Chazal relate (in a Midrash cited by Rashi in this week's parsha, Shemot 1:7) that the Jewish women in Egypt gave birth to six children at a time. Although this midrash may be a hyperbolic expression explaining the explosive growth of the Jewish population in Egypt, it expresses the age-old aspirations of Chazal and observant families that there be large Jewish families. It is therefore appropriate to discuss this week a joyful topic, the question of whether a husband is permitted to assist his wife in the birthing process through modern techniques such as "Lamaze" or "Bradley Method." We will begin with a discussion of the question of at what stage a woman in labor is considered a "Niddah", at which point the couple are forbidden to engage in physical contact.
Rav Feivel Cohen (a noted contemporary authority on the laws of Niddah) writes (Badi HaShulchan 194:30) that when woman's water breaks water she should be considered a "Niddah", unless there is a great need for the husband to assist her. Rav Cohen believes that there is concern that she becomes a Niddah when her water breaks, although in a case of great need, one may assume that she is not yet a Niddah. Rav Cohen does not cite a textual source for this ruling, rather he writes (Tziyunim 48) "this is the accepted protocol among Halachic authorities."
Not all authorities agree to this rule. Dr. Abraham S. Abraham (Nishmat Avraham Yoreh Deah page 98-99) cites Rav Shlomo Zalman Auerbach zt"l and Rav Yehoshua Newirth Shlita who both rule that after breaking water if the woman performs a (internal examination) and finds no blood, she does not have the status of a Niddah. This author has heard prominent Rabbis say that the latter opinion is more persuasive since breaking of the water is not associated with seeing blood and since no classical source states that after breaking water a woman becomes a Niddah. A couple should consult with their Rav concerning which opinion to follow.
The question of whether a woman becomes Niddah during labor is debated among the Achronim. The Shulchan Aruch (Yoreh Deah 194) in the chapter which discusses the Niddah laws pertaining to a woman giving birth does not state that once in labor a woman is considered a Niddah. The Shulchan Aruch does, however, state (194:1-2) that a (woman who has given birth) has the status of Niddah even if she did not see blood (a highly unlikely occurrence). The reason is that Halacha accepts the view that the uterus does not open without some blood being released (see Niddah 21a). The question the Achronim debate is whether this rule applies also to a woman in labor.
As we stated, the Shulchan Aruch, when discussing the laws of Niddah, does not mention that when a woman is in labor that she automatically has the status of Niddah. However, the Shulchan Aruch does state in the context of Hilchot Shabbat (Orach Chaim 330:3) that a woman is considered a and has the status of a , a dangerously ill patient, "from the time when she sits on the birthing stool or from the time that blood comes forth, or from the time that her friends have to support her arms and hold her up since she cannot walk." This ruling is based on the Talmud's discussion on Shabbat 129a.
The Acharonim debate if just as a woman is considered a at the onset of labor, she is also considered a Niddah at the onset of labor. The dispute is summarized and analyzed in the Badei Hashulchan (194:Biurim s.v. ). The Sidrei Taharah (a major commentary to the Shulchan Aruch's codification of the laws of Niddah) points out that the aforementioned Gemara in Shabbat 129a mentions that when a woman is in labor that the uterus opens. Applying the rule , that the uterus does not open without releasing some blood, the Sidrei Tahara argues that it follows that when a woman is in labor she is considered a Niddah even though she has not yet seen any blood.
On the other hand, other Achronim disagree. These authorities include the Noda Biyehuda (in a responsum published in Teshuvot Meiahava 11b) and the Beit Meir. They argue that the rule applies only when something is released from the uterus. In such a situation Halacha believes that we must be concerned that some blood was released along with the object that issued from the uterus.
Rav Moshe Feinstein rules (Igrot Moshe Y.D. 2:76) that one should follow the strict opinion of the Sidrei Tahara. Rav Feivel Cohen (aforementioned Badei Hashulchan) rules that in case of need the lenient approach can be followed. He argues in support of the lenient view from the fact that the Gemara, Rishonim, and Shulchan Aruch with its early commentators never mention that a woman whose labor has begun is a Niddah.
Physical Contact During Delivery
After blood begins to flow from the woman, she is considered a Niddah. A suggestion has been made that the husband still may nevertheless touch his wife because this is considered , not a sexual type of contact which, some rule, is permitted (see, however, Shach Y.D. 195:20 and Igrot Moshe E.H.II:14). Rav Aharon Lichtenstein has stated (in a lecture to Yeshiva University rabbinical students) that even though contact between husband and wife in the delivery room is not of a sexual nature, nevertheless it is of a loving nature. Rav Lichtenstein rules that such contact is considered and thus forbidden once the wife becomes a Niddah.
Another suggestion is that since a woman during delivery is considered a , then perhaps physical contact should be permitted, as the Halacha allows in case of danger to life (see Rema Y.D. 195:16). Virtually all authorities do not accept this argument, because doctors and nurses are readily available during delivery and therefore physical contact between the couple is not necessary to save a life in almost all cases. In the rare case that the husband must touch his wife during delivery to save her life, then physical contact would certainly be permissible.
The Husband's Presence in the Delivery Room
Most contemporary authorities permit a husband to be present in the delivery room (see Nishmat Avraham Y.D. p.108). Rav Moshe Feinstein (Igrot Moshe Y.D.II:75) presents the consensus view when he states that the husband may be present during the delivery provided that the husband avoids physical contact with his wife and does not look at the parts of her body that are normally covered (i.e. he cannot watch the emergence of the baby from the birth canal). The presence of the husband is important, though, as several scientific articles have been published pointing out the importance of companionship during birth (see, for example, the New England Journal of Medicine, 303:597-600,1980).
The situation of a woman giving birth is fundamentally different from that of a person who is ill. A sick individual most often does not have to be active in order to overcome the illness. By contrast, a woman in delivery must remain calm while working hard to deliver the baby. Therefore, meeting the mother's psychological needs are of great importance. This is especially the case if the couple has studied the Lamaz or Bradley method together. In such a case, the husband coaches the wife to follow what they were taught.
For this reason, most contemporary authorities permit a husband to attend childbirth. The sensitivity to the psychological needs of a woman in birth is deeply rooted in Chazal. The Gemara (Shabbat 128b presents the following rule:
"We assist a woman to give birth on Shabbat and for her sake we desecrate Shabbat... As our Rabbis taught: If she requires a light, her friend must kindle a light for her.
...Now it is obvious that a blind woman in labor does not require light, and we might think that since she cannot see, it would be forbidden to light a candle for her (on Shabbat).
This passage comes to inform us that we set her mind at ease, for she believes that if there is anything required, her friend will see it and do it for her."
In light of this passage, both Rav Moshe (Irgot Moshe Orach Chaim) and the Chazon Ish (Igrot Hachazon Ish 141) permitted husbands to travel in a car on Shabbat to the hospital with their wives to deliver a baby. Even though the paramedics and doctors are able to take care of the wife's medical needs, the husband's presence is necessary to provide psychological support. The psychological support is not viewed as frivolous, as it is even permissible to ride in a car on Shabbat in order to provide the support to the expectant mother.
Finally, it should be noted that nearly all contemporary authorities view psychological needs as legitimate concerns that must be taken into consideration when rendering an Halachic decision (a full list of the sources is provided in Rabbi J. David Bleich's "Contemporary Halachic Problems" II:299). The Talmudic sources for this approach include the aforementioned Gemara in Shabbat 128b which permits lighting a lamp for a blind woman who is giving birth on Shabbat, due to concern for her psychological well-being. A second is the Jerusalem Talmud (Shabbat 14:3) which interprets the verse in the Torah "and God will remove from you all illness" as referring to (thought). The Pnei Moshe (commenting on the Jerusalem Talmud) explains as "thoughts that arise in one's mind and worries that a person greatly imposes on his heart."
The consensus approach regarding a husband's attending childbirth, is that he is permitted to attend provided that he avoid physical contact with his wife after she becomes Niddah. For further discussion of this issue see Rav Henkin's Teshuvot Bnei Banim 33 and Dr. Avraham Steinberg's essay on this topic in the Fall 1981 issue of the Journal of Halacha and Contemporary Society. May Hashem bless His nation with many healthy children.