From MIDWIFERY MATTERS, Issue No.109, Summer 2006
IT'S ALWAYS SEEMD ODD to me that there aren't many Jewish midwives. Maybe it
doesn't seem like an obvious job for a nice Jewish girl, yet as a Jew and a
midwife, I've always felt part of a long chain of midwifery tradition. Even
though another group of 'working women' lays claim to the title of the oldest
profession, midwives must have a better claim to it and Hebrew midwives are
the first recorded in history. Since Eve first gave birth, women have been helping
with the process of pregnancy and childbirth. There are references to midwives
and midwifery from the earliest parts of the Hebrew Bible as well as from the
Mishnah and the Talmud. The Hebrew Bible, which Christians know as the Old Testament,
contains traditions from at least 3,000 years ago; the Mishnah records discussions
of rabbis who lived around 2,000 years ago and the Talmud consists of commentaries
on those discussions from around 500 years after that.
The first midwife to be mentioned is present at the birth of Benjamin
(Gen. 35:17). The nature of Rachel's labour pains makes her predict that the
baby will be a boy but her skill is not enough to prevent Rachel dying in childbirth.
The midwife who looks after Tamar (Gen 38:28) is skilled enough at palpation
to recognise that twins are on the way, as she ties a red thread around the
first baby's wrist, and expert enough to manage a complicated twin birth, as
the second twin is eventually born first and both babies and their mother survive.
The first midwives we know by name are Shifrah and Puah who saved
baby boys from Pharaoh by pretending that the babies were all BBAs (Ex. 1:19).
The Talmud interprets their names to relate to what midwives did; Shifrah derives
from a root 'shafar', to make beautiful, because the midwife 'cleans the baby
when it is born covered in blood' and Puah relates to the root 'p'ah', to call,
because the midwife calls out to the labouring woman to encourage her and also
to the root 'p'ah', to breathe into, because she 'revives the baby when people
say it is dead'.
The rabbis of the Talmud had surprisingly detailed knowledge about
pregnancy. They calculated the length of pregnancy as between 271-273 days;
since they were working from the date of conception rather than from the LMP,
this fits in pretty well with the modern count of 280 days. Some premature babies
obviously survived, as the minimum length of pregnancy is given as 212 days.
They knew that a baby's sex was determined from the moment of
conception, as a prayer for an unborn child to be a boy or a girl is given as
an example of a 'prayer in vain'. However, they thought it was possible to influence
the conception by ensuring the woman reached her climax first or by aligning
the bed North/South, both of which were supposed to make it more likely for
a boy to be conceived.
By examining miscarried fetuses, the rabbis worked out a lot about
fetal development and about possible abnormalities. An unborn baby in the womb
is described as having 'eyes like the dropping of a fly and a long way away
from each other; two nostrils like the droppings of a fly but very close to
each other; a mouth like a thin stretched hair. Its penis is like a lentil or
if it is a girl, its genitals look like a grain of barley'. They also describe
what is clearly a foetus papyraceous, comparing it graphically to the sole of
a shoe or sandal, as well as anencephalic babies.
The importance of diet in pregnancy is already recognised in the
Bible, where Samson's mother has to follow a particular diet because of the
influence this will have on the unborn child (Judges. 13:14). In the Talmud,
some foods were recommended; others, such as purgative herbs, were seen as potentially
harmful. Pregnancy cravings already existed then and were seen as the expression
of a vital need, so even if the craving was for a normally forbidden (not kosher)
food, the pregnant woman was allowed to eat it.
Birth usually took place on birth stones or on a birth stool,
and the woman was supported by other women. The stool must have had three legs
as it is likened to the Hebrew letter 'shin' which has three upright strokes.
The importance of a trusting relationship between the mother and the midwife
is reflected in a proverb: 'if the woman giving birth and the midwife were quarrelling,
the baby would be lost'. The midwife used oil for massaging mother and baby
and this was so necessary that it could be bought even on the Sabbath, when
one would not normally be able to handle money or buy anything. The laws of
the Sabbath in general were set aside for the purpose of caring for the labouring
woman, even to the extent of lighting candles for a blind woman - even though
she cannot directly benefit from the light, the Talmud says that the reassurance
she would derive from knowing that her midwife can see what she's doing is sufficiently
important.
The interpretation of Puah's name shows that midwives would breathe
into the baby if it needed resuscitation; another method was to rub the placenta,
perhaps to stimulate the baby's circulation via the umbilical cord. Once the
baby was breathing and the cord was cut, it was washed with water, rubbed with
salt and swaddled (Ezek 16:4). The head was presumably swaddled too, to make
it assume the 'correct' shape, as the Talmud says that the reason Babylonians
had round heads was supposed to be because their midwives were not sufficiently
skilled at swaddling.
We've all heard women in labour say, 'Never again' and it was
just the same 2,000 years ago. According to the Talmud, the reason the woman
has to bring a sin-offering to the Temple once she has recovered from the birth
is because in the grip of her labour pains, she will have sworn a 'false oath'
never to sleep with her husband again!
As well as descriptions of normal childbirth, there are mentions
of operative deliveries. In some cases, the procedure must have resembled that
which gave the caesarean its name, where the baby who would become Julius Caesar
is reputed to have been cut from the belly of his dead or dying mother. However,
it is clear that the rabbis knew not only of sections which both the mother
and the baby survived but also of VBACs, as there is a discussion on whether
the second child of a woman whose first baby was born 'yotze dofen' (coming
out of the abdomen) counts as a first-born. Tantalisingly, they don't tell us
how it was done nor how they overcame the problems that meant it was not until
well over a thousand years later that an 'advanced' society like ours was able
to ensure both mother and baby survived the experience.
Updated LW October 3, 2006