Guiding Couples Through Infertility

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sad woman This post originally appeared in February, 2010. I am republishing it today because Racheli Sprecher Frankel, whose talk I summarized below, is the mother of 16-year-old Naftali Frankel. Last Thursday, Naftali and two other young boys were hitching rides home when they were kidnapped by Hamas terrorists. Their whereabouts are unknown. Prayer services are being held around the country for the boys:
Yaacov Naftali ben Rachel 
Gilad Michael ben Bat Galim
Ayal ben Iris Tshura

Our hearts go out to Sprecher Frankel and to all of the families. We pray that the boys will be returned soon.

I’m continuing my report on the Kolech conference on fertility. The next round addressed aspects of infertility treatment. Those of you offended by Ir-Shai’s statements can breathe easy for this post.

Racheli Sprecher Frankel is a mother of seven from Nof Ayalon, educated at Matan and Nishmat, and a Yoetzet Halacha (an advisor on matters related to Jewish law, especially marriage). She serves as a —œhalachic counselor— for infertile couples.

Sprecher addressed the “inter-halachic” issues surrounding fertility. In other words, unlike Ir-Shai, she focused on how the couples she counsels observe Jewish law in the context of infertility. She stressed that no one pressures couples to come to her or to ask halachic questions. Many couples don’t ask.

She pointed out that Jewish law stresses the importance of not offending people or making them feel bad. She warned against making sensitive remarks to couples without children or who have not had them in a few years, asking when they are going to have (another) baby.

Sprecher-Frankel was the only speaker to address criticism of “Puah” directly. She said that as an institution, Puah has done extremely important work in addressing the issues related to infertility and Jewish law. It has become a monopoly, as it were, and like any monopoly, it invites controversy and criticism from people who would prefer a different approach. But first and foremost Puah should be recognized for its contribution to the discussion, and for the many couples it has helped over the years.

Her job as an adviser to infertile religious couples consists of four main areas:

  1. Hilchot nidah. Fertility treatment causes changes in the woman’s menstrual cycle, and this affects when the woman can go to the mikveh and have relations with her husband.
  2. Fertility issues related to halacha. Classic halachic infertility is when a woman ovulates before she goes to the mikveh, precluding her chances of pregnancy. Sprecher-Frankel stressed that this is not nearly as common as many people think.
  3. Technology. Which types of technology are permitted for religious couples, and with what accommodations?
  4. Spiritual guidance. Infertility treatment leads to questions and crises of different sorts, including religious.

Sprecher-Frankel gave an example of an unusual halachic dilemma, a “classic Nishmat story.” A woman in her 40s, recently married, had stopped ovulating. With treatment she succeeded in stimulating an ovulation, but it occurred before she would be able to get to the mikveh. She called to ask what she could do to mitigate the situation, since she was not willing to give up on what was likely to be her only chance at biological motherhood. An intra-uterine insemination (IUI) was quickly arranged for her. Later Rabbi Cherlow said he would have ruled that she go to the mikveh earlier, for a more “natural” conception.

She also pointed out an important issue that can cause stress among infertile couples. The husband may ask his rabbi whether a treatment is permitted. The wife will only learn about this secondhand, and she might not get the whole picture. Also, the answer could change once more time has passed, but she doesn’t have access to the rabbi to ask. A halachic counselor can help in such a situation.

Related posts:

Are Rabbis Too Strict about Abortion and Birth Control?

Infertility Art: Maybe This Month

Body and Soul in Fertility, Halacha and Science

Photo credit: Eggybird

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Comments

  1. “Like”
    I’m sorry I missed this conference. It sounds very interesting.
    {I’m glad not everyone in Kolech is confrontational. Somehow even when they are right (and they are often right) some members of Kolech come off so shrill.}
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  2. Nishmat’s work is avodat kodesh.
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  3. Good for her that she mentioned the issue of people asking about when a couple is going to have (another) child. It’s a major cause of stress for people and it’s soooo easy to avoid.

    I’m glad she helps couples to make sure that both husband and wife get to discuss the halachik issues. But, every woman should know that she should absolutely have access to a Rav. There is almost never a good reason for a man to talk to the Rav to the exclusion of his wife, or for a woman not to talk to a Rav herself. If using a Yoetzet helps a woman deal with the Halachik issues, and engage witht he Rav, then good. But, if a Yoetzet is not available or useful in a particular case, there should be nothing to keep a woman from moving forward.

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  4. I understand that there’s another group that does work like Puah’s. A friend told me about it. Thank G-d I’m not an expert in these matters. B”H, there are many families blessed with children because of their great work.
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  5. I know so many women who suffered from Halachik Infertility – I can’t imagine it is such a small phenomenon. Almost all these women took hormones to lengthen their cycles :-(

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    • Unless you really know what their diagnosis was, you really can’t make that statement. What many people don’t realize is that many doctors, especially OBs without expertise, throw hormones like clomid at women without doing any testing. I cannot tell you how many women I know of who were told that their problem was the they ovulated too early and that clomid would take care of the problem, only to find out after they had moved to a specialist that they weren’t ovulating altogether. Why didn’t they know? Because they were menstruating, and the doctor had never bothered to monitor a cycle. And of course, even if your friend tells you that she took hormones to lengthen the cycle, you don’t know the whole story.

      And then there are the women who assume that they are assur when they aren’t, and that messes things up, as well. That’s why one of the first pieces of halachik advice given to women who bleed more than 5 days is “Bring ANYTHING that isn’t fire engine red to the Rov – you may be making yourself crazy for nothing.”

      Yes, Halachik infertility does exist, but it’s not as common as people think.

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      • observer, thanks for that, I think you may be right.

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      • This advice isn’t just for women who bleed for more than five days. Bleeding at “other times of the month” can also wreak havoc with couples going through fertility treatments, and there are non-hormonal solutions that only a competent rav can “prescribe”. I don’t want to get into details because every women needs to get the advice suitable for her specific situation, but there’s much more to the matter than bringing anything that’s not “fire engine red” to a rav.

        You brought up another important point: Go to a specialist! I’m sure there are many expert OB’s that aren’t experts in fertility treatment.

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        • –Bleeding at “other times of the month” can also wreak havoc with couples going through fertility treatments, and there are non-hormonal solutions that only a competent rav can “prescribe”. –

          Absolutely! And, “go to a knowledgeable Rov” is the first piece of Halachik advice (that should be) given to any woman with mid-month spotting.

          The halachik bottom line with these issues is that you need to talk to a very knowledgeable Rov about these issues. Making assumptions is a recipe for trouble.

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  6. A Walker in Jerusalem says:

    Perhaps the real issue regarding halachic infertility is a lack of clarity during pre-wedding instruction.

    Are madrichot not driving home to their students that what looks like a 6-day “bleed,” might not be?

    Are women being advised to ““Bring ANYTHING that isn’t fire engine red to the Rov” only once they’ve encountered trouble conceiving, or are the madrichot telling them this before the wedding?

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    • I know someone whose rav told them that stains were not okay. They moved and found a different rav, then she had a baby.

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    • Some are telling their students, others, apparently not so much. And all too often, even when they HAVE been told in very strong and clear terms, it just doesn’t always get through for some reason.

      My daughter told me that when they talked to the Rov about something, fairly early on (so that wasn’t an issue), the Rov told them that they should NEVER hesitate to have something checked, and one of the things he pointed out was that this could have a negative impact on getting pregnant.

      He also told them that one of the reasons that Rabbanim do not charge for dealing with these shailos is because they don’t ever want there to be an excuse for such a shaila not being asked. I found that very interesting.

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  7. Frankel has tapped into a deep truth: Sometimes people with kids can be cruel to the infertile without even knowing it. All those questions and comments about having kids can really hurt. Frankel sounds like a good counselor.
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