Conceiving Agency

Reproductive Authority among Haredi Women

Michal S. Raucher

• Publisher: Indiana University Press
• Year: 2020
• Print ISBN:
  9780253050014
  9780253050014
• eBook ISBN:
  9780253052384
• Topic: Theology & Religion
• Subtopic: Jewish Theology

Conceiving Agency: Reproductive Authority among Haredi Women explores the ways Haredi Jewish women make decisions about their reproductive lives. Although they must contend with interference from doctors, rabbis, and the Israeli government, Haredi women find space for—and insist on—autonomy from them when they make decisions regarding the use of contraceptives, prenatal testing, fetal ultrasounds, and other reproductive practices. Drawing on their experiences of pregnancy, knowledge of cultural norms of reproduction, and theological beliefs, Raucher shows that Haredi women assert that they are in the best position to make decisions about reproduction.

Conceiving Agency puts forward a new view of Haredi women acting in ways that challenge male authority and the structural hierarchies of their conservative religious tradition. Raucher asserts that Haredi women's reproductive agency is a demonstration of women's commitment to Haredi life and culture as well as an indication of how they define religious ethics.

ONE

MEDICINE AND RELIGION

Doctors and Rabbis in Israel

DR. MIRI LEVIN, AN OBSTETRICIAN who works at Bikur Cholim as well as some clinics around Jerusalem, told me about a Haredi woman who was in labor when the baby’s heart rate dropped significantly. The doctor wanted to perform a cesarean section, but the woman’s husband called their rabbi, who objected to the procedure. After multiple phone calls sent back and forth between the doctor and the rabbi, the rabbi refused to approve the operation, and as a result, the husband refused as well. Eventually the doctor called a judge, who mandated the C-section. “This is rather scary,” I remarked to Dr. Levin as she told me the story. She agreed, and I continued, “Because a rabbi is not a doctor.” Levin laughed and responded, “I’m glad you think that, but many Haredi women do not know the difference.” This, Levin claims, is what makes it difficult for the doctor to contradict the rabbi. According to Dr. Levin, because women do not trust that their doctors are advising them based on their medical expertise, they may see the disagreement as evidence of a mere difference of opinion, instead of understanding that a doctor and a rabbi are speaking from within two different frames of reference and have distinct reasons for issuing their opinions.

When Dr. Levin told me this story, I was shocked and disappointed. I could not believe that a rabbi, over the phone, could make a medical recommendation and that people would think he has sufficient information and authority to challenge a doctor. I was also concerned about the laboring woman whose life and fetus were in danger and yet who seemed to lack any say about what should be done. This was apparent both in her husband’s actions and in Dr. Levin’s retelling. And although I was relieved that the judge eventually mandated the C-section, I was scared to think that this event might be commonplace. I was surprised that Dr. Levin blamed this Haredi woman for not knowing the difference between a rabbi and a doctor. Instead, it seemed that this woman’s husband and rabbi did not respect the doctor’s authority over medical decisions. This case of a rabbinic challenge to medical care, and Dr. Levin’s retelling of it, which includes her characterization of a Haredi woman as ignorant, capture the relationship I will dissect in this chapter. Doctors and rabbis work together, sometimes reluctantly, to make decisions about Haredi women’s reproductive health care. Each views the other as merely instrumental in achieving his or her own goals, while they overlook women’s participation. While I did not hear of any other cases of this magnitude, my research with physicians and nurses in the field of reproductive medicine revealed that Haredi rabbis and the doctors who treat Haredi women exist in a relationship built on mutual benefit and mistrust. What makes this relationship particularly challenging is that at least in the field of reproductive medicine—though we will see that their relationship extends beyond this specialty—the lines of authority between doctor and rabbi are blurred because of how the two figures have come to work together. Haredi women struggle to enter the conversation about their reproductive health care because doctors and rabbis do not prioritize women’s own reproductive experiences and authority.

This chapter establishes the medical context for Haredi women’s reproductive agency. Although it might seem odd to begin a book about women’s agency with a chapter about doctors and rabbis, this chapter is a necessary starting point because doctors and rabbis are also a woman’s starting point in her journey toward reproductive agency. When pregnant, a Haredi woman faces a closed network of doctors and rabbis who benefit significantly from this relationship. Rabbis claim authority over reproductive decisions because what is at stake in reproductive medicine is nothing short of establishing kinship with the next generation. Rabbis want their authority to be a central part of the family structure. Doctors, for their part, cooperate with rabbis either because they have a financial interest in the Haredi clientele or because they see cooperating with rabbis as the only way of providing medical care to Haredi patients. Although sometimes women benefit from this holistic model of medical care, women often feel stifled when they are unable to escape rabbinic oversight in medical care. A description of the setting for Haredi women’s reproductive care is crucial for understanding how these women create reproductive agency that is embedded in their cultural and theological contexts and their embodied experiences of pregnancy. Other scholars have demonstrated how women and doctors in Israel are engaged in a struggle for authority, and some have spoken about the “triadic relations among Israeli rabbis, doctors, and infertility patients.”¹ I suggest that when rabbis and doctors are working together, pregnant Haredi women are overlooked.

Drawing on interviews with doctors and nurses who work extensively with Haredi patients and building on ethnographies from Susan Kahn and Tsipy Ivry, I analyze the contours of the relationship between doctors and rabbis in Haredi women’s reproductive health care. This chapter thus lays out the structural setting for women’s reproductive agency. First, I argue that the way doctors and rabbis compete for authority reflects larger epistemological struggles between medicine and religion or culture. Then, as I explore the ways rabbis exert control over the medical field, I argue that the process of “koshering” medicine is the result of long-standing concern about medicine contaminating Haredi life. Rabbinic oversight, furthermore, leads to suspicion toward medical professionals, suspicion that can be allayed only with more rabbinic oversight. The next section looks at how medical professionals respond to the “koshering” of their field by stereotyping Haredi women’s reproductive needs. Although this can result in holistic health care, these assumptions also tend to silence women’s individual experiences.

Finally, this chapter introduces the idea, to be further explored in the next few chapters, that although doctors and rabbis benefit from cooperation in the medical arena, they compete unsuccessfully for authority over Haredi women’s medical decisions.² This is because women have internalized a mistrust of both doctors and rabbis and thus prioritize their own embodied experiences. Throughout this book, we will see that sometimes this results in women ignoring medical care altogether.

COMPETING FOR AUTHORITY

A relationship of conflict and cooperation exists in a context wherein doctors and rabbis each have something to gain from the relationship. Doctors work with rabbis so that they can effectively treat Haredi patients and gain even more Haredi patients through rabbinic referrals. Rabbis work with doctors so that they can extend their authority. Rabbis have inserted themselves into medical decisions as gatekeepers for their Haredi constituents because there is a historical concern about the contaminating influence of secular doctors on Haredi life. Haredi patients, as a result, are often reluctant to turn to doctors for medical care and advice, unless those doctors have been sanctioned by their rabbis. Many doctors have therefore established relationships with rabbinic authorities and become familiar with halakhic concerns in order to attract and keep Haredi patients. If doctors and rabbis work together, both groups can benefit from the cooperation.

This relationship, however, often blurs the boundaries between doctors and rabbis and the distinct spheres of authority they maintain. Medicine and religion exist in this context as two competing epistemologies. Writing specifically about how medical knowledge came to dominate birthing practices in the West, Brigitte Jordan explains as follows:

Frequently, one kind of knowledge gains ascendance and legitimacy. A consequence of the legitimation of one kind of knowing as authoritative is the devaluation, often the dismissal, of all other kinds of knowing. Those who espouse alternative knowledge systems then tend to be seen as backward, ignorant, and naïve, or worse, simply as troublemakers. Whatever they might think they have to say about the issues up for negotiation is judged irrelevant, unfounded, and not to the point (Jordan 1989). The constitution of authoritative knowledge is an ongoing social process that both builds and reflects power relationships within a community of practice (Lave and Wenger 1991; Wenger 1990).³

The complicated relationship between doctors and rabbis that is described in this chapter reflects how one group judges another in an effort to devalue a different form of knowledge and thereby restore one’s own authority. Recall Dr. Miri Levin from the opening vignette. Dr. Levin seemed most concerned that her patient did not respect a doctor’s authority. Dr. Levin wants all patients to prioritize medical information. Instead of one group becoming dominant, however, the resulting framework is one of a blended medical-rabbinic reproductive health care in which doctors and rabbis compete for authority. As women reject this blended system in favor of their own reproductive authority, they are responding to the relations of power within the community.

Rabbinic Involvement in Contemporary Israeli Medicine

Rabbinic involvement in medical decisions is an example of da’at Torah, or the idea that rabbis have the intellectual ability and the authority to weigh in on all sorts of decisions. In the last few decades, Haredi rabbis have come to regulate every decision and action among their constituents, regardless of whether it is ostensibly a religious question. Instead of only fielding questions about holiday observance or the permissibility of certain food items, Haredi rabbis now influence business, political, and medical decisions as well. Making decisions that are far beyond the religious realm reflects the rabbinic fear of secular influences and authorities. Haredi rabbis regulate all means of access to the non-Haredi world—the internet,⁴ cell phones,⁵ the radio,⁶ and other media,⁷ for example. Haredi culture works hard to protect Haredi Jews from outside influences because “corrosive secular Israeli culture might contaminate the Haredi enclave.”⁸ In a similar vein, to calm their fears regarding the contamination of religious structure from secular doctors, who will introduce a different way of prioritizing medical information, rabbis involve themselves in the practice of medicine.

Rabbinic concerns about the influence of medicine are compounded by the fact that medicine and medical technology are hegemonic forces in Israeli culture. Since the 1960s and 1970s, medical care in Israel has become increasingly sophisticated and reliant on technology. Additionally, medical care is regulated by national health insurance and heavily subsidized by the government. Within the technologically advanced Israeli medical system, individuals are expected to prioritize scientific information and the use of medical technology.⁹ Fearing the authority of medical hegemony in Israel, rabbis promote the idea that one cannot fully trust a doctor to provide the best care because many doctors are hostile to religious patients and their needs; therefore, patients need the rabbinic community to tell them which doctors to visit.

This section will explore this phenomenon in medicine more broadly and then turn to its manifestation in the specific field of fertility treatments and reproductive care. Rabbinic involvement in fertility treatments is an attempt to prevent the contamination of kinship lines while also ensuring that rabbis—and, more broadly, Judaism—remain part of the kinship structure for those relying on medical technology to conceive. In this sense, rabbis are not just competing for authority but for a place in the Jewish future. Religious authorities fear that patients or doctors might think religion is not needed in a technologically sophisticated, medically advanced Israel. Therefore, rabbis have inserted themselves into medical care by sowing doubt and fear among patients.

By attempting to institutionalize rabbinic involvement in medical decisions, Israeli rabbinic organizations draw on the underlying mistrust many Haredi individuals have for the medical establishment. Based on a study of general practice consultations in Israel, Michael Weingarten and Eliezer Kitai found that Haredi individuals were more likely to turn to their rabbis than were Israelis belonging to other religious affiliations. Although patients turned to particular rabbis “to strengthen their faith in their medical healer,” Weingarten and Kitai explain that the rabbis “took it upon themselves to pass judgment on the quality of care the patients were receiving from their doctors, even to the point of recommending that they change to the care of some ‘better’ specialist.”¹⁰

Ezra LeMarpeh (A Healing Aide) is one such organization that provides medical referrals to Jews around the world. While the organization performs many charitable services (such as loaning wheelchairs, importing rare medications, and providing additional ambulance services within Israel), its leaders encourage patients to rely on rabbinic guidance for their medical decisions while reinforcing a sense of mistrust in the medical establishment. On the organization’s website, Rabbi Elimelech Firer, founder and director, writes, “People don’t come to us to get a remedy for their illness or a prescription for a cure. Instead, they come to receive support and advice. People come to us to streng...

Table of contents

• Cover
• Title Page
• Copyright
• Epilogue
• Dedication
• Contents
• Acknowledgments
• Introduction
• 1. Medicine and Religion: Doctors and Rabbis in Israel
• 2. Books and Babies: Pathways to Authority
• 3. The Embodiment of Pregnancy
• 4. Reproductive Theology: Embodying Divine Authority
• 5. Abortions, Finances, and Women’s Reproductive Authority
• Conclusion: Haredi Women’s Bodies and Beyond
• Works Cited
• Index
• About the Author