Rabbi Yehuda Finchas
Pikuach Nefesh for a Woman in Labor
Sandra was extremely nervous as her due date fell on Shabbat. “Rabbi, what do I do? How do I get to the hospital on Shabbat? Sammy must come with me – is that okay?”
In the last column, I explained that according to Sephardic poskim,pikuach nefesh (saving a life) should ideally be carried out by Jews rather than non-Jews. Whereas the Ashkenazi minhag is to use a non-Jew or to use a shinui (a modification of the usual practice) whenever possible, if this will not cause any delay or any endangerment to the patient.
ShulchanAruch‘s Ruling on a Yoledet
However, all agree that with a yoledet (a woman in labor), a shinui should be employed whenever possible. As ruled in the Shulchan Aruch (O.C. 330:1): “A woman in labor is considered like a choleh she-yesh bo sakana (a sick person whose life is in danger), and Shabbat should be desecrated for all her needs. One may summon an expert midwife from afar to deliver her baby for her, or even light a candle for her, even if she is blind. Nevertheless, whatever can be performed with a shinui should be done by using a shinui.”
Magid Mishnah’s Explanation
Hacham Ovadia, zt”l, (Hazon Ovadya, Shabbat Vol.3 p. 333) explains that this is based on the ruling of the Magid Mishnah (Hilchot Shabbat 2:11): From the Rambam’s language, it appears that a choleh she-yesh bo sakana does not require a shinui – only a yoledet does. The Rambam writes, “The rule is that Shabbat regarding a choleh she-yesh bo sakana is like a weekday in all matters.” The reason for this distinction between a yoledet and a choleh she-yesh bo sakana is because the labor pains of a yoledet are part of a natural process, and not even one in a thousand women dies in childbirth. Therefore, the Sages were stringent in requiring a shinui whenever possible for a yoledet, but they were not as stringent for a choleh.
When Is a Shinui Necessary?
Hacham Ovadia (Halachot Olam, Vol. 4, p. 140) explains that a shinui is only necessary when it will not cause any delay or endanger the woman or baby. If there is a risk, a shinui should not be employed. Therefore, when not urgent, it is preferable to go to the hospital with a non-Jewish driver. If this is not possible, a Jewish driver is permitted. Similarly, any preparations that can be made before Shabbat should be done before Shabbat (Hazon Ovadya, Shabbat, Vol. 3, p. 320). However, there is no need to arrange to sleep near the hospital before Shabbat (Halichot Olam, Vol. 4, p. 141).
Permitted Actions During Labor
Sammy can accompany Sandra to the hospital (Hazon Ovadya, ibid). In fact, he should accompany her even if she did not specifically request him to come (Yabia Omer, Vol. 9, OC 108, #179). This will provide her with yishuv hada’at (peace of mind). Even if violations of Shabbat are necessary, they may be permitted due to the principle of yesuvei da’ata – reassuring a woman in labor (Shulchan Aruch, O.C. 330). This is based on the Gemara (Shabbat 128)that allows for actions to calm and reassure a yoledet, ensuring that all her needs are addressed. For example, it may be permissible to switch on a light so that the medical staff can properly see what they are doing (this is allowed even if the woman is blind). Similarly, it is permissible to give her an epidural catheter and administer medications through it (Hazon Ovadya, ibid, p. 322).
Conclusion
In conclusion, a woman in labor is considered to be a case of pikuach nefesh, and Shabbat should be desecrated for all her needs. Sammy can certainly accompany Sandra to the hospital. However, whenever possible, any preparations that can be made before Shabbat should be completed in advance. Additionally, if it will not cause any delay or endangerment, actions should be performed with a shinui or by a non-Jew.Rabbi Yehuda Finchas is a recognized expert, lecturer, and author on Medical Halacha. He is the head of the Torat Habayit Medical Halacha Institute. His latest book is “Brain Death in Halacha and the Tower of Babel Syndrome.” To contact Rabbi Finchas, please email rabbi@torathabayit.com.