Daily Halacha Tuesday: May one choose to give birth at home according to Halacha

Home birth:[1]

In today’s times, due to medical reasons which is Torah, women give birth in a hospital, rather than at home.[2] Nonetheless, this does not come to say that home births are forbidden, and this matter is dependent on the conditions of one’s city, and the rulings of the Rabbi of that city.[3]

Husband assisting:[4] In the event of an emergency homebirth, the husband is to do whatever is necessary to assist his wife in the birth even though she’s a Nida.

Shabbos:[5] Even in the event that there is a midwife available for a homebirth to be performed without desecrating Shabbos, one may [and at times should] call an ambulance to give birth in the hospital.[6] Certainly, a woman may choose to give birth at home rather than the hospital even on Shabbos, even if it may cause more Shabbos desecration, if that is where she feels more comfortable.[7]

The pros of a homebirth versus a hospital birth:[8]

1. Some woman feel more comfortable giving birth in their home setting.
2. She receives private and personal care from the midwife or doctor who is totally dedicated to her birth as opposed to a hospital where attention must be given to many other women giving birth simultaneously.
3. The possibility of infection from a virus or illness.
4. There is no possibility of the baby being accidentally switched.
5. On Shabbos, there is possibly less Shabbos desecration that will need to take place when giving birth at home.

The cons of a homebirth versus a hospital birth:[9]

1. It’s possible that the midwife will be unable to come for whatever reason.
2. There could be medical complications with the birth that cannot be foreseen [i.e. such as intensive bleeding, fetal distress, complications that require a C-section to be performed] and it will take time until she arrives to the hospital to get emergency care.
3. The hospital contains many more advanced medical equipment to assist with the birth.

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[1] Sefer Hasichos 5747 2:37 “In previous generations women would give birth in their homes with the help of a midwife, however, in today’s times due to medical reasons women give birth in a medical facility. Accordingly, this is a directive of Torah which states that a doctor is to heal and the doctors are given permission to heal”

[2] The statistics: Over 98.5% of births in the United States take place in a hospital setting. Nonetheless, throughout the years homebirths have rose considerably. A similar rate can be found in almost all own countries throughout the world, including Europe, in which 1% or less of all births take place at home, with exception to the Netherlands in which the number is much higher at about 16% of all births. In Israel, less than half a percent of all births take place at home, with only between 300 to 700 births taking place at home annually. To note, that a large percentage of these homebirths are not planned but due to lack of choice. [https://www.ncbi.nlm.nih.gov]

[3] Otzer Hamelech p. 210 [in response to Rav Levi Bistritzky, brought below in detail] “In New York, many women give birth inside their homes with agreement of the rabbis. Seemingly the conditions of this matter are different in your city, and it is obvious that only one who lives in the city can make a judgment for that city”; Shulchan Menachem 6:8 [p. 33]; Ketzos Hashulchan 140 footnote 1 ruled that one may not desecrate Shabbos for the sake of giving birth in the hospital unless the doctors say that the specific woman needs special medical supervision for her birth; See Toras Hayoledes 7 footnote 1 who does not give any ruling on the subject and simply lists the pros and cons.

The Rebbe’s response to Rav Levi Bistritzky: Rav Levi Bistritzky OBM, who was the chief rabbi of the Chabad community in Tzefas, had issued a ruling which prohibits homebirth’s and requires mothers to give birth in a hospital. This ruling was the result of a growing trend amongst some members of his community to give birth at home, and in certain cases doing so ended up compromising the health of the baby or mother. His ruling faced opposition from members of the community including from some of the leading Shluchim of the Rebbe to the city of Tzefas, who opposed it both ideologically, and under the claim that the Rebbe himself had given his blessings to many individual women to give birth at home. As a result, Rav Levi Bistritzky wrote to the Rebbe regarding whether the rumors are true and as to if true and as to whether he should retract his previous ruling. The Rebbe’s response to Rav Levi Bistritzky is not less than fascinating, and reveals the proper Torah attitude and attitude of the Rebbe towards a Mara Diasra of the community, and how he’s to give his rulings. In his response, the Rebbe makes the following points: 1) A rabbi must rule in accordance to the code of Jewish law, and not based on letters, including even letters of the Rebbe, as any letter that is contrary to Jewish law is considered null and void. 2) Prior to giving a controversial ruling a rabbi should build a coalition with other rabbis prior to publicizing his ruling. 3) In a generation such as ours in which many people don’t always listen to the rulings of rabbis, Rabbis are to beware to the utmost from publicizing new decrees and prohibitions that are not based on explicit rulings in the code of Jewish law. This especially applies when the reason behind the prohibition is not revealed to the public. This especially applies when rabbis in other communities rule that the matter is permitted, and other communities are accustomed to being lenient. 4) The above matter is only within the jurisdiction of officiating Poskim, and community leaders are not to mix themselves into the decision-making even if they have rabbinical ordination. 5) It is obvious that when I write a private response to an individual [that his wife may give birth at home] it is meant for him and solely for him based on their personal and private situation, and is not to be taken as a public directive or allowance. 6) It is well known that I do not intervene regarding controversy that surrounds the rulings of rabbis in Israel, and it is the job of the local rabbis in Israel to hear and arbitrate regarding the matters. 7) In New York, many women give birth inside their homes with agreement of the rabbis. Seemingly the conditions of this matter are different in your city, and it is obvious that only one who lives in the city can make a judgment for that city. [See Menachem Meishiv Nafshi 1:83]

[4] Toras Hayoledes 6:4

[5] See Toras Hayoledes Chapter 7

[6] The reason: Being that in today’s times hospitals are more medically equipped for births and the various possible complications associated with birth, than is a home birth with the assistance of a midwife. Likewise, many more Shabbos desecrations may need to take place by a homebirth verses in a hospital [Toras Hayoeldes ibid] However, in previous times where there was no advantage of giving birth in a hospital versus at home with a midwife, then some Poskim ruled that one may not desecrate Shabbos for the sake of giving birth in the hospital unless the doctors say that the specific woman needs special medical supervision for her birth. [Ketzos Hashulchan 140 footnote 1]

[7] See Toras Hayoledes 7 footnote 1

[8] Toras Hayoledes 7 footnote 1

[9] Toras Hayoledes 7 footnote 1