Chulin 72 — “Labor of Love”

Our Gemara on Amud Aleph discusses Torah and rabbinic rulings regarding the circumstances that a midwife would be rendered impure should she come in contact with a dead fetus while it is still within the mother. Technically speaking, according to Torah law, so long as it is within the mother, it does not radiate the impurity of a corpse. However, since it is sometimes difficult to ascertain the moment of birth, there is a rabbinic ruling that the midwife will contract this impurity, even if she contacts the dead fetus within the womb.

However, the Gemara questions this logic:

“If so, the Sages should also decree that the woman herself, who is carrying the fetus, is impure, since she also might not notice that the fetus’s head emerged. The Gemara explains: A woman accurately senses with regard to her own body whether the head of the fetus had emerged. The Gemara asks: But then she would have said this to the midwife. Why is there a need for a decree? The Gemara answers: Since the mother is distracted by the pain of childbirth, she does not have the presence of mind to warn the midwife.”

The throes of childbirth represent a different mode of awareness and coping than typical. We do not expect a woman in that state to be a reliable informant for others; she is deeply engaged in her own internal process.

The experience of childbirth is powerful and personal, and for a long time has been under assault by the medical community with a particular agenda. From a young age, people are exposed in the media to supposedly agonizing travails of labor. The power of suggestion lets every woman know that childbirth is a medically complex procedure that can only be performed by the great Doctors within the medical establishment. While of course there is more than a grain of truth to that, because labor complications can be life-threatening, at the same time many of the medical procedures are self-fulfilling prophecies.

For example, there is a debate about whether fetal monitoring is a good thing or not. On the one hand, in the rare instance where the fetus is in distress, monitoring the heartbeat can make the difference between saving its life or not. On the other hand, there are many false positives with the readings, which indicate problems with the heartbeat, but might just be due to the ordinary vicissitudes of labor, and the inability of the equipment to properly detect under the circumstances. This leads to an increased medicalization and enactment of procedures, such as C-sections and other interventions.

Likewise, while labor can be painful and epidurals, no doubt, relieve that pain, they may also subdue and slow down the labor process to the point where unfortunately a C-section and other interventions are required. There is a study regarding subjective experiences of labor pain, relative to personal narratives and expectations, and a sense of empowerment by the woman prior and during the labor. That is to say, pain is a relative experience. While pain is real, it might be magnified when there are feelings of panic and mitigated when there is a sense of autonomy, acceptance and mindfulness. (For more on this study, see Midwifery 30 (2014) 1029–1035, “Women’s experiences of labour pain and the role of the mind: An exploratory study.” Whitburn, Jones, Davey, and Small.)

In reaction to this, many women are choosing home birthing, which of course brings its own risks. The point that I wish to make is not necessarily to advise one way or the other, but to signal that there is a bias promoted by a particular agenda. Doctors and hospitals will not get sued for “playing it safe” and using fetal monitors and/or jumping to relieve pain through epidurals, and/or moving towards a C-section. However, they will get sued, if in a much less likely scenario, something does go wrong during labor, and the........

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