heart, pg. 153). .The author of this passage, Rabbenu Bachya, points out the marvels of human development as a means of increasing our awareness of the Almighty. The beauty of the Judaic conception of child-development is inherent in the fact that every aspect of creation is imbedded in the halakhic (Biblical law) framework of life.

In order to comprehend the scope of the life-cycle in the framework of the Bible, we must begin with marital relations. By forbidding marital relations for at least seven days after the end of the menstrual period (when the wife immerses in the mikveh (ritual pool) in order to purify herself," (Lev. 15:28) the Bible lays the physical and psychological foundations for healthy conception. The Talmud points out that the most favorable time for conception is near the menstrual period (opinions differ as to whether the exact time is before the menses or immediately after immersion).(Niddah 31b; Sotah 27a). The prescription that the husband is to cohabit with his wife on the night of her immersion resolves the question in practice (Kiztur Shulchan Aruch 155:8) for as modern scientific investigation has shown this is the most favorable time for conception.

As a framework for life, Judaism does not depend only on biological factors. It also takes into account the subtle psychological elements in marriage. The Talmud notes that the reason biblical law forbids marital relations for seven days after menstruation is that separation makes the heart grow fonder. When the couple meet again after a minimum of twelve days separation they are like newlyweds.(Niddah 31b) As such, the time is ripe for conception and the development of a healthy new child.(Niddah 43a)

The Code of Jewish Law requires modesty in marital relations, as outlined in Shulchan Arukh Orach Haim, siman 240. Adherence to these principles has practical implications for the couple's offspring, as is evident from the following story: a woman was asked why her children were so beautiful. She answered that it was because her husband was very modest in his relations with her, which took place (in accordance with the Biblical prescription) in the middle of the night and not at the beginning of the night or in the early morning. Similarly, all sorts of children's handicaps are attributed to immodesty during relations between man and wife.(Nedarim 27, Lev. Rabbah 15:5)

As a result of the importance assigned to conception and the provisions made for the healthy development of the fetus, pregnant women are pampered in Biblical law and in Jewish society. "A pregnant woman who smells sanctified meat (of the sacrifices,) [or pork, and desires it so intensely that if she does not eat it, she and the fetus are in danger], one may dip a piece of bread in sauce of the meat and bring it to her mouth. If this satisfies that is good; if not, then it is permitted to feed her the fat of meat itself, for there is nothing which stands in the way of saving a life except idolatry, incest, and murder." (Yoma 82)

It is also permitted to give a pregnant woman food to eat in accordance with the halakhic measures) on the fast of Yom Kippur if her situation warrants it. On one such occasion, when a pregnant woman had a longing for food on Yom Kippur, Rabbi Judah the Prince advised that someone should whisper into her ear that it was Yom Kippur. When this was done, the longing disappeared. The son who was born to her became a great rabbi. As a comment on this incident, the Talmud cites the verse in Jeremiah (1 :5) "Before I formed thee in the belly, I knew thee." (Yoma 82)

In the Bible, special precautions are cited to protect a pregnant woman from physical harm: "It men strive and hurt a woman with child, so that her fruit depart from her, and yet no other mischief follow, he shall be surely punished, according as the woman's husband will lay upon him, and he shall pay as the judges determine " (Exodus 21:22)

The Talmud mentions that one of the miracles of the Temple was that no pregnant woman suffered from the scent of the holy flesh during the pilgrimage to Jerusalem in the holidays. (It was believed that strong odors had a bad effect on pregnant women.) (Avot 5:8). The barking of a dog is mentioned in the Talmud as "possible cause of miscarriage".(Bava Kamma 83a, Shabbat 63a).

As a preventive against miscarriage, pregnant women used to wear a stone around their necks. This stone, called the even tekoma ("stone of preservation"} was worn at all times, even on the Sabbath. Although it is forbidden to carry weights outside the home on the Sabbath, special permission was granted in this instance. (Shabbat 66b). A woman suspected she was pregnant when she missed her menstruation, but the Talmud notes that pregnancy can occur before the onset of the menses, as in the cases of Justinia, who became pregnant at the age of six, (Niddah 9a, 45a) and Bathsheba, David's wife, who was a mother at the age of six.(Sanhedrin 69a). Pregnancy can also occur after menopause, as in the cases of the Matriarch Sarah, who was eighty-nine years old at the time of her pregnancy (Genesis 17:2) and Jochebed, the mother of Moses, who was said to have given birth at the age of 130 (Bava Batra 119b). However, these cases are remote, and the Talmud notes that sixty years is the limit for a multipara and forty for a primipara (Bava Batra 119b). In addition, pregnancy before the age of twelve was prevented. (Yevamot 12b)

During pregnancy a woman's 1imbs become heavier. Diagnosis of pregnancy is certain only after the first three months. Therefore, a widow or divorcee is not permitted to remarry until three months after the date of her husband's death or the divorce, so that the paternity of the next child would not be a matter of doubt. (Yevamot 42a) Diagnosis of pregnancy in later months is no problem, for as the rabbis state, it is quite evident. (Kettubot 16a). One talmudist notes the theory that it is possible know the sex of the fetus during pregnancy, for the quickening is felt earlier if the child is a boy. ((Niddah 31a)

According to the Jewish tradition, the sex of the fetus is determined at the moment of conception. If the man gives forth his seed first, the child will be a girl; if the woman gives forth her seed first, the child will be a male. This is ascertained from the text:. "If a woman gives forth her seed and bears a male child" (Lev 12:21). For this reason, it is of no avail to pray that the child will be either male or female once the woman pregnant. However, in the first three days after conception, it is advisable to pray for a successful conception. From the fortieth day of pregnancy prayers should be said for the fetus to develop normally (and not handicapped or malformed ); from the third to the sixth month, one should pray that the child will not be lost through miscarriage; and from the sixth to the ninth month, prayers should request that the delivery will be safe. (According to Rabbi Isaac, one may pray for the child to be male from the third day up to the fortieth day of conception if both the father and the mother brought forth seed at the same time in which case, the sex of the child has not yet been determined [Berakhot 60a]). Additional customs which may assure that the child would be male include giving money to the poor, placing the bed between north and south, abstinence before the approach of menstruation; and drinking wine of the Havdalah service (Bava Batra 10b, Berakhot 5b,)

Modern science has determined that normal pregnancy lasts 280 days, or nine months and seven days from the beginning date of the woman's last menstrual period. (Alan F. Guttmacher, "Pregnancy, Birth and Family Planning", 1973, pg. 63) This is an average figure and actual delivery may vary a few days before or after this date. The Jewish sages who calculated the duration of pregnancy in the first century arrived at a similar conclusion, with the additional period of seven days, following the menstrual period up to the woman's immersion in the "mikveh" (ritual bath).

"Samuel said: "A woman becomes pregnant and gives birth after 271 days to 273 days: for this reason, the Chasidim (ultra-orthodox) were known to have marital relations only on Wednesday, so that their wives would not give birth on the Sabbath and cause a desecration of the day of rest. (According to the calculation that menses last from five to seven days and that 271 days from that day falls on Sunday, 272 days on Monday, and 273 days on Tuesday. Furthermore, Mar Zutra points out that the numerical equivalent of' the word "heryaon" - the Hebrew word for "pregnancy is 271" (Niddah 38)

The question of the duration of pregnancy is associated with the legal problem of legitimacv. Rabbah Tosia'ah ruled that a child born twelve months after the departure of the husband abroad may still be legitimate.(Yevamot 80b) On the other hand, the minimum period of pregnancy is given by Mar Samuel as 212 days -the numerical equivalent of "harbe" (a great deal) - a word appearing in a biblical passage in connection with the trouble of pregnancy" (Jerusalem Talmud, Niddah 1:3) Various cases in the Responsa literature deal with this question as well.

The specification in Jewish law and custom concerning diet and hygiene during pregnancy predated modern prescriptions to assure the healthy development of the fetus. Proper diet is one of the first things an obstetrician discusses with his/her pregnant patient. Centuries before modern science realize good nutrition is the most important ingredient in producing healthy children, we find that alcoholic beverages were forbidden to Manoah's wife when she was pregnant with Samson because of the bad effect this would have on the child (Judges 13:4). Indeed, in the Talmud we find the warning that children "begotten during a state of inebriety develop mental deficiency (a fact modern society is sadly too aware of) (Nedarim 20b). It is interesting to note that the child's healthy development is directly attributed by the sages to a good diet. If the expectant mother ate fine peeled barley, she would contribute to the good growth of the child. A diet of meat, fish, parsley, paradise apples, and coriander was recommended to assure the child would be strong, healthy, beautiful, and clear-eyed. In addition, it was believed that eating the ethrog fruit cause the child to have a fragrant odor.(Kettubot 10b)

The precautions taken for the healthy development of the fetus extend beyond the medical and environmental prescriptions for the expectant mother into the legal framework of Halakha (Biblical Law). The legal status of the pregnant woman is based on principles assuring the maximum possibility of well-being for the fetus and safety for the mother. According to the Code of Jewish law, a pregnant woman (if divorced or widowed) may not remarry - until after the newborn is twenty-four months old, so that she may properly breastfeed him) (Kittzur Shulkhan Arukh 145:14)

ABORTION

As a result of the supreme value it places on life, Judaism offers a dynamic solution to the controversial issue of abortion based on Biblical moral principles. The Code of Jewish Law forbids cessation of pregnancy unless the continuation of pregnancy constitutes a danger to the life of the mother or might endanger her health, physically or mentally (Steinberg, pg. 146; Responsa Maharit, no. 99; Responsa Yavetz 1:43). According to the Talmud, "If a woman is in labor [and her life is in danger], one may remove the fetus from her womb , for her life takes precedence over his. (Oholot 7:6) "This is the case only if the fetus is not yet viable. However, "if the head has emerged, it is not permitted to touch him [the fetus], for one life does not have precedence over another."(Sanhedrin 72b) The law of the pursuer states that one must save a person who is being pursued by another who intends to kill him, even if this means killing the pursuer. However. this does not apply to the fetus, according to Maimonides, for it is not the fetus which is trying to kill the mother; rather, it is the natural course of childbirth that poses a threat and the fetus is only an intermediary ((Yad Hachazakah 31; Rozeah 1:9) In this case, it is not clear whether the fetus is pursuing the mother or the mother is pursuing the fetus (Jerusalem Talmud, Sanhedrin 8:9)

In the Responsa literature we find several rulings based on concern for the mother.(Mishpetei Uziel 2:47, Sheilat Yavetz, Siman 43) If the abortion is intended to secure the mother's health, even if she is not in mortal danger, an authorized Rabbi must be consulted along with medical experts concerning the possibility of abortion (Steinberg, pg. 146-9) If there is well-established proof that the fetus will be born handicapped and will suffer (as in cases where the expectant mother has German measles during the first three months of pregnancy or if the fetus is a carrier of Tay-Sachs disease (Responsa Seridei Esh 147:14) abortion may be considered in the earliest stages of although in all cases a Rabbi must he consulted and the father must grant consent for the abortion (Steinberg pg. 147.

In summarizing the Jewish sources on conception, pregnancy, and abortion, we find that Halakhah regards life as a gift from the Almighty which must be cherished and given every possibility for healthy development in accordance with the moral principles of the Bible.

CONTRACEPTION

The Code of Jewish Law permits contraception in some situations.(Kettubot 34a, Yevamot 12b,34b,69b). In all cases, an authorized Rabbi must be consulted. Some Rabbinical sources on the subject are the Chazon Ish. Responsa Ahiezer, Responsa Igrot Moshe.

EXERCISES:

The following related internet sites contain valuable halakhic guidelines regarding conception and insights into the dilemmas posed by fertility treatments:

www. utoronto.ca/wjudaism/contemp/a-stein - "Kol Akara- the Voice of the Barren Woman"

www. jcn18.com/newstand/wahrman/whomom1.htm - "Who's the Mother?"
www. jcn18.com/newstand/wahrman/reproducing.htm - "Give Me Children Otherwise I Am Dead" (on Assisted Reproduction and Judaism)

http://shamash.org/shuls/einstein/medlinks.html - Judaism and Medicine on the Web contains many relevant articles. The Jewish Law Web Site lists articles on "The Preembryo in Halakha" and The Use of Cryopreserved Sperm and Pre-embryos in Contemporary Jewish Law and Ethics" Further down in the listing are Medical/Legal Articles from Touro Law School including: "Genetic Mother Versus Surrogate Mother in Jewish, American and British Law"; "Halachos of Pregnancy and Childbirth".

Our next session on THE BIRTH PROCESS will complete the first section of this course: THE FOUNDATIONS OF DEVELOPMENT. I look forward to hearing from you.