י׳ בתמוז ה׳תשע״ב (June 30, 2012)

Nidda 40a-b: Caesarean Sections and Jewish Law

We have already learned that aside from the laws of ritual purity related to a and a zava, there is a separate category connected to childbirth. According to the Torah when a woman gives birth she is rendered ritually unclean with tum’at leidah – the impurity of childbirth (see 12:1-5). The Torah teaches that there are different rules for a woman who gives birth to a boy and one who gives birth to a girl.

When a boy is born the mother is ritually unclean for seven days, and then has 33 days during which time any vaginal bleeding does not render her impure;
When a girl is born the mother is ritually unclean for 14 days, and then has 66 days during which time any vaginal bleeding does not render her impure.

One of the unique elements related to tum’at leidah is that it is not related to bleeding; even if there is no vaginal bleeding at all during childbirth, the woman is, nevertheless, ritually impure.

What if the birth did not take place in the usual manner? Is the woman still rendered ritually unclean?

The fifth perek of Massekhet Nidda, which begins on today’s daf discusses this question. According to the Tanna Kamma of the Mishna, if the child that is born is a yotzeh dofen (literally “it emerges from a wall”) the laws of tum’at leidah do not apply to the mother. Rabbi Shimon disagrees, arguing that with regard to these laws, it is treated like any ordinary birth.

A yotzeh dofen refers to a birth that does not progress in an ordinary manner, rather by means of surgical intervention. Already in ancient times birth by means of Caesarean section was known, although such surgery was invariably performed on a mother that was already dead. Only with the advent of modern medicine do we find records of successful Caesarean sections performed on women who were alive. From the discussion in the Gemara, however, it does appear that Jewish physicians successfully performed such operations on women who survived the ordeal and were able to conceive and give birth to more children.