Monday, August 04, 2008

pregnant / nursing women fasting

This article http://www.ynet.co.il/articles/0,7340,L-3575177,00.html cites R’ Nachum Rabinovitch of Yeshivat Ma’aleh Adumim as allowing pregnant (after 5th month) or nursing mother to eat on 9 Av because these women are categorically to be treated as cholos (hat tip to Mother in Israel).

A bit of background: the gemara (Pesachim 54) writes that on Yom Kippur and 9 Av all pregnant or nursing women must fast. The implication drawn by some some Rishonim is that pregnant or nursing women are exempt from fasting on other fast days. The Rishonim differ as to whether that amounts to a blanket dispensation, or whether these women should try to fast and only eat if necessary for their health or the health of the nursing child (see Bais Yosef siman 594).

Someone who is too ill to fast is permitted to eat on 9 Av because the Rabbinic enactment of fasting was never imposed upon someone who is sick.

Having not seen the sefer I am not sure how to understand this psak of R’ Rabinovitch. Does he assume that all women in our times who are pregnant or nursing are categorically defined as “cholos” for whom no obligation to fast exists? I would have thought that if fasting was not risky for pregnant or nursing women living 1500 years ago it, that the risk has declined, not increased, with the advent of modern standards of pre-natal care and nutrition. A more interesting possibility would be to argue that even if the actual risks of pregnancy have not increased, our sensitivities toward what constitutes acceptable risk and good health has changed. 1500 years ago, pre-natal care may not have recognized the risk of fasting, or associated those risks with birth or health complications. Today, we know better. Should we take Chazal’s statement obligating pregnant and nursing women to fast as binding irrespective of these changes in medical knowledge / practice, or should we look at the statement as sensible in the given context of medical knowledge of 1500 years ago, but which may change over time? In other words, in lomdish terms, is the gemara a din or a metziyus -- is it a legal rule that absolutely binds all women to fast, or is the gemara simply a statement about what Chazal assumed to be the lack of health risks in fasting? A legal umdena seems to me to be far more inflexible than a medical one (and even there, I'm not sure).

What do you think?

23 comments:

  1. Barzilai10:45 AM

    Absurd.

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  2. Anonymous11:06 AM

    "1500 years ago, pre-natal care may not have recognized the risk of fasting, or associated those risks with birth or health complications. Today, we know better."

    Do we? On the contrary i understand that for healthy women there is no problem fasting.

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  3. My wife's ob gyns from when she had our kids always phrased it as "not recommended" - not a sakana, but a risk. I am not a doctor, so I don't know one way or the other - any ob-gyns in the readership who can elaborate?

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  4. and you know that I fasted tisha b'Av and Yom Kippur when pregnant or nursing and only skipped the one tisha b'Av that was a nidche 10 days after a c-section.

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  5. Barzilai1:44 PM

    The article really should have been headlined "Ikvesa Di'meshicha!" and cited the Mishna in the end of Sotah that in the time before Mashiach, "Chachmas Sofrim Tisrach."

    My mother, shetichyeh, happened to see the computer screen open to the ynet article. In her late eighties, prone to stomach ulcers, in dire need of pain medicine for arthritis, she would not dream of eating on Tish Ba'av. She agreed with the characterization of "brazenly independent".

    And as for his blithe psak that the psychologist should not let the husband know that his wife is not going to the mikva and not separating meat from milk, that's a wonderful and wise psak as well. Humble I would have thought about finding a circuitous way of at least putting the husband on guard. Or of having the psychologist tell his patient that what she was doing was terribly immoral and insisting that she either change her behavior or warn her husband. No such advice from him, though.

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  6. Anonymous3:33 PM

    "My wife's ob gyns from when she had our kids always phrased it as "not recommended" - not a sakana, but a risk. I am not a doctor, so I don't know one way or the other - any ob-gyns in the readership who can elaborate?"

    This is why you say we "Know" that fasting is bad for pregnant/nursing women?

    I don't think the statement from your doctor means much. Would your doctor recommend a healthy person, not pregnant or nursing, fast on a very hot day? W/o air conditioning as was the case till recent decades? Yet one can take steps to prevent dehydration in most cases. its the doctors job to be cautious when he has no data.

    Obviously, whole communities of pregnant/nursing women do fast with no ill effects, some fast on minor fast days too.

    This is from the yoetzet site:

    "There has been little study of the effect of fasting on breastfeeding. The only published article to date showed minimal biochemical changes in the milk and a small reversible decrease in milk supply on the day following a 24-hour fast. Thus, healthy women who are easily nursing healthy babies should fast the entire day."

    http://www.yoatzot.org/article.php?id=120

    The site also says that there is little data about pregnant women. There is some issue of pregnant women going into labor, but only when they are already at term.

    "The article really should have been headlined "Ikvesa Di'meshicha!"..."

    I'm surprised by the article.R Rabinovicz is reputed to be a big t"c so I would not pass judgement before seeing the original.

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  7. Anonymous5:50 PM

    Your wife's doctor carries more weight if he's a yerei shamayim.

    How do you give any credence to "rabbi" Rabinovitch?

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  8. Must every discussion of a controversial and admittedly problematic pesaq necessarily engender vicious personal attacks in the comment threads?

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  9. Anonymous6:58 AM

    Fasting when pregnant can be dangerous, even if you are not at term. I was 24 weeks pregnant last Yom Kippur and was told by my ob/gyn, who did realize the full weight of Yom Kippur, under no circumstances to fast. So I spoke to my rav and managed to do a technical fast - a half mouthful of water every 10 minutes, I believe, but I don't recall the exact time. That said, I am now nursing a 6-month old and plan to fast Tisha B'Av the traditional and optimal way. When I was pregnant it would have been a sakana for the baby, though, because fasting causes the body to produce the same hormone which causes contractions.

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  10. Rabbi Maroof, you're right. We should limit the criticism to things like "kimedumeh li she'hu chamor," as the Rashba said about the Bedek Habayis, or "ein lo mo'ach be'kadkado," as many rishonim said, or "im lamad, lo chazar, ve'im chazar, lo shimeish."
    I'm sorry, but I was meshameish several gedolei hador, and, while I am admittedly not even chometz ben yayin, I can confidently say, as you do, that the psak, and the posek, are both problematic.

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  11. There may well be a difference in terms of *who* is dishing out the criticism. In Bava Metziah 83b, both Rabbi Yehoshua ben Korcha and a fuller called Rabbi Eleazar beRabbi Shimon "chometz ben yayin," only the fuller was acting insolently.

    I do not know who "anonymous" is above, such that he should be questioning someone's rabbinic credentials on the basis of a surprising psak he does not like. (And which certainly appears to be against an explicit gemara.)

    As an aside, bli neder, tomorrow I plan on posting part 8 of my series of posts on fasting on the 17th of Tammuz, and the topic is exactly this psak of Rabbenu Tam, brought down in Hagahos Maimoniyos. And part of that post will be an explanation of just why this rather surprising psak may in fact be halachically sound.

    Kol Tuv,
    Josh

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  12. Barzilai12:17 PM

    I just recieved a letter that made clear that R Rabinowitz is far from an irresponsible posek. According to my correspondent, he and I apparently shared a great deal of our shimush, and he learned by my rebbi muvhak as well. I apologize for my intemperate and impetuous comments. I will, bli neder, try to find his teshuvos and see why he was mattir.

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  13. The teshuva, or at least an earlier incarnation of it, can be found in Tehumin, vol. 17.

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  14. Anonymous4:59 PM

    anonymous 6:58
    it goes without saying that if pregnancy is in any way problematic one should consult both with doctor and rav. however, i seriously doubt that fasting is usually dangerous or anything like it since the study done in israel showed otherwise, with the increase in women going to labor confined to women who were already at term and about to give birth. Again, i think it goes without saying that if there are any risk factors for mother or baby one asks shailas in consultation with doctors.

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  15. Anonymous5:49 PM

    going back to the study the study in fact found a DECREASE in women going into labor when they were not at term!

    But fasting may be dangerous for anyone who is at risk of premature delivery. However the study did not find risk for most women and only an increased likelihood of going into labor when people are at term.

    One thing that R Bliech points out in his article is that the climate in Jerusalem is such that one can get dehydrated without showing symptoms and that is dangerous So one has to be informed and take precautions, drink if dehydrated, talk to your doctor and rav about that.

    I'm wondering if these psakim from Israel are due to the increased danger of dehydration there, less likely to be air conditioning. etc?

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  16. anonymous:
    which study? perhaps there was more than one study? For example, I found this:

    http://jn.nutrition.org/cgi/content/abstract/133/5/1709S
    "Epidemiological evidence suggests that maternal psychosocial stress, strenuous physical activity and fasting are independent risk factors for preterm birth and low birth weight."

    At any rate, I updated my post to be clearer. (See here.) Thanks.

    Kol Tuv,
    Josh

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  17. Barzilai5:49 PM

    I have it on excellent authority that Rav Shteif used to tell the men who were leaving kinos to tell their wives, ibros imainikos, to go eat, Tisha Ba'av notwithstanding. Ayy, the Gemara? So maybe nishtaneh hateva. That is certainly possible. Ayy, then what about Yom Kippur? Maybe osei mizvah are not nizok.

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  18. I don't get it. Before you were up in arms over this ("absurd") psak, now you have it on authority that R' Shteif gave it an OK and all is good? The gemara is mechayeiv ubros u'meneikos; whether it's R' Shteif telling you otherwise or R' Rabinovich, either way you should have the same problem.

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