Motherhood IV: Postpartum

Postpartum complications are a serious medical concern, and can be life-threatening. Therefore, the Talmud teaches that a postpartum woman is still considered to be at risk (a chola she-yesh bah sakana), such that halacha may be pushed aside for her needs for three or even seven days, as needed.

This is the accepted halacha:

So, for example, a woman does not fast on any fast day, including Yom Kippur, for a week postpartum—and possibly longer, depending on her health. And she does not generally fast on Tish’a Be-Av for at least thirty days, again possibly longer depending on the situation. Learn more about major fasts postpartum here.

Aruch Ha-shulchan adds that if those attending to the postpartum woman—presumed to be women—attest that she has medical needs that entail performing melacha on Shabbat over the first seven days, their assessment is relied upon, much as a doctor’s would be.

Aruch Ha-shulchan also takes into account that some women need more time to recover, and that in those cases, too, Halacha gives weight to what the woman and her physician report. Already from Talmudic times, there is also an understanding that full recovery takes much longer.

For a discussion of the halachic implications of this more extended recovery with respect to fasting, see our articles on major and minor fasts. For a discussion of implications regarding contraception, see here.

It is of course not only the mother who needs care after birth. Yechezkel, in a prophetic parable addressing Yerushalayim, describes a newborn girl who is not properly tended to, from which we can infer the type of basic care expected to be given to an infant:

As in the prophecy, a baby requires cleaning, protective treatments and careful swaddling. See here for a discussion of the baby’s vulnerable state and how it might affect a nursing mother’s fasting.

A woman becomes nidda during labor or with childbirth, and the process of returning to ritual purity postpartum has an interesting halachic history. The Torah details a complex process, including a set period of ritually impure bleeding followed by a set period during which any bleeding is considered ritually pure:

According to Torah law (before the acceptance of rabbinic decrees in place today), a woman would immerse after seven days following the birth of a boy or fourteen following the birth of a girl, without observing any clean days.¹ From that point on—until forty days after the birth of a boy or eighty after the birth of a girl—any bleeding would have the unique status of blood of purity, dam tohar. She and her husband would be halachically permitted to engage in physical contact, including intercourse, even if she were still bleeding. At the end of this time period, she would resume observing the usual halachot of nidda and would bring a sacrifice to mark the conclusion of the process.

Uterine bleeding in the first seven or fourteen days after childbirth was considered equivalent to nidda blood, while uterine bleeding during the next thirty-three or sixty-six days was considered dam tohar, ritually-pure blood.

According to one position in the Talmud, the difference between the two types of postpartum bleeding is purely halachic and metaphysical, not physiological:

In the Talmud, Yalta, a learned woman, points out that dam tohar provides theological balance to the prohibition of nidda in a way that highlights the Divine workings of both laws.

It is God, not just physiology, that determines what is ritually pure or impure. This balance can be significant for a woman, who might come to associate all her bleeding with impurity, and distance from the sacred. The Torah law of dam tohar offers an important reminder that uterine bleeding is not always inherently impure.

Seven Clean Days

Our sages usually require seven clean days any time a woman has a blood flow of uterine origin,² and that approach is ultimately applied to bleeding during and after childbirth. In the twelfth century, Rambam reports that all women would observe seven clean days following postpartum bleeding and prior to immersing.

This remains the practical halacha today.

Though postpartum bleeding rarely ends on time for this, a woman can count her clean days during the initial seven or fourteen days. But after the birth of a girl, she cannot immerse before the night at the end of the fourteenth day, even in the rare case where she completed her clean days earlier.

Halacha of Dam Tohar

Even after a woman finishes bleeding postpartum and counts seven clean days before immersion, she is often able to get to the mikveh within forty or eighty days of giving birth, during the time that dam tohar is relevant. Rambam states that by his era, dam tohar had become subject to local custom. Following the initial postpartum immersion, couples in some locales would have relations during dam tohar bleeding while those in other locales would treat it like nidda bleeding and refrain.

The concern that led to this Geonic decree derived from the very same feature of dam tohar that makes it extraordinary, that it is still uterine blood, so that its key distinction from nidda is halachic and not physical. This could ultimately give rise to confusion once the time period of dam tohar had come to an end. Rosh explains:

Today, accepted halacha is to treat dam tohar like nidda bleeding, and for couples to refrain from physical contact when a woman has bleeding after her first postpartum immersion, until she gets to the mikveh again.

During the time of dam tohar, bleeding is evaluated like bleeding at other times of life. That also means that the leniencies of stains are in place (learn more here) and that non-uterine blood, such as blood from a wound (common after tearing or an episiotomy, learn more here), does not affect a woman’s halachic status.

Now that it has become customary to treat dam tohar like nidda bleeding, the forty and eighty days are no longer relevant.³

Regardless, postpartum bleeding (lochia) can stop and then start up again and typically lasts for about four to eight weeks.

The weeks in nidda postpartum largely overlap with the time that it is medically recommended to wait before resuming relations following childbirth. But being in nidda can pose other challenges for a couple, limiting affectionate and supportive physical contact and sometimes complicating baby care.

For example, even casual touch between a couple is prohibited. A couple also may not pass items from hand to hand, since that could accidentally lead to touch. Rema is more stringent on this point, and prohibits even tossing things to each other.

As above, for the first month postpartum, a woman is considered like someone who is ill. This means that leniencies with respect to passing things directly or providing other types of assistance (aside from direct touch or washing her when not needed) can apply when they are important for her care or recovery, and can potentially apply beyond that point if she takes longer to recover:

One of the most common halachic questions postpartum is whether the couple can pass the baby directly to each other. Since the couple are not permitted to pass “anything” from hand to hand, an infant ordinarily should not be passed from one parent’s hands to the other’s during nidda. However, Badei Ha-shulchan’s ruling leaves room for leniency with passing the baby directly in the initial time period after delivery if it would otherwise be difficult or detrimental to the new mother to get up or shift position to accommodate putting the baby down first. The couple should be careful not to touch.

It is also considered fully permissible to set a baby down right beside its mother (or father).

Writing about six hundred years ago, Tashbetz rules leniently in a wider range of cases, recognizing a distinction between a baby and inanimate objects. He invokes a principle from halachic discussions of carrying on Shabbat, that “a living being carries itself,” which can be a basis for leniency and debatably may apply to infants.⁴ Tashbetz argues that parents passing a baby are not really the ones taking action, since the baby “carries itself.”

Some halachic authorities reject or limit this position.⁵ For example, Rav Shmuel Wosner suggests that Shulchan Aruch, in leaving room for tossing objects, implies that the prohibition applies specifically when there is an unbroken physical connection between the passing hand, the object, and the receiving hand. Perhaps a baby moving of its own volition is considered an interruption to that connection, and thus akin to a toss. In that case, Tashbetz’s ruling should be limited to those who follow the lenient position that permits tossing objects during nidda:

Rav Ovadya Yosef argues that the analogy to tossing is forced, since even a tossed object is impelled entirely by the motion of the person tossing it. Babies are different because they introduce their own motion into the equation, so that the action of passing can be ascribed to the baby rather than the parent. He therefore permits passing a baby directly between parents as needed. Even so, he suggests that it is fitting for those who follow Rema to be more stringent.

Nowadays, in many communities, practice is to be lenient in cases of need or if the baby even just reaches its arm toward the other parent—something even very young babies can be manipulated to do. Here, for example, is Rav Eliezer Melamed’s ruling on this point in Pninei Halacha.⁶

Beyond the technical questions of what is considered passing, Halacha recognizes that a baby is not a standard object, but a vulnerable human being whose safety is paramount. When there is no safe surface on which a baby can be placed, and no one else is available to help, the baby should be passed directly with an effort not to touch.

Yeshiva University’s Rav Mordechai Willig is reportedly more lenient—building on the halacha that some harchakot are relaxed in case of illness, but focusing on the baby as the party who requires special consideration:

Other Baby Care

Customs vary regarding how one spouse can interact with a baby that the other spouse is holding during nidda. Rav Shmaryahu Karelitz writes that the second spouse should not kiss the baby in that situation and should avoid washing them (since it will likely lead to touch), but can feed the baby as necessary:⁷

Ultimately, a couple need to make every effort and sometimes engage in creative thinking to avoid touch, while using their common sense to ensure that their baby is safe and its needs are met.

The Mikveh

The process of getting to the mikveh can be especially challenging after childbirth. Aside from the unpredictable nature of postpartum bleeding, there is also typically sensitivity, dryness, and even stitches or tearing that can complicate efforts to perform bedikot or make them more painful. Additionally, some hormonal contraceptive methods commonly prescribed for breastfeeding women can cause irregular staining. This can make it more difficult to complete the clean days, depending on when a woman begins to use them. It can be helpful to discuss these considerations with a rav or yoetzet halacha. (Learn more about this aspect of postpartum contraception, including recommended timing, here).

Writing in Nishmat Ha-bayit, Yoetzet Halacha Shira Kfir suggests that a number of leniencies are common postpartum to help women reach the mikveh:⁹

For further discussion by Yoatzot Halacha of practical measures to take becoming tehora postpartum, see here.

Perhaps the most widely known postpartum beracha is birkat ha-gomel, a beracha of gratitude to God for surviving a life-threatening event such as childbirth. We discuss the halachot of reciting birkat ha-gomel here.

There is another, earlier opportunity to recite a beracha of gratitude and praise: upon one’s joy at the birth of a child.

The earliest sources seem to describe this as a beracha specifically over the birth of a boy (which can feel challenging from a modern perspective). In practice, we will see that there is a wide range of views as to whether to recite a beracha at all, and whether the beracha recited—or the joy it expresses—depends on a baby’s gender.

The relevant Talmudic passage first presents the essential halachic distinction between the berachot of she-hechiyyanu (praising God for enabling us to live and reach a specific time) and ha-tov ve-hameitiv (praising God for making things good for us). She-hechiyyanu is recited for personal joys, while ha-tov ve-hameitiv is for shared joy. The Talmud then provides an example of this principle, namely, that a father recites ha-tov ve-hameitiv (and not she-hechiyyanu) over the joy he shares with his wife at having a son.

The baraita here emphasizes the parents first learning that their newborn is male (until the advent of ultrasound in the late 20th century, a baby’s gender would be revealed only at birth), which may have been seen as a central element in the happiness that gives rise to the beracha.

The passage does not explicitly relate to the prospect of a mother reciting this beracha, or of either parent reciting a beracha upon the birth of a daughter. Shulchan Aruch makes it clear that a mother does recite this beracha for a boy, but does not raise the possibility of reciting a beracha upon the birth of a girl. Rema adds that in the case of only one surviving parent, the beracha is she-hechiyyanu:

The instance cited in the Talmud is the birth of a boy, and this is codified in the Shulchan Aruch. While some Talmudic texts emphasize the special joy of having sons,¹⁰ Talmudic sages express different attitudes about the birth of daughters. The sages of the Mishnaic era explicitly debated whether only sons are considered a blessing, or also daughters:¹¹

Bar Kappara, the first baraita, and Rabbi Meir see male offspring as more advantageous, at least under certain societal conditions (whether in Avraham’s time or their own).¹² But Rabbi Yehuda and “others” view having a daughter as a blessing specially noted by the Torah. Even if we follow the latter, more positive, perspective overall, whether to recite a beracha over the birth of a daughter remains a matter of halachic discussion, especially since the key Talmudic passage in Berachot seems to emphasize a boy’s gender as a reason for the beracha.

Rashba, for example, argues that only those who experience practical benefit may recite ha-tov ve-hameitiv, and then provides two different reasons for why specifically the birth of a son is expected to bring practical benefit:

This leaves open the question of whether Rashba is simply explaining a ruling that he considers to be final—ha-tov ve-hameitiv is recited for a boy but not for a girl—or whether he considers joy at the birth of a baby to be situation-dependent, such that changes in roles of male and female children and attitudes about them could make a difference in rulings. For example, Rashba assumes that it is sons who will support and assist their elderly parents, whereas in our society that role is often assumed by daughters.

Rav Jonathan Sacks, in an article on innovation in halacha, phrases this question well:

Indeed, the position that Rav Sacks identifies as constitutive is found in Aruch Ha-shulchan:

Aruch Ha-shulchan clearly states that how the parents actually feel has no effect on the halacha of reciting the beracha.

Perhaps in contrast, Rambam never mentions the birth of a boy as cause for this beracha, but simply cites the general rule about individual or shared joy.

Rav Nahum Eliezer Rabinovitch takes Rambam’s omission of any example as demonstrating what Rav Sacks calls a regulative approach. On this reading, it is up to the couple to determine what genuinely brings them joy, and then to apply the rules of berachot accordingly:

So far, we have seen two main options for addressing the question of whether a couple that feel joy at the birth of a daughter recite ha-tov ve-hameitiv. Rav Rabinovitch rules that they should, based on his reading of Rambam. Aruch Ha-shulchan rules that they should not.

A third possibility, really a variation of Aruch Ha-shulchan’s view, is advanced by Mishna Berura. He maintains that one most likely may not recite ha-tov ve-hameitiv at the birth of a girl, regardless of how one feels, but that she-hechiyyanu is recited at the joy of seeing her for the first time:

This ruling seems to derive from the impulse to recognize the value and joy of a daughter’s birth, which was not always to be taken for granted. Even so, Mishna Berura does not present it as a halachic innovation, but rather as being so simple that it did not need to be mentioned.¹³

In practice, there are three approaches, all well represented in different communities. To begin with, Rema notes that many do not recite ha-tov ve-hameitiv even at the birth of a boy:

In many communities, especially among eidot ha-mizrach, no beracha is recited on either a boy or a girl’s birth. Instead, a boy’s father keeps this in mind when reciting she-hechiyyanu at the berit mila. We see this approach, for example, in Ben Ish Chai,

In many communities, ha-tov ve-hameitiv is recited at the birth of a boy and she-hechiyyanu is recited at the birth of a girl, in line with Mishna Berura’s ruling. In a few communities, it has become accepted for ha-tov ve-hameitiv to be recited at the birth of a girl as well, when that is reflective of the parents’ mood at her birth, as Rav Rabinovitch ruled.¹⁴ Here, for example, is Rav Yosef Tzvi Rimon (himself a father of eight daughters, and no sons).¹⁵

Timing

When should this beracha be recited? As we saw, the passage in Berachot describes a husband who recites the beracha upon first receiving the news that his wife has given birth and does not mention the wife’s recitation.

The earliest point at which a woman—along with her husband, if he is in the delivery room—could recite this beracha is immediately after birth. A woman who wishes to do so should first cover her lower body (as with a hospital gown or sheet) and try to make sure that her hands are clean, although washing them is not obligatory.

Still, while the beracha is rooted in receiving the good news of a birth, it need not be recited immediately as long as the news remains fresh in the couple’s minds and they are still in the first wave of spreading the news.

This ruling gives a woman time to clean up from the birth and regain her composure before reciting the beracha or responding amen at her husband’s recitation.

As we discuss here, she also has the prospect of reciting birkat ha-gomel when she has more fully recovered, typically at least a week after giving birth.

The halachot we’ve discussed here are a window into some of the personal physical and spiritual processes of the initial postpartum period. In our next piece, we move on to discuss more communal rituals: berit mila and pidyon ha-ben for a son, and various practices for recognizing the birth of a daughter.