Just for You: The PUAHCare Article Series. From the files of a PUAH rabbinic counselor. Because your fertility journey is so much more than a medical experience.

(Courtesy of PUAH) To abort, or not to abort? As a PUAH rabbinic counselor, this is one of the most difficult questions I’m faced with.

A woman calls me, crying that the ultrasound showed her baby will be severely handicapped. The doctors are recommending abortion. What should she do?

From a halachic perspective, this question is not always black and white. There are certain extreme circumstances where Halacha does allow for aborting a pregnancy. In such cases I turn to the gedolei haposkim for help.

When Yael first called me with this question, I didn’t think hers would be one of those complicated cases. A 35-year-old woman from up north, she told me that she’d just returned from her anatomical ultrasound where the doctor discovered a serious heart defect.

“He said that the defect is correctable, but that it would involve a very complicated surgery,” she said. “The doctor recommended I consider aborting.”

I was surprised at this doctor, and told her, with great sensitivity of course, that there is no halachic justification for abortion in this case. With this surgery, the baby had a 90% chance of complete recovery.

Yael and her husband decided to go ahead with the pregnancy.

Then, in her 29th week, Yael called again. This time, she was sobbing on the phone. “I just came back from another ultrasound. Now they found cysts on his brain! They told me that this probably means my baby will have cognitive problems. Cognitive problems! Together with a heart defect! I can’t handle all of that! Rabbi — I think I want to abort.”

Now this was already a halachic question. Despite the late stage of the pregnancy, the fact that the baby had multiple issues, and that Yael was in a fragile emotional state, were serious considerations. I knew that there were some poskim who permitted abortions in similar circumstances.

The doctors had referred her for an MRI, and we decided to wait until those results were in before proceeding with the she’eila. She underwent the MRI in her 32nd week. After receiving the results, she called to tell me that the findings indicated a significant chance of mental retardation.

“I can’t give birth to a baby like this!”

We have a rule in PUAH that before deciding on a pregnancy termination we always send the mother for a second opinion. I told her this, and asked that she make an appointment with a different OB-GYN. At the same time, I contacted one of the leading poskim that night to discuss the case. He told me that, depending on what the second doctor has to say, he thought there was room to allow for an abortion.

Satisfied that I’d done all I could for now, I went to sleep. At 2 a.m. I was awakened by the shrill ring of my phone.

It was Yael, and she was in a panic. “Rabbi! My water broke! What should I do? My water broke! I’m terrified: I can’t give birth to this baby!”

What should I do? I thought, beginning to panic myself. Instead, I davened for siyata dishmaya, that I shouldn’t steer her wrong. And then I told her that she must get to the hospital immediately, since once the water breaks there’s a chance of infection. I also told her that I’d already spoken to a posek, and that, though he wouldn’t give a heter before hearing from the second doctor, it looked like he would probably allow it.

Yael and her husband went to the hospital. In Israel, in order to perform an abortion, one must get official approval from a special committee. Shortly before dawn, the social worker had Yael sign the papers, and her husband took these forms to the committee. When he returned to the room, he saw a bunch of doctors gathered around his wife’s bed.

“What happened?” he cried.

One of the doctors looked up. “We’ve just reviewed this MRI. In our opinion, the first doctors made a mistake; this scan looks normal.”

The husband’s mouth dropped open. Before he could even react, a nurse alerted the team that Yael’s fever was spiking. They needed to get the baby out.

Everything moved quickly, and within a half hour Yael had given birth to a baby boy. Because of his heart condition, he was immediately whisked away to the NICU. But initial testing showed that he was neurologically intact.

One and a half months later, the baby underwent a successful heart surgery. In all other ways he was developing normally. Several months later, this now perfectly healthy baby had his bris milah.

As a rabbi, it’s not easy to be confronted with life-and-death questions. But stories like these remind me that all I have to do is my best; ultimately, Hashem is in charge of working things out the right way.

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