Aborting a Jewish fetus – Termination of Pregnancy in Cases of Fetal Medical Anomaly and Genetic Mutations:[1]
The decision to terminate a pregnancy due to fetal medical anomalies or genetic mutations is one of the most emotionally and ethically complex challenges a Jewish couple may face. This article explores the halachic and ethical considerations surrounding such decisions, particularly when modern medical diagnostics reveal severe or life-limiting conditions in the developing fetus. Advancements in prenatal screening — including high-resolution ultrasounds, amniocentesis, and genetic testing — have made it possible to detect a wide range of anomalies early in pregnancy. These may include conditions such as anencephaly, Trisomy 18 (Edwards syndrome), Tay-Sachs disease, or other severe genetic mutations that can result in profound disability or early neonatal death. While these technologies offer critical insights, they also present families with heart-wrenching choices.
For many parents, the moment of diagnosis marks the beginning of an intense inner struggle. On one hand, there is the deep emotional bond already forming with the unborn child, and the spiritual weight of the sanctity of life. On the other hand, there is the fear of bringing a child into the world who may suffer greatly, or whose life may be tragically brief. The decision to terminate a pregnancy under such circumstances is never taken lightly and often involves consultations with medical professionals, rabbinic authorities, and mental health counselors.
This article seeks to examine the intersection of Jewish law (halacha) and medical ethics in these situations. It will explore classical sources, contemporary rabbinic responsa, and real-world case studies to understand how Jewish tradition approaches the permissibility — and limits — of abortion when a fetus is diagnosed with serious medical conditions. Through this exploration, we aim to provide clarity, compassion, and guidance for those facing these difficult decisions.
- Halachic Background on the severity of an abortion:[2]
There exists major debate amongst the Poskim[3] as to the exact Halachic source[4], reason[5], and level of severity[6], of the act of abortion of a Jewish fetus. Nonetheless, practically there is consensus amongst almost all the Poskim that is forbidden to be done for one reason or another, and so is the final ruling of today’s Poskim that it constitutes a Biblical prohibition.[7] All in all, irrelevant of the technical legal debate, Judaism views abortions very seriously, considering it tantamount to murder[8], and hence is only permitted to be done in very limited situations, such as when the pregnancy poses a danger to the life of the mother. This article will focus on the specific subject of terminating a pregnancy due to reasons of fetal anomaly and mutations.
The form of abortion-surgical versus medicinal:[9] It is debatable whether the taking of an abortion pill is Biblically forbidden by a Jew or only Rabbinical. It is unclear if this debate applies likewise to a gentile fetus. [Medicinal abortion, commonly referred to as the “abortion pill”, is medically effective for terminating pregnancies up to 10 weeks (70 days) gestation. After this period, the success rate of the pill decreases, and surgical intervention is generally recommended.[10] With regards to whether abortion pills are medically effective for aborting fetuses who carry medical anomalies, so if a severe anomaly or genetic mutation is diagnosed early (e.g., via first-trimester screening or amniocentesis), and the pregnancy is within the medication abortion window, pills may be used. For later-term diagnoses, such as those made during the second trimester, medication abortion may still be an option but often carries greater complexities.]
- The general Halachic approach to fetal anomalies:[11]
The lenient approach: Certain Poskim[12] have suggested that it may be permissible to terminate pregnancies through medication in cases where fetal anomalies are detected that would likely result in significant dysfunction or mental incapacity after birth.[13] Likewise, based on the same approach, the termination of a pregnancy where the fetus is diagnosed with conditions such as congenital deafness and muteness may be considered permissible — depending on the severity and prognosis.
The stringent approach by Non-lethal Conditions: Nevertheless, many Poskim[14] unequivocally reject this perspective and maintain that abortions, including those involving defective fetuses, are Biblically prohibited. Furthermore, even according to the former approach, abortion is permitted solely when the defect is certain and only if the abortion is done via medication, and practically, even they conclude that this is not to be done.[15] This especially applies to a gentile fetus.[16]
Lethal Conditions: Nonetheless, some Poskim[17] permit the termination of pregnancies involving fetuses with severe abnormalities or defects that render postnatal survival impossible. The reason for this is because these fetuses are not regarded as possessing the status of life even while they are within the womb [i.e. they are considered a Treifa]. [Practically, this latter position reflects the accepted rulings of numerous Rabbanim and Morei Hora’as who are experts in this area. These Rabbanim first aim to confirm the prognosis concerning fetal longevity through consultation with the couple and their healthcare providers. If indeed the medical professionals dealing with the couples case determine that the fetus is unlikely to survive long term[18], permission is granted to terminate the pregnancy.]
- The necessity to clearly diagnose the fetal condition:[19]
Any consideration of leniency with respect to termination of pregnancy on the grounds of fetal anomalies and anticipated limited lifespan is contingent upon a thorough and definitive diagnosis in contrast to a mere suspected condition.
Clearly Diagnosed Conditions: These are confirmed through definitive medical tests such as high-resolution ultrasound[20] or amniocentesis.[21]
Suspected Conditions: These are based on probabilistic assessments, such as family history or intrauterine infections, without definitive diagnostic confirmation.
- Specific conditions and their ruling in Poskim:[22]
Tay-Sachs Disease:[23] While some Poskim[24] have explicitly addressed the permissibility of abortion in cases of Tay-Sachs, many Poskim[25] disagree, and practically the permissibility of termination is dependent on the certainty of diagnosis, the severity of the condition, the expected suffering of the child, and mainly on his estimated life expectancy.
Down Syndrome (Trisomy 21 / Mongolism):[26] While the diagnosis is definitive, the prognosis is variable — some individuals live relatively functional lives, while others face severe disabilities. Because of this uncertainty, Poskim are divided: Some Poskim[27] permit abortion under specific conditions, especially if the expected quality of life is extremely poor or if the burden on the family is overwhelming. However, most Poskim[28] prohibit abortion, emphasizing the sanctity of life and the potential for meaningful existence despite disability.
Anencephaly:[29] Because the condition is universally fatal and the fetus cannot survive outside the womb, many Poskim[30] permit abortion in such cases, even in later stages of pregnancy. The rationale is based on the principle of preventing unnecessary suffering and recognizing that the fetus lacks viability.
Lethal Congenital Heart Defects:[31] Some Poskim[32] have written that abortion may be permitted in these cases, especially when the prognosis is extremely poor and the child is unlikely to survive beyond birth or early infancy. The reasoning is that the fetus may be considered a nēfel (non-viable), and therefore, there may be no halachic obligation to preserve its life at all costs. As with other cases, the permissibility depends on the certainty of diagnosis, the severity of the condition, and the stage of pregnancy, and should be evaluated with rabbinic and medical guidance.
Rubella Infection (German Measles) During Pregnancy:[33] Because the diagnosis of fetal damage is probabilistic rather than definitive, Poskim are divided: Some Poskim[34] permit abortion, especially in early pregnancy, due to the high likelihood of severe congenital defects and suffering. Most Poskim[35] however prohibit abortion, emphasizing the lack of certainty and the potential for the child to be born without major disabilities. [Rubella is considered one of the most significant causes of congenital anomalies, which is why extensive vaccination programs have been implemented in Israel and worldwide to prevent infection during pregnancy.]
Summary:
Halachic perspectives on abortion for fetal anomalies vary. Some authorities permit termination, often by medication and only in early pregnancy, if the fetus has severe disabilities like congenital deafness or muteness—typically requiring a definitive diagnosis. Others prohibit abortion in non-lethal cases, emphasizing the sanctity of life. However, in cases of lethal conditions — where the fetus is not expected to survive birth or live beyond a short time — some poskim permit abortion. This view is accepted by many contemporary rabbinic authorities, who emphasize the need for thorough medical evaluation and consultation with a qualified Rav. The decision to permit abortion in such cases is made only after confirming the diagnosis and prognosis with medical professionals and assessing the halachic implications with a posek experienced in these matters.
| Issue | Halachic Position | Medical Context | Permissibility | Notes |
| Lenient Approach | Some permit medication abortion for severe anomalies or dysfunction | Includes mental incapacity, deafness, muteness | Permissible if defect is certain and via medication | Practical application rare, depends on severity |
| Stringent Approach (Non-lethal) | Most Poskim prohibit abortion, even for defective fetuses | Emphasis on sanctity of life | ||
| Lethal Conditions | Some permit abortion when survival impossible (Treifa) | Fetus not deemed to have halachic “life” status | Permitted after medical confirmation and rabbinic consultation | Accepted by expert Rabbanim in such cases |
| Diagnosis Necessity | Leniency depends on clear, thorough diagnosis | Definitive tests (ultrasound, amniocentesis) needed | Suspected conditions generally not grounds for abortion | Distinguishes between confirmed and probable cases |
| Tay-Sachs Disease | Poskim divided; depends on certainty and severity | Fatal neurodegenerative disorder | Permissibility based on diagnosis, suffering, life expectancy | Case-by-case basis |
| Down Syndrome | Most prohibit, some permit in severe cases | Variable prognosis; some functional, some severely disabled | Possible if life quality poor or family burden overwhelming | Majority emphasize sanctity, potential for meaningful life |
| Anencephaly | Often permitted due to universal fatality | Fetus cannot survive outside womb | Permitted even in later pregnancy stages | Principle: prevent suffering, recognize non-viability |
| Lethal Heart Defects | Permitted in extremely poor prognosis | Child unlikely to survive beyond birth or infancy | Non-viable status removes obligation to preserve life | Requires rabbinic and medical guidance |
| Rubella in Pregnancy | Poskim divided; some permit, most prohibit due to uncertainty | High risk of congenital anomalies, but damage probabilistic | Permitted early if likelihood of severe defects high | Vaccination programs aim to prevent such cases |
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[1] See Encyclopedia Hilchatit Refuit Hapalah Vol. 2 pp. 773-817; Sefer Puah Vol. 3 pp. 155-165
[2] See Sanhedrin 57b and 72b; Ohalos 7:6; Erechin 7a; Tosafus Sanhedrin 59a, Nidda 44b; Rambam Rotzeiach 1:9; Melachim 9:4; Michaber C.M. 425:2; Smeh C.M. 425:8; Maharit 1:97 and 99; Chavos Yair 31; Sheilas Yaavetz 1:43; Beis Yehuda E.H. 14; Noda Beyehuda Tinyana C.M. 59; Panim Meiros 3:8; Toras Chesed Lublin E.H. 42:31-32; Meiy Nida Nidda ibid; Beis Yitzchak Y.D. 2:162; Peri Hadama 2:143; Rav Poalim E.H. 1:4; Mishpitei Uziel C.M. 3:47; Doveiv Meisharim 1:20; Tzafnas Paneiach 1:59; Igros Moshe C.M. 2:69; Yabia Omer E.H. 4:1; Tzitz Eliezer 8:36; 9:51; 14:100; 20:2; Mishneh Halachos 9:328-330; Koveitz Teshuvos C.M. 1:221; Nishmas Avraham C.M. 425 [summary on all above]; Madanei Shlomo p. 355; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 717, 737, 752-782-817; Igros Moshe C.M. 2:69; See Toras Hayoledes Chapter 66; Many Letters of Rebbe in Shulchan Menachem 6:4, brought in footnote below
[3] Poskim who rule the prohibition is Biblical: Toras Chesed ibid in opinion of Rambam; Moshav Zekeinim Shemos 21:22; Chikrei Lev O.C. 58; Maharam Shick Y.D. 155; Achiezer 3:65-14; Otzer Hamelech Tumas Meis 106; Or Sameiach Issurei Biyah 3:2; Meshech Chochma Parshas Vayakhel; Sdei Chemed Mareches Halef 252; Divrei Yissachar C.M. 168; Beis Yitzchak ibid; Binyan Dovid 47; Yabia Omer ibid; Igros Moshe ibid; Mishneh Halachos ibid; Many Poskim in Encyclopedia Hilchatit ibid footnote 186
Poskim who rule the prohibition is Rabbinical: Ran Chulin 58a; Toras Chesed ibid; Maharam Shick ibid; Achiezer 3:65-14 in opinion of Ran ibid; Shut Tzafnas Paneiach 59; Chaim Veshalom 1:40; Tzelusa Deavraham 60; Maharash Engel 5:89; 7:170; Beis Yehuda E.H. 14; Emunas Shmuel 14; Some Poskim in opinion of Tosafus Nidda [brought next]; Tzitz Eliezer 8:36 in opinion of Rambam; Encyclopedia Hilchatit ibid footnote 185
Poskim who rule the prohibition is not so severe: Tzeida Laderech Mishpatim; Maharit ibid; Mishpitei Uziel ibid, based on Sanhedrin 72b
Poskim who rule there is no prohibition: Tosafus Nidda 44b as understood by some Poskim [Maharitz Chayos Nidda ibid; Mileches Shlomo Nidda ibid; Yakhil Shlomo O.C. 330; Toras Chesed ibid; Tzitz Eliezer ibid] but dissented by other Poskim who learn that even according to Tosafus ibid, it is forbidden. [Chavos Yair ibid; Yaavetz ibid; Sheilas Yaavetz ibid; Meiy Nida ibid; Beis Yitzchak ibid; Peri Hadama ibid; Doveiv Meisharim ibid; Tzafnas Paneiach ibid; Igros Moshe ibid; Mishpitei Uziel ibid]
[4] There is no explicit verse in Scripture which mentions a prohibition against abortion. On the contrary, from Scripture alone one can erroneously deduce that he abortion of a fetus is not so severe as certainly not tantamount to murder. [See Shemos 21:22-23; Bava Kama 42a; Mechilta Derashbi Mishpatim 8] Likewise, there is no explicit statement found in the Talmud which prohibits the abortion of a Jewish fetus, even though it explicitly discusses a prohibition against aborting a gentile fetus due to the provision against murder found in the seven Noahide laws.
[5] See Encyclopedia Hilchatit ibid pp. 754-756 for various different reasons mentioned in the above Poskim for the prohibition: 1) Due to the biblical murder prohibition [this is the most accepted approach amongst today’s Poskim that abortion is tantamount to actual murder and is forbidden due to the murder prohibition]. 2) Due to that it damages the body or property of the woman. 3) due to a wasting seed. 4) due to entering the woman into danger. 5) as one prevents the fetus from becoming a Jew who will be observant in Torah and mitzvot. 6) due to desecration of God’s name being that even Gentiles prohibit it. 7) due to the prohibition of steeling, as one is considered to be stealing the life from the fetus.
[6] See previous footnotes that some Poskim rule the prohibition is Biblical while others rule it is rabbinical, and according to some, there is an opinion who holds that there is no prohibition at all
[7] Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 752 “almost all of them agree that there is some level of prohibition against causing an abortion even though they dispute the exact essence and severity and reason behind the prohibition… [Furthermore] the most accepted approach amongst today’s Poskim is that abortion is tantamount to actual murder and is Biblically forbidden due to the murder prohibition”; Igros Kodesh 15:338; Many Letters of Rebbe in Shulchan Menachem 6:4, brought in footnote below
[8] See Encyclopedia Hilchatit ibid footnote 199-200; Likkutei Sichos 24:230 “The truth is that parents asking their daughter to commit abortion go through an abortion of a fetus is tantamount to them asking her daughter to kill her own child heaven forbid, and they the parents are asking to murder their own grandchild heaven forbid. For the remainder of all of their lives the trauma of what they have done will be engraved within their souls, and certainly they should negate this completely”; Areinu Niflaos p. 186 “This is not considered an abortion heaven forbid but rather the murder of the fetus. It goes without saying that the mother of the fetus or the father should not even entertain the idea of killing a fetus especially when it is theirs. Even if one considers himself a secular Jew it does not permit him heaven forbid to become a murder. Even the Nazis, may their names be obliterated, did not kill their own children but rather the children of the Jewish people.” Letter of 9th Kisleiv 5745 “If there are people who will try to influence you to abort your fetus heaven forbid, you shall tell them that this is considered premeditated murder of a creature that does not yet have the ability to protect itself from those who want to kill him and the same God that formed the fetus is the God who created them sometime earlier and He sees and watches what they are doing.”
[9] See Mishnas Avraham on Sefer Chassidim ibid; Beis Yehuda E.H. 1:14; Chaim Veshalom 1:40; Chavos Yair 31; Sefas Hayam E.H. 14; Yabia Omer E.H. 4:1; Tzitz Eliezer 9:51 Shaar 3; 14:101-3
[10] In clinical practice, abortion pills (mifepristone and misoprostol) are typically provided up to 10 weeks (70 days) of gestation, as per FDA guidelines and the American College of Obstetricians and Gynecologists (ACOG)[1](https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/10/medication-abortion-up-to-70-days-of-gestation). However, some providers and international guidelines, such as those from the World Health Organization, support their use up to 12–14 weeks, especially in cases involving fetal anomalies [2](https://www.verywellhealth.com/how-long-can-you-use-the-abortion-pill-5525557). In Israel, early-term medication abortions are available through HMO clinics and hospitals, but later-term terminations — especially those involving fetal anomalies — typically require approval from a termination committee and are more often performed via surgical procedures.
[11] See Encyclopedia Hilchatit Refuit Hapalah Vol. 2 pp. 773-817
[12] Sheilas Yaavetz 1:43; Mishnas Avraham on Sefer Chassidim ibid; Tzitz Eliezer 13:102 and Y.D. 27:7 regarding Jewish fetuses; See also Beahala Shel Torah 1:116; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 780 footnote 300; Sefer Puah Vol. 3 p. 155 footnote 127-130
[13] The reason: As one is not liable for capital punishment for killing an insane person. [Mahariy Chagiz in Halachos Ketanos 37] Or, as he won’t come to fulfill Mitzvos. [Beahala Shel Torah 1:116]
[14] Igros Moshe C.M. 2:71 “And since murder is prohibited even for a fetus, it is clear that even if we assume with certainty that this is a child who will only live for a short while and will be sick the entire time and will not have any mental sanity and we would be required to spend much time caring for him, and even if due to this there is worry that the mother may get sick, it, it would still remain forbidden to murder the fetus and one who does so would be synonymous with one who murders a healthy fetus.”; Yaskil Avdi E.H. 6:85; Rav Unterman in Noam 6 and Shevet Meyhuda Shaar Chamishi pp. 359-367; Shevet Halevi 7:208; Kaneh Bosem C.M. 1:126; Nishmas Avraham C.M. 425:1 p. 160 in name of Rav SZ”A; Mishneh Halachos 5:233; 6:14; 9:328-330; Teshuvos Vehanhagos 2:736; Sefer Puah Vol. 3 p. 155 footnote 126
[15] See Mishnas Avraham ibid who says that not everyone agrees to the assertion of the Halachos Ketanos that one is not liable for capital punishment for killing an insane person, in addition to the fact that is not really possible to ever know one hundred percent that the child will be insane.
[16] As it is not clear if according to the Halachos Ketanos even a Gentile is exempt from killing a Shoteh and Cheresh, and on the contrary, from the fact that a gentile is liable for killing a Treifa, it would be implied that perhaps there also liable for killing a Shoteh and Cheresh. Vetzaruch Iyun
[17] Nishmas Avraham C.M. 425:1; Shevet Halevi 7:208; 10:259-1; 11:197; Maaseh Chosheiv 3:9; 4:26; Shiurei Torah Lerofim 4:239; Rav Z.N. Goldberg in Techumin 5:258; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 pp. 773 footnote 272; Sefer Puah Vol. 3 pp. 154-155 footnote 121; Based on Nida 30a and Kesef Mishneh Issurei Biyah 10:11
[18] See Maaseh Chosehv ibid and Sefer Puah Vol. 3 p. 155 that even if he can survive more than 30 days, i9f he wont survive past age 20 and even that is only through risky medical procedures, then it is allowed.
[19] See Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 773; Sefer Puah Vol. 3 pp. 165-166
[20] High-Resolution Ultrasound: This imaging test uses sound waves to create detailed pictures of the fetus inside the womb. During the procedure, a technician moves a special device (transducer) over the mother’s abdomen. The high-resolution capability allows for precise visualization of fetal organs and structures, helping detect physical anomalies, such as heart defects, limb malformations, or neural tube issues. These results are often available in real time and are non-invasive, meaning there is no risk to the fetus or mother.
[21] Amniocentesis: This is an invasive diagnostic procedure usually performed between the 15th and 20th weeks of pregnancy. A thin needle is inserted through the mother’s abdominal wall into the uterus, guided by ultrasound, to withdraw a small sample of amniotic fluid. This fluid contains fetal cells and various chemicals produced by the fetus. Laboratory analysis of the sample can detect genetic disorders (such as Down syndrome or Tay-Sachs disease), chromosomal abnormalities, and certain infections. Amniocentesis provides highly accurate results, but it carries a small risk of complications, such as infection or miscarriage.
[22] See Encyclopedia Hilchatit Refuit Hapalah Vol. 2 pp. 773-817; Sefer Puah Vol. 3 p. 155-175 [see there also for aids/HIV; women who are on certain medications or medical procedures that may effect fetus; Hydrocephalus; CMV; Lack of kidneys; mental retardation; Siamese twins ]
[23] Medical Background: Tay-Sachs is a severe autosomal recessive genetic disorder, particularly prevalent among Ashkenazi Jews of Eastern European descent and Jews from North Africa. It results from a deficiency in a specific enzyme, leading to the accumulation of harmful substances in the brain and progressive neurological deterioration.
Clinical Course: Symptoms typically begin around six months of age, including developmental regression, blindness, seizures, muscle stiffness, and ultimately death by around age two to three.
Diagnosis: The disease can be definitively diagnosed during pregnancy through enzyme testing or genetic screening.
[24] See Tzitz Eliezer 13:10; 14:27 – 7; Haskama of Rav Woldenberg to Sefer Hiulchos Rofim Urefua; Lev Aryeh 2:32; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 74 footnote 276; Sefer Puah Vol. 3 p. 161 footnote 160-161
[25] Igros Moshe C.M. 2:69; Nishmas Avraham C.M. 425:1 in name of Rav SZ”A [permits within 40 days]; Mishneh Halachos 5:233; 6:14; 9:328-330; Teshuvos Vehanhagos 2:736; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 774 footnote 277; Sefer Puah Vol. 3 p. 161 footnote 159
[26] Medical Background: A chromosomal disorder caused by an extra copy of chromosome 21. It leads to characteristic facial and physical features, intellectual disability of varying degrees, and a higher risk of associated health issues such as heart defects, gastrointestinal anomalies, infections, and certain cancers.
Diagnosis: Can be confirmed during pregnancy through amniocentesis or chorionic villus sampling (CVS), which detect the chromosomal abnormality.
[27] Tzitz Eliezer 14:101-102; 15:43 – 4; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 775 footnote 280; Sefer Puah Vol. 3 p. 164 footnote 173
[28] All Poskim who prohibit abortion by Tay Sachs; Poskim in Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 775 footnote 281; Sefer Puah Vol. 3 p. 164 footnotes 174-176
[29] Medical Background: A severe neural tube defect where major portions of the brain and skull are missing. Infants born with anencephaly typically die within hours or days after birth.
Diagnosis: Can be reliably identified during pregnancy through elevated maternal serum alpha-fetoprotein (AFP) levels and detailed ultrasound imaging.
[30] Nishmas Avraham C.M. 425:1 in name of Rav Y. Zilbishtrom; Shevet Halevi 10:259-1; Based on Nida 30a and Kesef Mishneh Issurei Biyah 10:11; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 776 footnote 284 and 286; Sefer Puah Vol. 3 p. 158 footnote 138-140
[31] Medical Background: These are severe cardiac anomalies diagnosed in the fetus that may lead to death either in utero, during delivery, or shortly after birth. In some cases, even if the baby is born alive, survival is only possible with extremely intensive medical intervention, and life expectancy may still be limited to a few months or years.
Diagnosis: Such conditions can often be identified through detailed fetal echocardiography and other advanced prenatal imaging techniques.
[32] Maaseh Choshev 3:9; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 777 footnote 287; Sefer Puah Vol. 3 p. 162 footnotes 164-165
[33] Medical Background: Rubella is a mild viral illness in the mother but can cause severe congenital defects if contracted during early pregnancy. The earlier in gestation the infection occurs, the greater the risk to the fetus. Possible fetal complications include: Congenital heart defects; Eye abnormalities; Microcephaly (small head); Intellectual disability; Retinal inflammation; Deafness
Diagnosis: The fetal damage cannot be confirmed with certainty prenatally. Risk is assessed based on: Laboratory confirmation that the mother contracted rubella during pregnancy; Gestational age at the time of infection; Statistical likelihood of fetal harm
[34] Tzitz Eliezer 9:51:3; Amud Hayemini 32; Seridei Eish 3:127 [prior to 40 days]; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 778 footnote 290; Sefer Puah Vol. 3 p. 157 footnote 134
[35] Igros Moshe C.M. 2:69; Rav Unterman in Shevet Meyehuda p. 344 and Noam 6; Mishneh Halachos 5:233; 6:14; Kaneh Bosem C.M. 126; Besivilei Harefua p. 65-72; Teshuvos Vehanhagos 2:731; Encyclopedia Hilchatit Refuit Hapalah Vol. 2 p. 778 footnote 291; Sefer Puah Vol. 3 p. 157 footnote 135
