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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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15 Comments »

  • rachsd says:

    Hi Liz,

    The quotations from the 19th century medical academics are unbelievable!

    I’m sympathetic to the view that painful birth is bad for women, but on the other hand I’ve heard that now, there are actually too many interventions. That is, more C-sections etc than is healthy for women.

  • Akiva says:

    oh not that old chestnut, about how much more enlightened Judaism was/is in matters medical compared to such backwards and positively medieval european societies…..
    How about this lovely little bit from the Kabbalat Shabbat service –
    “For three transgressions women die in childbirth: for having been negligent in regard to the laws of Niddah, the separation of Challah, and the lighting of shabbat candles.’
     
    Bah. I read this every shabbat, and every shabbat it sickens me.

  • rivqaberger says:

    The 19th century comments are staggering, but there are reasons why not being anaesthetised during labour are good: you can push the baby out more effectively, and your recovery will be better afterwards. That said, I’m all for pain relief if needed and given at the appropriate time in labour — certainly it should be the woman’s choice, not a cleric’s or doctor’s (apart from actual medical concerns, obviously).

  • Ben says:

    Akiva, if it sickens you, why do you keep on reading it?

  • Ari says:

    Akiva,

    It is a quote from the Mishna.  It is part of the Jewish philosophical tradition that suffering often times results from sin.  A view that suffering is not in general caused by some sin is problematic from a normative Jewish standpoint.  Now of course this is more complex as almost everything is.  Especially today when religious people of all stripes blame the people with the other stripes for the suffering of Klal Yisrael in the previous century and in every day life.  All the more so when we accept the gravity of the Shoah.  However, the idea that in general we should search for a reason for suffering is imperative and affirms our belief in the Righteous Judge.  All the more so when our great teachers included such statements in the Mishna and when it is the simple intention of a great many lines of Scripture.  

  • Robert Hagedorn says:

    This is relevant to the general story of Adam and Eve–Adam and Eve had anal sex instead of the kind that would allow them to be fruitful and multiply.  As a result, they both were cursed.  Who’s smart enough to figure out what’s wrong with this exegesis?  Google “Robert Hagedorn’s Blogs”

  • ariel says:

    Akiva,
    The passage to which you refer is optional. I have never read it in my life and didn’t know it contained the statement you refer to until someone else pointed it out to me a couple of years ago. It can be replaced by a Dvar Torah (as in many congregations I’ve been to) or alternatively, you can adopt nussach Sefard and say K’Gavna, which is a beautiful extract from the Zohar about The Secret of Shabbat…
     
    Imagine naming your child Anaesthesia! How about Chloroform or Epidural….they’d grow up as tough kids!

  • Akiva says:

    It may be optional as part of the Siddur, but it is not optionally part of the Mishna. It is unequivocally part of the canon, so to speak.

  • ariel says:

    there are a lot of unpleasant statements that are part of the canon…it doesn’t make them halacha.
     
    take pirkei avot for instance…good advice, but not binding halacha (as far as I know)

  • Sam says:

    There is nothing wrong in women giving birth by C-section. It is the method of choice for a majority of female obstetricians when they themselves bring forth their own infants. And not only for the avodance  of pain caused by a natural labour, but many other reasons of which I am not going into here. We are living in a modern time and pain relief if easily available should be not optional, but offered to all who need it.
    The Curse of Eve was never meant as a directive to the medical profession in my humble opinion.

  • Stuart says:

    Akiva said: …Imagine naming your child Anaesthesia! How about Chloroform or Epidural….they’d grow up as tough kids!…
    1. Perhaps the name Anastasia comes from Anesthesia
    2. “tough kids” – sounds like the Hebrew “tafkid” – meaning role or task – in this case perhaps to promote the importance of pain relief in this situation and the general Torah interpretive stance that it represents as has been mentioned.

  • The Hasid says:

    Anaesthesia, the 19th century version of Epponnee Rae.

  • Leo Braun says:

    “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”! [Liz Paratz]

    • Ever since, condemned Adam’s descendants wallowed in pubs to soothe their grief, while the overburden chores Eve’s descendants toiled for the family sustenance by the sweat of their brow. Besides the endurance relentless labouring pain, since the Eve’s ‘sin’ resulted in the incessant curse for the women.

    Answerable apparently for the Eve’s adultery, committed with an ‘outsider’! Yeah, allegedly there were other humans on earth, besides Adam and Eve. Whose sin resulted in the birth of Cain with the positive (+) blood, since his father (possibly a Blackfoot Indian) possessed ‘A’ positive (+) blood). However Adam and Eve had to have a negative (–) blood type ‘O’, the purest possible (devoid ensuing mutations).

    Fast-forward a couple of thousand years, uninformed women nowadays of their negative (–) blood type (A, B, AB or O) consequences during pregnancy/labour, faced a real danger when carrying a positive (+) blood type child. Besides the subsequent sorrow to learn of inability to have further children, unless swapping not suitable partner for the negative (–) blood type!

  • Leo Braun says:

    I was 18 when I became pregnant with my one and only child. The doctor the HMO assigned to me was a complete idiot. They never asked me my blood type or my husbands … nor did they ever type my blood, because if they had they would have given me the shots. Well this doctor was fresh out of her internship (I didn’t find that out until later). Her partner should have never left her to practice alone. She almost cost me and my child our lives due to her negligence.

    She did not check to see if my pelvis was correct for a vaginal birth (turns out I cant deliver naturally). She made me push for 5 hours, then when we were both in such distress her partner decided to check on my condition. After checking my pelvis he took her into the hall and yelled at her. He came in and said I had to have a C-section now. They pulled out the epidural because our blood pressures dropped so low.

    I had a C-section with no pain medication at all

    If her partner had not stepped in, we both would have died. A week later I was still in the hospital and she was gone from the practice. Moved to another state where I could not sue her. Since we both made it thru okay I gave up on making her pay for the most horrible moment of agonizing pain that any person could possibly suffer. I was flayed and disemboweled, with no anesthetic until after the delivery. Over 15 minutes of agony, and months of recovery.

    I have Fibromyalgia now (chronic overactive pain response) due to that trauma. But I felt lucky since we both made it thru. She is perfect in every way. No harm done. Only 5 pounds at birth, so really vaginal should have been no problem. Except my doctor was a moron, because every gyno since then has confirmed that my bones will not allow natural delivery.

    But really of all the things that went wrong, I find out another thing was overlooked, my blood type. I had tried several times to have another baby but I kept miscarrying. I only have my one child. If it weren’t for my daughter surviving that fubar delivery I would have never had a child. So don’t believe their lies, I wish I had known 17 years ago that my blood type made a difference. I was robbed of unborn children! Yet, all you have to do is take a home blood-type-test and you will know for sure. Order, it its called an Eldon Card Kit.

  • Leo Braun says:

    Reading these comments I am surprised that you allow people to post on the RH-Neg subject due to the secrecy around the RH-Neg blood group. I have this bloodline and it was deliberately kept secret from me all my life by family and the medical profession.

    For myself, it has been hell. I have suffered discrimination all through my life, never understanding the reason why? It’s like living the life of a slave with the wrong blood color. Your family hate you, the state hate you. It is like belonging nowhere, you don’t have the same basic human rights that everyone else takes for granted.

    I found out quite by chance, about my bloodline, due to the fight to keep my beautiful daughter alive!

    Hence I found out late in life, why my family hatred me, and why they behaved in such a cold cruel way towards me. I now believe that this life is a test, and that truth ordinates in a minority of one.

    I don’t expect you to print this, due to secrecy the around this subject.

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