Is a Woman in Labor a Niddah?

In the last post, I listed several points that were assumed in the formulation of the restrictions that many Halachic authorities placed upon the husband in the delivery room. The first point was that a woman in labor has the status of a Niddah, and that because of this the husband and wife are forbidden to touch each other. So we must start our series by explaining the origins of the Halacha that a woman in labor is considered a Niddah, then we can analyze if indeed this assumption is necessarily true.

The Torah states:

Speak to the Israelite people thus: When a woman at childbirth bears a male, she shall be unclean seven days; she shall be unclean as at the time of her menstrual infirmity. On the eighth day the flesh of his foreskin shall be circumcised. She shall remain in a state of blood purification for thirty-three days: she shall not touch any consecrated thing, nor enter the sanctuary until her period of purification is completed. If she bears a female, she shall be unclean two weeks as during her menstruation, and she shall remain in a state of blood purification for sixty-six days. (Leviticus12:2-5)

From here we learn that a woman in childbirth has the same status in terms of "uncleanliness" as a woman who menstruates.  For the following verse we learn that a woman who is menstruating is prohibited to have sexual intercourse with her husband:

Do not come near a woman during her period of uncleanness to uncover her nakedness. (Leviticus 18:19)

The context of the verse I just quoted is referring to sexual intercourse, which the Torah calls "coming near" as a euphemism for intercourse.  The fact that the Torah uses the terminology of "coming near" instead of more explicit language as used in the other verses in the same chapter will be of importance later in our discussion.  Be that as it may, we now have established that a woman who gives birth is prohibited to have intercourse with her husband until a certain period of time is completed and she immerses in a mikveh.

At what point during childbirth does the Niddah status begin? This is very unclear from the verses themselves.  From the simple meaning of the verses it would seem that this "uncleanliness" only begins after she "bears a male" or "bears a female" meaning after the baby is born.  It is by no means clear from the verses themselves that she becomes "unclean" during labor prior to the actual birth.  Even if she has bleeding during labor prior to birth, which almost always is the case, from the verses themselves we do not know if this bleeding would render her a Niddah.  I say this because we see in the same chapter that not all blood associated with childbirth is considered "unclean" menstrual blood.  Since this is not menstrual blood, we do not know from these verses when exactly she becomes a Niddah.  For this we have to rely upon the Talmud and further rabbinic explanations.

In the Talmud Tractate Niddah 21a, the Talmud makes several points clear (please forgive me for not bringing the direct quotes here as I usually do.  The discussion is several pages long and it would be quite tedious.  Feel free to study it yourself)

1. The Talmud records a debate among the rabbis as to whether or not it is possible for the uterus to "open" and discharge some tissue (or a baby!), and there be no bleeding accompanying that discharge
2. In the case of an actual birth, whether it is a live birth or tragically a miscarriage or stillbirth, the woman is considered a Niddah regardless of whether or not there is bleeding. Some Rabbis say that this is because it is impossible to have the uterus open and there be something exiting the uterus without blood.  Other Rabbis say that it is because a woman is "impure" due to a birth even without blood.

It is thus inferred that there are two ways to understand the verses quoted that declare that a woman who delivers a baby is "impure" like a Niddah.
 
The first group of rabbis understanding is that the "uncleanliness" is a result of bleeding. They apply the rule that "There is no opening of the uterus without blood".  Even if you don't see any blood, she is still "impure". Though this is virtually impossible in a full-term delivery, it could apply in cases where the uterus opens to deliver other types of tissue such as Fibroids or polyps.  According to these authorities, the time that the women becomes a Niddah in childbirth would be the point when the uterus opens, or when she has obvious uterine bleeding.  Exactly when is the time that the "uterus opens is unclear, and we will have to search the sources to clarify this. 

The second group of rabbis argue that it is possible to have the "uterus open without bleeding".  According to these rabbis, the "impurity" of the childbearing woman has nothing to do with blood.  They hold that it is the birth itself that causes this impurity, which would only apply to the birth of an actual child, whether alive of stillborn.  But it would not apply to passing other types of tissue as long as there is no blood.  Practically speaking, according to the second group of Rabbis, if there is blood during labor, the woman would be considered a niddah if the blood came from inside the uterus.  However, until there is bleeding, even if she was in labor, she would not be "impure" until the actual birth occurs.

The Halacha has been determined on the side of the Talmudic Rabbis who hold of the first explanation (See Maggid Mishna on Maimonides Mishna Torah Laws of Forbidden Interourse 5:13 for full explanation of why we decide according to this opinion).  That it is the blood of the delivery that causes the "impurity".  Once the uterus opens, she is assumed to have blood even if we don't see it, because "there is no opening of the uterus without blood". So, the question of when a woman has the status of Niddah is dependent upon exactly when this event of "opening of the uterus" is assumed to have occurred. 

Interestingly, the question of exactly when the process of labor begins as it relates to exactly when she becomes prohibited to her husband is not discussed in the Talmud at all.  The "Opening of the Womb" is discussed, but only as it relates to two other Halachic issues.  In order to make sense out of this, one must understand that there are three Halachic issues related to the beginning of the labor process. The three issues are Ritual impurity, Desecration of Shabbat, and Niddah status. The first issue is related to ritual impurity.  this is discussed in the Mishna in Oholot:

If a woman was having great difficulty giving birth and they carried her out from one house to another, the first house is doubtfully unclean and the second is certainly unclean. Rabbi Judah said: When is this so? When she is carried out [supported] by the armpits, but if she was able to walk, the first house remains clean, for after the womb has been opened there is no possibility of walking, For stillborn children are not [deemed to have] opened the womb until they present a head rounded like a spindle-knob. (Mishna Oholot 7:4)

This issue of ritual impurity has little relevance in practical Halacha today, as we no longer are concerned about ritual impurity after the destruction of the temple. However, if one assumes that ritual impurity begins at the same time as the Niddah prohibition between the couple begins, then one would derive from this Mishna that as soon as a woman is in significant pain (and needs help to walk) that would be the time she would be prohibited to her husband as a Niddah. Rabbi Shimon ben Avraham of Sens (1150-1230, also known as the Rash MiShantz) compares this Mishna to another discussion in the Talmud Shabbat.  He points out that they seem to contradict one another regarding when this moment of the "opening of the womb" is. The following Gemara is discussing at what point a woman in labor is considered in a situation of life-threatening risk for whom the desecration of Shabbat would be permitted.

With regard to the matter of the open womb, the Gemara asks: From when is it considered that the opening of the womb has begun? Abaye says: It begins from when the woman sits on the travailing chair. Rav Huna, son of Rav Yehoshua, said: It begins from when the blood flows and descends; and others say when her friends need to carry her by her arms, as she can no longer walk on her own. (Shabbat 129:a)

So here we have two different explanations for when the "womb opens" though the context is very different. The context here is regarding the laws of Shabbat and being allowed to violate the shabbat for her.  If we assume that the time of "the opening of the womb is the same for all three categories, we then have to reconcile which is of these opinions is authoritative.

It is important to explain the the ritual impurity being discussed in Oholot is the impurity that the deceased body of the stillborn baby would impart to the house within which it is born.  As long as it is within the woman's body, it would be considered a "Tumah Belu'ah" - an impurity contained within her body and as such a house in which the woman was present would not be "impure".  As soon as the "womb is open" though, then the corpse would be exposed to the house and the entire house and its' contents would become ritually impure.  In Oholot, we are not discussing the "impurity" associated with Niddah status.  That impurity would indeed coincide with the onset of the contact restrictions between husband and wife.  Thus we are discussing three completely separate areas of Halacha: Ritual impurity, Niddah, and Shabbat.

However, it is not clear that the time that a woman is considered in a life-threatening situation and the time that she becomes a Niddah is necessarily the same moment.  They may be different points in time even though the Talmud uses the same terminology of "the opening of the womb".  Some later authorities seem to make the assumption that in all three of these categories of Halacha: ritual impurity; Shabbat desecration; and Niddah status; that the moment of the start of labor is the same.  This seems to have been the underlying assumption of the Rash MiShantz when he asked why the Mishna in Oholot was contradicted by the amoraim in Shabbat. 

This assumption seems reasonable enough, except that at least one of the opinions regarding the "opening of the womb" on Shabbat is when the bleeding starts.  On the other hand, when it comes to Niddah status, we know that it will start even without seeing any bleeding at all. We described above in Niddah 21a above that even without bleeding, we assume that there is always blood even if we don’t see it as soon as the womb "opens".  This leaves us with some mind-bending cyclical logic.  When does the "womb open" = when the bleeding starts.  When do we assume that bleeding starts even if we don't see it = when the womb opens.  Round and round we go.

One way out is to assume that the criteria for shabbat are completely different than the criteria for Niddah status. However, the accepted halachic norm has been to assume otherwise. Indeed, Rabbi Elhanan Ashkenazi (from late 18th to early 19th century) attempts answer the seeming contradiction raised by the Rash MiShantz between the Gemara in Shabbat and the Mishna in Oholot by explaining that regarding ritual impurity, the womb must be open a significant amount, however regarding violating shabbat, the time from when we are allowed to violate Shabbat is much earlier, even when the womb is "only open a little bit" (my translation):

That which we said in the Mishna (in Oholot) that the opening of the womb is only from when she can no longer walk on her own, that is only when the womb is open a significant amount which is required for her to be ritually impure, However, even a small opening occurs before she is unable to walk, and therefore regarding Shabbat and danger to life all of those Amoraim (Talmudic Rabbis) ion Tractate Shabbat felt that we can violate the Shabbat as soon as the womb begins to open even if it is only open a small amount, she is still approaching birth (and is in danger) and therefore there is no contradiction (with the Mishna in Oholot) and therefore the same rule would apply regarding her Niddah status and the husband must be careful (from touching her) as soon as the womb opens even a little unless it turns out that the labor was false ...(Sidrei tahara 194:25)

While the above may seem a bit obscure, it is actually very important.  For reasons which he does not explain at all, Rabbi Ashkenazi has just explicitly done two things.  First, he stated that "opening of the womb" is not universally the same event. For the purpose of determining ritual impurity it is a different event than it is when determining the laws of Shabbat.  This makes perfect sense.  But then he states clearly that the laws of the "open womb" on Shabbat are exactly the same as the laws for when the husband may no longer touch his wife.  He offers no explanation as to why he made this assumption.  How did he know that? Maybe just like the "opening of the womb" is determined differently for ritual impurity than it is for Shabbat desecration, it might also be determined differently as it relates to Niddah status?  One could easily make a very logical argument that regarding shabbat, one should be allowed to violate shabbat at any question of the possibility of labor, even in the very beginning stages, while regarding Niddah status, maybe it occurs much later?

Nonetheless, the words of Rabbi Ashkenazi became standard in the subsequent Halachic literature.  Most influentially we find this in Iggerot Moshe Yoreh Deah 2:75, and in other modern Poskim.  Thus, according to Rabbi Feinstein, the moment she feels labor pains, is the moment she is prohibited.  Other Rabbis are more lenient and say that it is only when she starts to have bleeding, or is fully dilated (which they equate with "sitting on the birth stool" to push the baby out), or when she is in so much pain that she requires help to walk.

In truth, since the overwhelming majority of women have some bleeding even in the early stages of labor, the other two criteria of not being able to walk on her own or being fully dilated are rarely relevant.  We have now explained the halachic basis for the current halachic guidance that a woman in labor is a Niddah.  This is what we saw reflected on the yoatzot website, and what appears in most of the modern halachic literature. Exactly when it begins is a bit of a Halachic moving target, but we've done the best we can to explain the options available in the current literature. The same point in time that the Gemara in Shabbat determined she was in labor regarding the allowance to desecrate Shabbat for her, is the same point at which she becomes a Niddah.

I would like to suggest a potential alternative based on the same sources, but coming to a very different conclusion. The following logical steps are listed in chronological order, using the sources that we have quoted so far. However, these steps lead us in another direction completely:

1. The Mishna and the subsequent Talmudic discussion that began in Niddah 21a gave us two alternative understandings of the biblical teaching that a woman that has a child has the status of Niddah
2. The first understanding was that the birth itself and not the blood is what renders her a Niddah, and the second understanding was that it is the blood that renders the woman a Niddah, and that even if we don't see blood, there is always blood when "the womb opens". The Halacha was determined by the second approach
3. The "opening of the womb" for shabbat purposes is determined by when the woman is in danger, and all agree that this is the moment she begins having labor pains or even if there is any doubt about her status.  However, let us assume for a moment, unlike Rabbi Ashkenazi, that the "opening of the womb" regarding Niddah status is not the same as it is for Shabbat.
4. The Talmud in Niddah from which we derive the idea that delivery = blood even if we do not see any blood is discussing cases where a woman passes any sort of tissue, even a piece of "flesh" (likely a polyp or fibroid).  This tissue was almost certainly only noticed when she actually passed the tissue.  In other words, the application of the "opening of the womb always has blood" law only happened after the delivery, and the Niddah status did not start until it passed out of her body.  
5. Taking all of the above into account, it is quite reasonable to assume that the "opening of the womb" in Niddah 21 also refers to the actual delivery of the baby as the start of the Niddah status, not the onset of labor
6. The bleeding that occurs during labor is almost always bleeding from the dilation of the cervix and not uterine blood.  In fact, uterine bleeding, which is the blood that the Talmud is referring to when it states the rule of "there is no opening of the womb without blood" does not usually start until after delivery of the baby when the placenta separates.  In fact, bleeding from the uterus during labor can be a sign of a problem called an abruption which can be dangerous, and certainly is not the norm.
7. Bleeding from the cervix, most Halachic decisors agree is not considered Niddah blood, but rather has the status of "Dam Makkah" - the blood of a wound.  This is somewhat debatable, but most Halachic decisors rely on this assumption if a woman bleeds after a doctor checks her cervix before labor or strips the membranes or other interventions than can result in cervical bleeding. (Feel free to ask me for sources offline or in the comments regarding the assertion I just made regarding cervical bleeding)
8. If you follow my logic outlined in steps 1 through 7 above, a woman in labor is not a Niddah until the delivery of the baby.  Even if she has bleeding, it can be assumed to be coming from the cervix.  Bleeding from cervical dilation is simply not Niddah blood as it is not uterine in origin. Only after the delivery do we apply the rule that any opening of the womb necessarily has bleeding.  In fact, I can tell you from my extensive medical knowledge and experience, that this is exactly when the uterine bleeding typically begins.  As soon as the baby is born.

My arguments above are all well-established from the biblical verses, the Talmudic discussions, and the later rabbinic authorities. I only needed to make one jump that was not documented in the halachic literature.  Rabbi Ashkenazi explained that the idea "the opening of the womb" is not necessarily the same for the laws of ritual purity and the laws of shabbat.  He stated, without citing any sources, that the "opening of the womb" is the same concept for shabbat and for Niddah.  I argue, based on scientific understanding of the process of birth, and based on the context of the Gemara in Niddah, and based on simple logic, that this is not correct.  The timing of "the opening of the womb" for Hilchot Niddah is not the same as it is for violating shabbat.  So according to me, the idea that a woman in labor is a Niddah is simply incorrect.  A woman that just had a baby though, as the Torah clearly states, is a Niddah.

There is an indicator that I may be correct about the assertion I just made. The earlier halachic authorities, when they describe the law that a woman who gives birth has the status of a Niddah, simply do not discuss at what time during labor she gets the status of a Niddah.  The Shulchan Aruch, and the Tur in the beginning of chapter 194 of Yoreh De'ah simply state that a woman who had a baby is a Niddah.  The Rambam does not discuss exactly when during labor she is prohibited to her husband, and the rishonim who explain the gemara in Niddah also do not discuss this question. This discussion only began with some of the commentaries on the Shulchan Aruch. There is a reason that Rabbi Feinstein's source for the timing of the onset of Niddah status in labor was from an 18th century Posek and not a Rishon.  The reason is because the rishonim do not deal with this question at all. Perhaps this is because this question was irrelevant to the earlier Halachic decisors?  Perhaps it is because she is not a Niddah until the birth?

I know that the absence of evidence is not the same as the evidence of absence, but it certainly seems quite plausible.
 
We now need to move on to the next step.  The yoatzot website, after concluding that a woman in labor is indeed a Niddah, stated that the couple are therefore not allowed to have physical contact.  That will be the subject of our next post.

Addendum:

After publishing this post, I thought of a clear proof for my argument above, so I am adding it here.  I argued that "the opening of the womb" as it regards Hilchot Niddah is the time of delivery of the baby, and not the onset of labor pains or bleeding.  It is pretty clear from the Rambam that this is the case.  The Rambam states as follows (my translation):

If the child becomes broken apart (lit. "cut up") inside her womb and delivers piece by piece, whether it comes out in order of the limbs like feet first then thighs etc, or whether it comes out in random order, she is not considered impure as it regards the impurity of a childbearing woman until most of the child has exited her body. once the head comes out, that is considered most of the body....(Rambam Hilchot Issurei Biah 10:6-7)

The Rambam here is stating as clear as day, black on white, that she is not a Niddah until either the baby's head or most of the body has delivered.  It is inconceivable that she hasn't been going through a process of labor prior to the delivery of this baby.  Clearly despite having been in labor for a while, she is still not a Niddah until the delivery.  This is clear proof that the Rishonim understood that "Tumat Leydah" the impurity associated with childbirth, does not begin until after the child is born.  The "opening of the womb", as it seemed clear from the Gemara in Niddah as we argued above, is referring to the actual passage of tissue or the baby.  It is not referring to the onset of labor.