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Are Jewish Women Condemned to Hard Labour?

June 21, 2010 – 10:19 pm15 Comments
Pregnant Barbie

Image source: Babble.com

By Liz Paratz

The very first commandment of the Bible is to ‘be fruitful and multiply.’ But unfortunately, subsequent attempts to be ‘fruitful’ resulted in mix-ups with apples and ultimately got Adam and Eve expelled from the Garden of Eden. Not to mention, they were also cursed. Adam was condemned to toil for his food by the sweat of his brow, and Eve with the curse of labouring in pain.

Fast-forward a few thousand years and if we are condemned to ‘bring forth children in sorrow’, why do even the most religious of Jewish women use pain-relief in childbirth? Is it wrong? What do other religions following the Bible say about it?

Why is it so?

As one doctor pointed out to our class during our obstetrics and gynaecology rotation, childbirth (and the desire to have a ‘natural delivery’) is a unique phenomenon.

If someone fractures their leg and is rushed to the Emergency Department, the nurses and doctors don’t (usually) crowd around and encourage the screaming patient, telling them they’re doing great, that they just need to work through their pain, they need to breathe right, but they’re doing just great, and do they want a heat pack or some classical music? Rather, fast and effective pain relief is a key part of the management plan.

On the other hand, the attitude to pain in childbirth is much more complex. The American College of Obstetricians & Gynaecologists recognized this in 2004 with their position statement that, ‘Labour causes severe pain for many women. There is no other circumstance where it is considered acceptable to an individual to experience untreated severe pain, amenable to safe intervention, while under a physician’s care…

What lies behind this hesitant attitude towards pain relief in childbirth?

Pain Relief in Western Culture

Historically, the question of whether to relieve pain in labouring women or uphold the Curse of Eve was basically an academic one. Even if doctors and midwives had wanted to relieve their patients’ pain, there weren’t really any pain-relieving drugs available.

However, by the Middle Ages, some (allegedly) pain-relieving herbs had been identified and the debate around the Curse of Eve began. The extremely powerful Church vilified midwives who offered any pain-relieving herbs as witches. They claimed these modern pain-relieving midwives were defying the Bible’s orders – by definition they were therefore servants of Satan. In 1591, King James VI (of King James Bible fame) ordered the Scottish midwife Agnes Sampson to be burnt alive for the sin of offering Euphemia MacLean (also burnt) pain relief during her labour.

About 250 years later, the mid-1850s marked the birth of obstetric anaesthesia. Appropriately, it was a painful and obstructed birth.

The editor of the Edinburgh Medical and Surgical Journal declared that pain was medically necessary during childbirth, and preventing it would pose risks to the mother. In case you were wondering about that claim, the editor graciously explained that, ‘pain is the mother’s safety, and its absence her destruction….it has been ordered that ‘in sorrow shall she bring forth’’. Any doctors who offered anaesthesia to their patients were thus painted as blasphemers ‘playing God’ and defying the natural order.

Another Irish professor of midwifery agreed with the editor’s position, because ‘after all, it was the Almighty who had seen fit to allot pain to natural labour, and most wisely we cannot doubt’.

Despite its ‘sinfulness’, obstetric anaesthesia took off. When Dr James Young Simpson used chloroform in a labour in 1847, the mother was so grateful that she named her baby ‘Anaesthesia’. In the next few years, the successful reputation of anaesthesia grew exponentially. Tragically, its popularity as a baby-name did not follow a similar trend.

In 1853, anaesthesia cracked the A-list when Queen Victoria gave birth to her 8th child with the assistance of chloroform. Given that she was head of the Church of England, this effectively ended the religious opposition to obstetric anaesthesia.

Pain Relief and Judaism

But if using pain relief in labour were a real sin, then surely Queen Victoria’s use of chloroform shouldn’t have altered the Jewish perspective. If we were meant to be upholding the Curse of Eve, then we should still be shunning pain relief today.

In fact, it appears the Jewish take on ‘the Curse of Eve’ has always been a bit different  – for several reasons.

Reason 1 – Linguistic

In 1849, the editors of Canada’s British American Journal of Medical Science invited the Chief Rabbi of Canada, Rabbi Abraham de Sola, to write an article on the Jewish interpretation of Genesis 3:16.

According to R. de Sola, it was simple. The common English translation ‘in sorrow shall she bring forth’ was incorrect. Drawing upon the linguistic analyses of the deliciously-named medieval Rabbi Kimchi, he pronounced that a better translation would be ‘in toil or labour will she bring forth’.

He based this upon the Bible’s use of the word etzev, rather than a more explicit word for pain such as ke’ev, tzarah, yagon or anachah. By translating the phrase as ‘in toil shall she bring forth’, he then construed the ‘toil’ as referring only to the uterine contractions required to deliver the baby rather than the sensation of acute pain. Basically, uterine contractions required, pain optional.

Where this leaves elective C-sections is debatable, but hopefully Braxton-Hicks can qualify for contractions.

Reason 2 – Interpretative (aka what about Adam’s Curse?)

Some rabbinic authorities also point out that the Curse of Eve does not mean that women must suffer in childbirth, only that in the natural course of events they will suffer if no pain-relieving measures are taken. By contrast, a ‘natural birth’ in the Garden of Eden would apparently have been an entirely painless event.

The story of Adam neatly illustrates this distinction. After all, Adam was equally cursed – cursed with the need to toil for his food by the sweat of his brow. Surely then, the Industrial Revolution should have sparked mass paranoia that the new machines defied the Curse of Adam. This would be a logical parallel to the obstetric anaesthesia debate of the 1850’s.

And today, the descendants of Adam have gone to the non-toiling extreme. Plenty of men work in an office all day and then come home. Perhaps they drop by Safeway to pick up their daily bread. Regardless, at no point in this scenario does even a single drop of sweat form on anyone’s brow.

Most people see nothing particularly wrong with this picture. The accepted interpretation is that, had we stayed in the Garden of Eden, no toil would have been required to gain food at all. Since we have left, the natural course of events is that farming is a labour-intensive activity.

However, we are certainly not forbidden from inventing machines to simplify the labour required, or even synthesizing ridiculously artificial compounds with code-names to replace real food in our diet.

Likewise, women are not forbidden from making things easier with modern drugs – we just recognize that we wouldn’t have required them in the first place if we’d been able to ‘just say no’ to that apple-dealing snake.

Reason 3 – Medical

Under Jewish law, a woman is considered to be in a state of danger while she is in labour, and for 3 days post-partum (hence the recitation of the Birkat ha-Gomel prayer after illness, childbirth or danger, recognizing the peril through which the mother has passed).

Thus the principle of Pikuah Nefesh applies and, if medically necessary, any required drugs must be given. There are delivery scenarios that may meet these criteria, and Judaism is unequivocal that in such circumstances there is no question that pain relief must be administered.

Enough Reasons Already?

In the wider world, the threatening words of Genesis triggered moments of panic that modern medicine was defying God. However, the Jewish interpretation of the ‘Curse of Eve’ and its significance for modern medicine has traditionally been quite divergent from the Western mainstream.

From the beginning of anaesthesia, Judaism appears to have been open to new technology, and reassuringly inclusive of pain relief as part of delivery. Ultimately, if analgesia in childbirth facilitates having babies, then surely that is the most desired endpoint. After all, multiplication was and is the original name of the game – even if each generation doesn’t do it quite the same.

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