Dr. Hanna Katan: Large Families,Yes. Demanding Careers for Mothers, No.

Ynet interviews Dr. Hanna Katan, religious Zionist mother of thirteen and gynecologist with a sub-specialty in fertility. Katan considers a large family to be the ideal and has served on a committe to encourage secular mothers to have more babies. Her own mother raised eight children and served as a role model for her.

When asked about combining a career with a large family, Katan responds:

“I wouldn’t recommend it. The list of priorities was always clear to me: My family comes before my career. When my daughter expressed an interest in medicine, I suggested that she study nursing and become a nurse. It’s very difficult having such a demanding profession as a woman: The unending duties on Shabbat and on holidays as well, the kindergarten birthday parties I missed.

She mentions that she did not advise any of her children, male or female, to study medicine.

Katan disagrees with the stereotype of an unhealthy, poor mother whose many children don’t get enough attention.  According to Katan, studies that show disadvantages among children of large families are based on populations without the resources that Orthodox Jewish families enjoy. [My husband read somewhere that modern Orthodox Jews and fundamentalist Christians are the only educated, socio-economically stable population to raise large families.]

As a fertility specialist, Katan has helped families who struggled to get pregnant with their ninth child. When asked about lack of attention, she responds, “There is extra attention from the older siblings which smaller families lack, and it’s as important.”

For me, spacing of children is more of an issue than the number. Toddlers need their parents (ideally their mothers, if she is the primary caregiver) as much as they did when they were newborns, if not more. Couples who plan to try and conceive before their baby is a year or so need very strong support.  Relationships with older siblings are wonderful but babies and toddlers are still the parents’ primary responsibility.

Of course, each family is different and spacing of children is only one factor in the success of a family.

Related posts:

Child Spacing Part 1: When Does Chinuch Begin

Child Spacing Part 2: Fertility and Parenting Styles

How Do Large Families Manage? Meet Tal and Talia, parents to a fictionalized large family.

Thanks to Jameel for sending the link.


  1. I once asked a mother I met in Tsfat how it felt to have 12 children. She explained that when her first baby was one, she knew how to raise a newborn. When her first baby was two and her second baby was one, she knew how to raise a two and one year old. And so on.

    I’m not sure I agree with her that sibling attention, even of a loving older sibling, is as important as that of the parent/adult primary caregiver.

    The idea of this many children doesn’t make sense for me as I practice attachment parenting which gives the baby the absolute maximum in parental attention, but I’m very interested in how others do it. Off to read your links on child spacing.

    ~ Maya

  2. I’m not into attachment parenting, personally, but my children have been very much into attachment babying (even the bottle-fed one) That is, both kids spent more than 1/3 of their first three months attached to a parent’s chest with a baby carrier of some sort, and the 4 month old shows no sign of that need ebbing.

    I’ve found that children under 2 need pretty much constant 1-on-1 supervision (my older one will be 2 in June.) As a result, if you have 2 under 2, you’re likely be stretching yourself thin. Then again, I know twin moms who do fine, so I could be totally wrong.

  3. mominisrael says

    Maya, thanks for your comment. If you read those other posts you know what I think. Even if siblings are as wonderful as she says, teens are not around all day and night.
    TC, I think that’s generally true. But I’ve met many mothers who were thrilled with closely spaced kids.

  4. Generally, spacing siblings is considered an important part of AP for the reasons you mention. I know that I couldn’t be a good mother to closely bunched children– or more precisely, it would be very difficult for me. Does that mean that someone else couldn’t? I don’t think it’s fair for me to make that judgment.

    I thought this point was interesting about multipara being beneficial for health as many of the Orthodox women I know who have large families have health complications along the way that have affected future fertility.

    YNET: Doesn’t a prolific mother pay a price in terms of her health? // “Just the opposite. Being a multipara contributed greatly to a woman’s body. There are lower rates of uterine, ovarian and breast cancer among prolific mothers. In addition, being a multipara testifies that a woman is healthier, and points to a longer cell life.”

    She then goes on to say that she has clients with 8 children “crying… to have their 9th.” I want to say that if your body is telling you to stop, then you should stop, but on the other hand, I also feel that it would be unfair to say that to someone suffering from secondary infertility, so I don’t know.

  5. mominisrael says

    I don’t claim to be an expert but I think the same thing applies to mothers. In other words, I suspect that a large number of pregnancies will not lead to problems, but close pregnancies might. Keep in mind that all pregnancies can lead to complications (beyond the pregnancy/birth itself), so the more you have, the more likely something will go wrong. In other words are the chances of something going wrong with number 4 greater than with number 1, factoring out age? I don’t think so, but the staff at the hospital where I gave birth last time was sure that anything after 5 involved serious danger.

  6. My grandfather was a doctor, and I remember telling him one day when I was in my teenage years that I wanted to be a neurosurgeon. He replied that being a doctor is not a suitable job for a woman, because she has to take care of the kids and home, and medicine is too demanding.
    Well, I was pretty mad at him. I thought he was old-fashioned and chauvinistic.

    Now that I have 4 kids and a job, I understand exactly what he meant, and I agree with Dr. Hanna Katan’s view of medicine as a profession for mothers. Having a family means work. It takes time and effort. It cannot be easy to do your duty by both your patients and your children.

    Note that my husband cooks and cleans and takes care of the kids equally – actually more than equally!

    I agree that older siblings can contribute a lot and their attention is valuable to the younger siblings. However, I do not think it is fair to turn the older siblings into little parents for the younger siblings. They deserve a childhood, too. It is important not to drop all of the parenting work on them.

  7. “The staff at the hospital where I gave birth last time was sure that anything after 5 involved serious danger.”

    What are your thoughts on that?

  8. mominisrael says

    I gave birth in Tel Aviv. I heard that in Russia, they think that third births are dangerous. In Shaarei Tzedek in Jerusalem I doubt they are freaked out by number twenty.

  9. Maya – not an expert here, but 4 of my siblings have 6 or more kids. 3 of the women take excellent care of themselves during and after pregnancy, and seem to be in fine health both during pregnancy and afterward – they eat a lot of protein, take vitamins, etc.

    The 4th had very hard pregnancies, and I suspect they may have damaged her health.

    I have so-so pregnancies and am going to try to build up my strength very seriously before I have another go at it.

    I’m not a doctor, so… ymmv and all that. I think that a woman who has good pregnancies and good pre and post natal care can go through a lot of pregnancies safely without damaging her health.

  10. mominisrael says

    Does that answer your question, Maya?
    Victoria, thanks for sharing that story. As for siblings, there is a lot of middle ground between not helping at all and becoming mini-parents.

  11. It was interesting, but I was asking less about the pregnancies themselves than your take on what the staff was saying and why.

    In the Negev, no one said anything about the number of pregnancies– although perhaps they would if it wasn’t my first– but there was a tremendous emphasis on waiting a year for your body to recuperate.

  12. mominisrael says

    They wouldn’t let me give birth in the “natural birthing room” because it was my 6th. And while I was waiting the long hours for my contractions to catch up to my ruptured membranes (with meconium), while they pushed pitocin on me mercilessly (the doctor, not the midwives) they had a lot of opportunities to remind me that this was my 6th baby. They must have mentioned it half a dozen times.

  13. mominisrael says

    Oh, and I can’t recall any health professional telling me to wait a year before getting pregnant again, or bringing up the issue at all.

  14. “…While they pushed pitocin on me mercilessly (the doctor, not the midwives) they had a lot of opportunities to remind me that this was my 6th baby. They must have mentioned it half a dozen times.”

    Just in case you forgot. Lovely.

  15. Does anyone have any thoughts on pregnancy at45?

  16. Dr Hava-Yael Schreiber says

    Fully agree with Dr Hana Katan: since both being a mother and being a doctor are very demanding if you want to do it right, they are hardly compatible… It is possible though but then exhausting and with a lot of self-sacrifice and still remaining doubts and guilt feelings (I know since I am a friend and collegue of hers)
    About grand multiparas (women with more than 5 children) each case is individual: I have seen patients with 12 children and perfect health, well taken care of bodies, nice and happy families, all OK while some with 3 children are devastated bodies with zillion pregnancy-related complications. Here too we are not born equal, some are “made for having children” for some others it is excruciating to either get pregnant or keep the pregnancy or deliver…. As a rule one of the major risk factor is age (and when it is your 12th you are usually over 40) and obesity (diabetes, hypertension and need for Cesarean then increase tremendously… But a first mother at the age of 45 is also high risk pregnancy and delivery.
    As for the mother of 8 who cries for a 9th I think there is a lot of peer pressure in the religious circles and it is sad that a woman should feel she is worth something only if pregnant…. In any case she should look at the (more than) half glass full (8 kids) rather than the empty part (her “need for a 9th)
    Dr Hava-Yael Schreiber

  17. mominisrael says

    Dr. Schreiber,
    Thanks for stopping by and sharing your perspective. No one has mentioned gallstones,which are more common in ‘grand multiparas.’

  18. This is an interesting thread. I think that not only is each woman different, but that each pregnancy is different! After 6 vaginal births I ended up with placenta previa and a transverse position of the baby. The previa resolved a week before my due-date, and the baby assumed the head-down position. But when I came to deliver, he had returned to transverse. After an external version, he went into distress and I ended up with an emergency c-section (6 minutes total from leaving the room to the baby’s birth).
    As far as attachment parenting, not only do my husband and I ‘wear’ the baby, but the 20 year old son, the 17 year old daughter, and so on. The baby gets LOTS of touch and comfort — certainly more than #3 did!
    I don’t think that peer pressure is pushing a woman of 8 to wish for 9. After 6 I had a serious miscarriage at 20+ weeks, and mourned that loss. People are not widgets, so just because you have 6 doesn’t mean you ‘collected the whole set.’ If you really believe that the presence of a new person in your life is G-dly, and a gift, then you do want more (even if there are circumstances that make that impossible).

  19. Dr Hava-Yael Schreiber says

    About “the woman with 8 children crying for her 9th”, there is a difference between “being happy to have another one= not use birth control” and “crying= seeking fertiltiy treatments!” which means eventually getting risk for multiple pregnancy and heavy hormonal treatments, also not devoided of risks…. I see women who are busy running for blood tests and ultra-sounds for “fertility” when they have 7 kids at home and their last one is only 2 yo, I personally think it is crazy!!! Maybe it is not peer pressure but then it is psychologically unbalanced.
    I repeat that I am all for ladies for have many kids naturally and all is fine, my record is a patient with 17 children, not one miscarriage, she was looking great and well kept, and she sounded surprised that I did not scream at her like most other doctors “it is too much! you have to stop!” she was 45 yo and in perfect health, the only problem is that last kid was Down Sd but she handled that as well….

  20. Dr Hava-Yael Schreiber says

    I am sorry I did not re-read the last part of your E-mail, Lea
    and I sincerely understand how difficult a loss like a late miscarriage is
    This is one of the circumstances where a woman often wants a “tikun” and tries to have another child afterwards, even if just for “the victory of life over death”
    Nobody is trying to “limit” you or another woman, just saying that one should be happy with their lot if it sometimes stops at 8 and not 9 for physiological reasons (like age…) and not try to force things (with fertility treatments) Even women after a whole bunch of C section are allowed to have more if all is fine on the health level. Just not endanger the mother for that 9th baby!

  21. If you want to have a large family leave the spacing up to HaShem. Only he knows if and when you will be able to become pregnant again.


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