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Home > Family & Lifecycles > The modern dimensions of Jewish infertility

The modern dimensions of Jewish infertility
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Need for recognized mourning and ritual

When it comes to treating infertility, medical technology is moving at a rapid pace. After all, the first IVF baby is only in her early 20s. New techniques are mind-boggling. They include a variety of assisted reproductive technologies in addition to IVF, as well as collaborative reproduction, where a third party donates sperm or eggs, or even carries the baby in her womb.

While success rates for all of these treatments are very high, the whole process is taxing financially (treatments can easily cost thousands of dollars, often not covered by insurance), physically, and above all, emotionally. Beyond that, modern technology with regard to fertility brings with it moral, ethical, and halachic dilemmas that were unheard of when Jewish law and practices were set in place.

One such Jewish practice is the fact that according to Jewish law, a baby is not considered a viable life-a nefesh-until after 30 days, which means that couples that miscarry or have to terminate the pregnancy do not sit shiva or say kaddish.

Historically, this makes sense, since up until recently, there was a very high infant mortality rate, and many infants died before they were 30 days old. In those circumstances, it would have been too taxing for parents to have to observe the traditional mourning and burying rituals for each child who died as an infant.

"This tended to be merciful to parents for whom going through the traditional mourning rituals each time they lost an infant could have served as an impediment for having other children," said Rabbi Michael Siegel of Anshe Emet Synagogue in Chicago.

But today, modern technology has made it possible for premature babies to survive more often than not, and for newborns to receive organ transplants and grow into healthy adulthood. Now the time is ripe for Judaism to create new rituals for the parents who do lose an infant, because in an age of miracles, such a loss is especially profound.

"For couples to be able to heal and grow in faith, they need a sense of closure in the form of ritual," said Siegel. He added that the Conservative movement has recently distributed to its rabbis prayers and rituals for couples that have miscarried, delivered stillbirths, and other losses that Judaism does not officially address.

One family's experience

Despite these new rituals, many couples that have lost a pregnancy felt abandoned by Judaism at a time when the structure of a shiva or a burial service would have given them the closure--and the comfort--they needed.

Rina, 27, knows this only too well. Last July, pregnant with her first child, she and her husband went to the doctor for a routine 20-week ultrasound. They were excited, and the only thought on their minds was whether they wanted to know the sex of their baby. But within a few minutes of the examination, as the couple viewed their unborn child on the monitor, the technician stopped.

"I see an abnormality," she said, before abruptly leaving to find the doctor. In came a radiologist and a maternal fetal specialist, but still, Rina and her husband had no idea what kind of shock they were in for. "We didn't know what to think," recalled Rina. "It never occurred to us that it would be as bad as it was. We never thought it would mean that we wouldn't have a baby. We only thought, what's wrong with it?"

"What's the prognosis?" they asked the doctors, to which the doctors replied, "The baby's not going to be born--it's not viable. It won't make it to term."

From later testing, the couple found out that their baby had a rare genetic disease called Turner Syndrome, where a gene is missing from a chromosome. (Because it's a disease that happens at random, it carries no implications for subsequent pregnancies.) The doctors gave them two choices: to terminate the pregnancy, or carry the baby to term, and deliver a stillbirth. For them, there wasn't any choice.

"I couldn't imagine looking pregnant and people on the elevator saying, 'How far along are you?' and knowing in the end, I wouldn't deliver a living baby," she said, tears rolling down her face.

In the aftermath of this sorrow, Rina was afraid to call their rabbi. "I wanted to call a rabbi, but couldn't pick up the phone without crying. I was afraid to ask, in case Jewish law would say that we ended a life," she said.

But their rabbi called them, and reassured them that they did the right thing. Above all, however, he encouraged them to pray, suggested books to read, and said it was OK to be angry at God.

But what he couldn't give them was the authoritative Jewish structure to mourn for their loss. "There are no rules like sitting shiva, where you know what to do, or like having a ceremony. I mean, do you have ceremony or not? Because I don't just feel that I lost a pregnancy; I feel I lost a baby. I saw a picture of that baby, I saw its spine," said Rina.

She also felt that her friends in the community did not know how to respond. So they didn't respond at all.

"I wanted them to ask me questions, or say what you say when someone dies: 'I heard about your loss and I'm sorry.' A pregnancy loss is something where you need support. Whether it's after 20 weeks, when people know, or only after 10-12 weeks, you're invested in the pregnancy," she said.

When Rina was pregnant again this summer with a good prognosis, the trauma of her first experience was etched into her mind so much so that it took her a long time to accept her pregnancy.

"Until the 20th week ultrasound, I really didn't believe I was having a baby. My family didn't understand why I wasn't excited, but I thought, OK, I was pregnant, but maybe I would have a baby and maybe I wouldn't. Experience dictated that I wouldn't," she said.

"From this whole experience I learned that pregnancy and birth are not simple things. For many people, getting pregnant may not be easy. But then, even if you get pregnant, that doesn't guarantee you a healthy baby. But no one talks about it. They're not things that we talk about in our society, but people need to start talking."

As her due date approached, Rina slowly began to look to the future with hope. "I know that everything may not be right, but I sure hope it is. So now I think, we're going to have a baby," she said.

Her patience and optimism were rewarded. Rina had a healthy baby girl in July.

Looking forward

What can the Jewish community do to better meet the needs of those facing infertility?

According to Rabbi Siegel, it can start by being more sensitive.

"Because we, as a community, experience issues related to fertility in greater numbers, we have to come to terms with that and be understanding of the trauma," he said. What this means is--despite good intentions--parents should hesitate before asking their grown, married children when they're going to give them some grandchildren already.

"Comments like these, even said in jest, can be piercing. Often we have no idea what a couple is going through. If we were to assume that more couples are experiencing fertility challenges, we would be more sensitive in our language, and that would be a good start."

Educators also stress that fertility struggles encompass a huge spectrum that is overcome only when a baby is born healthy and safe.

"Educating people about this issue and the sensitivity of it--how it's multifaceted and complicated and frequent--is vitally important," said Bernstein, who helped launch the Jewish support group. "People in the Jewish community need Jewish support. As more light is shed on these issues, and as more information is shared, we will begin to understand what our people are going through."

© JUF News, 2000. May not be reproduced without written permission.

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