Emunah and Childbirth

Please go and read this article “ Emunah and Childbirth”, then come back here and read the rest of this post. I get what this lady is trying to say – that you need to have faith in God. I agree. However, her letter is dangerous. She is advocating ignoring medical advice in order to give birth naturally. There are situations where a caesarean section will save the life of a child and / or the mother and ignoring that urgent need could result in death. I will concede that there are many c-sections performed that are unnecessary – but it is all on a case by case basis. You cannot say flat out that the science of obstetrics is stupidity!! Being stupid is ignoring that the doctors are Hashem’s shlichim, his messengers, given the knowledge to help bring the next generation into our world.

I am flabbergasted that in this day and age there are people out there advising women to ignore the medical world – what does she want us to do, give birth out in the fields, have birthing mothers die because there are complications and no doctor around? Have babies die due to lack of prenatal care? Yes there are many instances where there is no need for medical intervention – but what about when there is a problem, what then? You can have all the Emunah you want, but trusting in God will not save your life or that of your baby if you are not in the right medical environment and need help.

What are your thoughts?

(Hat Tip @mikeage)

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  1. I agree with you 100%. I’m all for natural childbirth…when it is possible and advisable. There’s a hospital in Israel that isn’t, I believe, top notch. I chose to give birth there twice because my past experiences were relatively easy and complication-free. The treatment of the mother in the hospital was so warm, so personal, that I decided to opt for comfort over the 100%. At least that was what I felt – and still, I knew that if God forbid there would be a problem, the hospital had the resources or could have the resources to deal. I am not in favor of home births – especially for first-time mothers.

    A return to the all natural will, as you point out, returns to the dangers of the past as well. This woman rights of doctors that deliver on their schedule – well, who picked those doctors? It’s true – to some extent. With my second child, the doctor arrived and tried to break the birth sac and the water…thankfully she failed and the attempt was too painful. I told her NO and she didn’t try again. It broke when it was supposed to and I gave birth naturally each time.

    There has to be a balance between having too much of a voice to the point that we endanger ourselves and our babies and having no voice so that we feel violated and manipulated. There should be no automatics in birth – no automatic IV, no automatic pitocin. I was given pitocin in one birth – the doctor explained her reasoning and I agreed with it. She explained the process, and I understood.

    This isn’t about Emunah and Childbirth – this is about being an informed patient. HaShem is there in all births as He was in all conceptions. Our emunah belongs to God, not doctors. Ask questions, find the balance – but it has to be done in a way that doesn’t endanger anyone within the path of treatment.

    All natural can be an amazing experience – don’t let it be a stupid or tragic one.

  2. Mel from Monsey says:

    There is Emunah and there is Histadlus. We have to make the effort to use all the resources available and the Emunah that our efforts will cause to succeed in our endeavors. I do not believe that I will ever conceive and give birth. However, I have the Emunah that G-d will provide me with my needs. I have to work so that so that G-d will provide my groceries. I do not believe that G-d will deliver them without an effort my part.

    The same with childbirth, people have to avail themselves of the all resources available so that the childbirth comes to a successful conclusion.

  3. Bracha says:

    If someone wants to take risks with their own life and the life of their unborn baby, it is their decision. There’s no reason for the rest of us to pay attention to this kind of irresponsible attitude. What happened to “Venishmarten me’od l’nafshoteichem?” Also – I gave birth to 4 out of 5 of my kids via C-section. What stayed with me afterwards were the wonderful babies, not obsession with the birth experiences.

  4. The worst part about this is that he starts with some very true facts; the medical industry has become, in some ways, an industry, and there are many procedures done that are not medically justifiable.

    He then turns this into an article that is, IMHO, the epitomy of cutting off the nose to spite the face.

  5. Nora says:

    I have to agree with you 100%. No doubt there are medically unnecessary procedures performed all the time, not just in obstetrics. But there are also clear medical needs for surgery and other procedures.

    My mom’s water broke but she never actually went into labor or had a contraction with me. After a point that’s very dangerous for mother and baby so she had a c-section. Not what she planned but she did get me out of the deal. :-)

    Advocating ignoring medical advice and returning to home births is ridiculous and irresponsible. There’s nothing inherently wrong with a home birth unless you’re high-risk to begin with, but it wouldn’t be my choice. I think I’ll probably want the pain meds. Also, we choose our doc’s. If he/she tells you he likes 3-5 hours in labor and then recommends a c-section don’t go immediately. All you’ll do is sit around there in an uncomfortable gown. Mine has always said that babies are in their own schedule. Sometimes it’s a couple of hours and sometimes it’s a couple of days, as long as no one’s in danger then you should let the process work itself out.

  6. lady lock and load says:

    There are certain people that feel this way not only about childbirth, but about all illnesses. They don’t bring their babies for their shots to the doctor, and do not treat illness with antibiotics. I used to know someone like this. She got Rheumatic Fever because she did not take medicine for her strep throat. It was her religion (I forgot what it was called) that you rely on G-d to make you healthy, not docs and medication.

  7. Future Mom says:

    This reminds me of an article I read recently.

    I love going to the ob and seeing sonograms of how my baby is doing.
    I agree with you that the medical world is there to help us and we shouldn’t put ourselves in danger by not utilizing the help Hashem gives us in form of doctors and hospitals.

  8. Oy, that poor woman. It sounds like she had a very negative experience and as a result, is completely discounting the brachos that obstetrics have brought us. I have friends whose babies wouldn’t have survived without medical intervention. I have friends who wouldn’t have survived without medical intervention. Surely this woman’s emotional angst is blinding her from seeing the necessity of medicine. Just make sure that you get a good doctor, and educate yourself about your choices. :)

  9. Hindy B says:

    I have been reading your blog for a while now and don’t recall ever commenting. I am still getting over the idea that I need to hide my Jewish identity on the Web.

    But this!?!

    My sister has twin boys who are just over two years old. One of my nephews has spina bifida. Without her so-called ‘stupid’ sonogram, she would not have known prior to delivery. Without that knowledge, she would not have known that a vaginal birth could have caused untold further damage to my nephew’s condition. Without that knowledge, she would not have been able to find a team of doctors capable of operating on my nephew within days of his birth. Knowing these things allowed my sister to make choices that have made and will continue to make a tremendous difference to how my nephew is able to function on a daily basis.

    Shame on her.

  10. Elle says:

    I agree with her 110 %… i wish i had written it myself

    then again I’m a mother of 3 – two hospitals births, one c/s and one unassisted birth (yes on purpose). I am also a birthing doula who has worked with both homebirths and on staff at a very upscale hospital for a few yrs. I’ve witnessed many healthy births an c/s. so you know… I’m educated on both subjects professional and personally… and I’m biased :)

    i will say this one point that every women should take into consideration when making her choices about birth – Never make choices solely based on what a paid professional tells you (yes I am including doulas in this matter) if he serves to make money off of his opinion. Professionals, just like people – are biased in many ways. If they stand to make money off of a general view point it can easily influences how they promote the benefits of it or the penalties of the opposites. They also rarely look to disprove themselves! If they are wrong in their viewpoint, they’d likely be the last to know. Getting handed a list of facts — like the commonly held belief that women dropped like flies in old times because of lack of an OB present at the birth — isn’t always so clear and cut as it may seem. For instance while it is true that many women died in childbirth who birthed naturally in harder times past — it is not often mentioned that many women died do to unrelated things – such as illness and malnutrition (which effect anemia and clotting abilities – the highest reason for maternal death). The facts aren’t simply “them” vs “now”. There are many periods of civilization as well as locations where maternal deaths were at all time lows because of healthy conditions in those places… followed by high maternal mortality rates in poor places with diseased conditions. this is stuff you can easily find evidence of if like any other subject, you are willing to do a little research. One should always find the counter points to any argument before settling on anything. Likewise, no one should believe my argument without putting some thought into it — including mine!
    Maybe I’m biased… but then again doulas don’t generally drive BMWs, and they often give their services for free simply b/c they love assisting women in having wonderful births. Doctors? well… hmmm… that’s for you to decide ;)

  11. Elle says:

    p.s. I would be very careful with statements like this:

    “You can have all the Emunah you want, but trusting in God will not save your life or that of your baby if you are not in the right medical environment and need help.”

    I get that you are trying to make a point here… but um… God IS the creator of all life and He did just fine before doctors came along. God doesn’t need a doctors, doctors need God.

  12. Z! says:

    I would like to take this article and turn it on it’s head!! What if the writter couldn’t have children? Should she only have emunah in Hashem that He will have her conceive whenever, maybe? Do you not think for a minute that if Sarah Imeinu could have tested herself or done invitro, she wouldn’t have?!? She was so desperate for her husband to have a child she gave him her handmaid, for goodness sakes! Should an infertile couple not look into what might be the physiological reasons for not conceiving- if the technology and profesionals are available to them? What better reason to spend money than to bring a new life into this world? A TV? a Car?
    Let me be quite frank- childbirth was the 1 killer of women. (today it is heart disease, as we survive childbirth nowadays!)
    It was necessary at the time to “hospitalize childbirth”. Did it get a bit over controlled? Yes. Can it be reclaimed? Yes. And to a large extent, childbirth is returning to it’s “natural” state. Today’s women are being informed of their birthing options. You want a “home setting” that is very nice for you, I would still recommend being close to a hospital, because sometimes when things go wrong, they go wrong quickly!

  13. Elle says:

    Z – I mentioned this in my above comment… but the reasons for death during childbirth weren’t because of birthing alone or without an OB. That is an important factor to this. All facts must be considered for that argument to hold water.

    Furthermore I don’t think the article made mention of never using a doctor for any reason. it was more about not letting birth (and spiritual beautiful thing) become merely a medical procedure. About What Sarah would have done – all you can do is speculate that one. I would be careful abut assuming what she would and would not have done in any given situation. The choice to seek fertility treatment or not is a very personal and situational decision.

  14. Shorty says:

    I think the article is too far at an extreme. I tend to agree there are probably way too many c-sections than necessary (in my city, apparently something like 60-70% of births are via c-section). I was told the reason for so many, was because they can be scheduled making planning so much easier on hospital staff and i guess the parents.

    I think there are many times when c-sections are necessary to save a life (eg. placenta prevera (sp?) , or because the baby is G_d forbid breach. It is an amazing medical technology available to save lives. At the same time, c-sections have become perhaps a little too routine.

    Everytime there is a major surgery, which this is, there is a risk of infection and things going wrong. It should be used when its necessary not just out of some scheduling convenience.

    Ok now to emunah, there is emunah and like someone said there is hishtladus. It reminds me of the old joke with the drowning man, a ship, a helicopter and a rowboat came by and offered to save him. Each time he said G-d will save me. Then he drowned and died. When he got to heaven he asked G-d, Why didn’t you save me? G-d replied, i sent a ship, a helicopter…

    Don’t not use available technology because it somehow puts more trust in man than in G-d (how do you think that technology came about anyway??) Use it because it is necessary.

  15. kisarita says:

    Both sides are right. Research and scientific evidence are wonderful things, I’d take them over faith any day. However, most obstetrical practice today is not evidence based I’m sorry to say. So frankly folks you’re between a rock and a hard place.
    Your best bet is to get an independent minded practitioner, and to keep YOURSELF educated.

    see also Healthcare: an American Religion

  16. Liza says:

    My son’s labor and birth in a hospital were uneventful – until the placenta didn’t come out and I lost a lot of blood. If I hadn’t been in a hospital, surrounded by a team of doctors and nurses working furiously to get the placenta to come out and staunch the bleeding, I could have died. There was no previous indication during the course of the birth that this was going to happen, yet everything went downhill very quickly. If I’d given birth at home, there’s no way I could have gotten to the hospital in time, and I only live 15 minutes away. Sure, everything goes smoothly most of the time, but why take the chance? It’s the child that should matter here – not the way he/she came into the world.

    • Elle says:

      I can’t speak for your situation directly b/c I was not there to note the why’s or whats of the situation…

      but you do realized that midwives do have meds and herbs, right? and that many are available to non-medical personal? Home birthing doesn’t mean unprepared birthing. I think this is a common misconception that fuels the fire against homebirth.

      for instance at my own birth I had a handful of herbs that stop bleeding (or prevent clotting, which sometimes is more threatening than bleeding!) and I had full knowledge of how to use them… as do the midwives I had on standby in case I needed to call them for anything. I also have knowledge (as do other midwives and doulas) about how the placenta works. how to look for tears and so forth. I know what to do in the case of a rupture, I know neonatal resuscitation, I know how to cut a cord…. etc

      If you know what you are doing, you will knows the signs of a distressed labour/delivery. Many doctors don’t b/c they are trained to treat every patient the same with “standard procedure”. For instance, I had a client once where the baby would NOT come out. I meant that baby was just refusing to budge despite how intense the mom’s contractions where. The doctors solution? pump up the contractions medications (synthetic oxytocin) and get her and epidural so she wouldn’t pass out from the excruciating and unnatural pain it causes. The mom was frightened and exhausted! (These are the times doctors stand over you counting down til it’s c/s time!) Finally I asked the nurses permission to try a little technique that often helps babies come right now. With the mom’s permission, I turned her to the side and propped up her bum, and gently pusher her stomach to the side…. and down went baby into the birth canal right before our very eyes… (the baby was asynclitic and I could tell by the positioning!) she was born moments later to a very happy mom and a VERY surprised doctor. The nurse wasn’t too pleased with me lol, but the mom sure was! :) I didn’t say a word of course… and the doctor stood right before me and took every ounce of the credit himself – as if he has himself pulled the baby out of her womb with his bare hands.

      My point is doctors know how to treat “procedures” and handle c/s. I would NEVER attempt a c/s! I’m sure the mother and baby would never make it if I started cutting at them. I save that for knowledgable surgeons! But give me a labour mom who has a stuck baby and I’m pretty darn educated in how to help the baby move down. I can read a labouring mom, and the signs of a distressed baby or a stuck labour very well. I can tell by a mom’s face when he blood pressure is rising too high, and I can tell when a mom is in the throws of “transition” by the pattern in her breathing and the determination in her voice. A doctor doesn’t have these time tested and practical skills like a midwife or doula. They only have new-fangled gadgets to rely on – and when those fail they have no back up plan outside of c/s.
      as for bleeding out — the standard practice of hospitals is to pull the placenta out – this is a major cause of bleeding out. the standard practice of midwives is to let it separate naturally – this is why there is a strikingly low instance of bleeding out in home births. THIS is time tested and mother approved.
      I cannot guess that your situation was… but I am willing to bed a well educated midwife could have seen the signs of your problem well before it happens… and if nothing else WOULD have proper medication and herbs to control the bleeding as well. and wouldn’t thoguht twice about getting your emergency medical care if your situation called for it. midwives have nothing to prove.

  17. kisarita says:

    A cesaerean section increases risks for the mother, and in many cases for infants as well.
    Whats more they increase her risks for further pregnancy and limit the number of children she may have total.
    What’s more it interferes with mother infant bonding and affects the mother’s ability to care for her child and to resume her normal life for weeks afterwards.
    Even if everything goes well, I most disagree with you. THE WAY A MOTHER FEELS IS IMPORTANT. To tell a woman who had a bad experience that it doesn’t matter because only the child is important and not her feelings is wrong.
    In fact, when people feel unheard and unacknowledged, that is when they are most likely to move into extreme positions.

  18. kisarita says:

    Note Liza, the risks for bleeding are much higher with a cesaerean section. So if you have an unnecessary c/s your MORE likely to have bleeding. The difference however, goes less noticed because as you said, the hospital has a team available to fix problems, even the ones that they indirectly caused.

  19. Bells says:

    Query whether the author of the letter would have consulted the Rambam for medical advice.

  20. KISARITA:

    “it interferes with mother infant bonding”

    how so?

    • A child bonds with its mother in the first three minutes after childbirth. However, in many cases, the mother is not permitted to see the child during that critical time after a C/S. My wife wasn’t after her’s. I was only allowed to see the child, for a few brief seconds because they had to push it past me in the hallway where I was exiled.

  21. kisarita says:

    not obvious?
    maternal- infant separation, maternal sedation, pain and exhaustion, breastfeeding difficulties, increased risk for postpartum depression

  22. kisarita says:

    not obvious?
    what else would you expect from maternal-infant separation, maternal sedation, breastfeeding difficulties, prolonged pain and exhaustion?
    I have other speculations which are not medically proven, so we’ll leave it at that.

  23. kisarita says:

    Shorty mentioned c/sections being necessary for breech.
    This is incorrect.
    A couple of years ago ACOG came out with reccommendations to delivery ALL breeches by cesareans. This was the culmination of a long trend in obstetrics.
    It has most recently been modified by the Canadian ob gyn associations, however it may come to late for american physicians, as most practitioners have not learned breech birth skills.
    If you have a breech, your best bet is to go for a foreign practitioner with proven experience.

  24. Justine says:

    I get where this mother is coming from. I had a normal pregnancy and normal labor with my first child but ended up with a C-section after pushing for an hour and a half and not progressing. The baby wasn’t in distress (although he was posterior and brow) and for a long time I felt as though the OB should have intervened more in order to ensure that I could have delivered naturally.
    However, I am awed by the fact that my son was born healthy and in tact, that he never suffered at all and that he is, seven years later, one of the three lights of my life.

  25. anon says:

    All natural is fine so long as you’re in a hospital, under the care of a doctor. A home birth is dangerous, plain and simple, because a midwife has no ability to handle any irregularities. If it’s not a simple, basic birth with a normal healthy baby, the midwife is in over her head, and you’re in real trouble.

  26. kisarita says:

    I would agree with you anon that all natural but with emergency facilities available JUST IN CASE would be ideal; however the way the medical system is set up today many women can’t get both in the same location. It’s really unfortunate that people have to choose. More than unfortunate- an outrage.

  27. kisarita says:

    You’re also mistaken about doctors by the way- except for performing surgical procedures, most obstetricians are NOT equipped to handle emergency situations better than midwives.
    (what type of emergencies did you have in mind?)

  28. kisarita says:

    Let me emend my statement:
    A hospital TEAM, with all its equipment and protocols, is more adept at handling certain type of emergencies, obstetric and other.
    A doctor alone is no more effective than a midwife alone.
    I read your post as placing too much faith in the MD credential.

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