Sotah 40a ~ Gratitude is Good for You

סוטה מ, א

בזמן ששליח צבור אומר מודים העם מה הם אומרים אמר רב מודים אנחנו לך ה' אלהינו על שאנו מודים לך 

When the chazzan says Modim, what does the congregation say? Rav said “we are grateful for the fact that that we are able to give thanks” (Sotah 40a)

Detail of cover from Thanks! How the new science of gratitude can maker you happier.  By Robert Emmons.  Houghton Mifflin Harcourt, 2007.

Much has been written in the social sciences about the effects of gratitude on a person’s physical and mental health. In the page of Talmud that we are studying today, Rav expressed a rather odd idea- that of all the things for which one could be grateful, the simple ability to be grateful was the most important of all.  Let’s turn to some of that scientific literature and evaluate Rav’s statement.

Gratitude Journals

In a review of the psychotherapeutic effects of gratitude, Robert Emmons from UC Davis and Robin Stern from the Center for Emotional Intelligence at Yale suggest that gratitude involves (a) affirming the “good things” in one’s life and (b) the recognition that the sources of this goodness lie at least partially outside the self. They note that in experimental studies, persons who were randomly assigned to keep gratitude journals on a weekly basis exercised more regularly, reported fewer physical symptoms, felt better about their lives as a whole, and were more optimistic about the upcoming week compared with those who "recorded hassles or neutral life events.” Rather than focus on complaints, they wrote, “an effective strategy for producing reliably higher levels of pleasant affect is to lead people to reflect, on a daily basis, on those aspects of their lives for which they are grateful.” The authors believe that gratitude is an effective psychotherapeutic intervention, which may "spontaneously catalyze the healing process.” 

“Clinical trials indicate that the practice of gratitude can have dramatic and lasting positive effects in a person’s life. It can lower blood pressure, improve immune function, promote happiness and well-being, and spur acts of helpfulness, generosity, and cooperation. ”

— Emmons and Stern. Gratitude as a Psychotherapeutic Intervention. J. Clin. Psychol. 2013. 69:846– 855

Letters of Gratitude

Keeping  a record of things for which you are grateful seems to have  psychological benefits. So does expressing that gratitude to others. Researchers from Kent State University studied the effects of writing letters of gratitude on three qualities of well-being: happiness, life satisfaction and depression.  They followed 219 people who agreed to write letters of gratitude for three weeks.  “Participants were…instructed to write non-trivial letters of gratitude to an individual to express appreciation for them. Participants were asked to be reflective, write expressively, and compose letters from a positive orientation while avoiding ‘‘thank you notes’’ for material gifts.  The researchers reviewed the letters “to insure the basic guidelines were followed”, and found that those in the letter-writing group had a significant improvement in their levels of happiness, which included feelings of gladness, satisfaction and fulfillment.  Compared to the non-writers, the letter writing group also showed and increased life satisfaction.  

“Gratitude appears to be a powerful and preexisting resource that when utilized can produce positive effects upon well-being.”

— Toepfer et al. Letters of Gratitude: Further Evidence for Author Benefits. J Happiness Stud (2012) 13:187–201

Finally, those in the writing group showed significant decreases in symptoms of depression over time, compared to non-writers. The authors concluded that “…writing letters of gratitude may have potential for alleviating depressive symptoms prior to more severe clinical depression. Further investigation is required before such claims can be made but the results are promising.” The study was published in the Journal of Happiness Studies. (Perhaps a subscription to this delightfully titled journal would make a good antidote to news in the papers lately.)

Effect of writing letters of gratitude - means for experimental and control groups on well-being variables and depressive symptoms. From Toepfer et al. Letters of Gratitude: Further Evidence for Author Benefits. J Happiness Stud (2012) 13:187–20. 

If you are looking for an entire book of the psychology of gratitude and appreciation, then you might consider reading Gratitude and the Good Life by Philip Watkins. In his review of the health benefits of gratitude, Watkins notes that “grateful people tend to be religious people.” Watkins emphasizes that religiosity is not a requirement for gratitude, and that there are many non-religious people who are very grateful. Nevertheless, “a number of religious variables show moderate to strong correlations with trait gratitude.” Which leads us to...

Gratitude to God

While there are health benefits to anyone who expresses gratitude, one study looked at the effects of expressing that gratitude to God, rather than to a person, in a paper published in the Journal for the Scientific Study of Religion. There were four authors: two from the University of Michigan and two from the Research Services arm of the Presbyterian Church. (Interestingly no conflict of interest was declared by any of the authors. Should being a member of a Church count as a conflict?) The authors of the paper, Gratitude to God, Self-Rated Health, and Depressive Symptoms, analyzed data from the US Congregational Life Survey and wrote:

 There are three reasons why feelings of gratitude to God may affect physical and mental health. First… gratitude is a positive emotion that arises from the pleasant feelings that are associated with receiving a benefit. Viewing gratitude as a positive emotion is important because a rapidly growing body of research indicates that positive emotions are associated with a range of beneficial physiological effects, including a lower heart rate, lower blood pressure, and improved immune functioning… Second, research… reveals that positive emotions, such as gratitude, are associated with the adoption of a range of beneficial health behaviors, including exercise and medication compliance…Third, research…indicates that people who feel more grateful to God are able to cope more effectively with the deleterious effects of stress....Consistent with earlier research, the results indicate that individuals who feel more grateful to God are more likely to rate their health in a favorable manner…and they are less likely to experience symptoms of depression.

The authorship of מודים דרבנן - A meditation on Gratitude

Today’s page of Talmud cites five different versions of what should be said when the chazzan recites the Modim prayer in the repition of the Amidah. Here they are:

סוטה מ, א

אמר רב מודים אנחנו לך ה' אלהינו על שאנו מודים לך

ושמואל אמר אלהי כל בשר על שאנו מודים לך

רבי סימאי אומר יוצרנו יוצר בראשית על שאנו מודים לך

נהרדעי אמרי משמיה דרבי סימאי ברכות והודאות לשמך הגדול על שהחייתנו וקיימתנו על שאנו מודים לך

רב אחא בר יעקב מסיים בה הכי כן תחיינו ותחננו ותקבצנו ותאסוף גליותינו לחצרות קדשך לשמור חוקיך ולעשות רצונך בלבב שלם על שאנו מודים לך

1. Rav: We are grateful to you Lord our God, for the fact that that we are able to give you thanks.

2. Shmuel: The God of all flesh, for the fact that we are able to give you thanks.

3. Rav Simai: Our creator, and the one who formed creation, for the fact that we are able to give you thanks.

4. The Nehardeans say in the name of Rav Simai: Blessings and praises to your great name for your having given us life and sustained us, and for the fact that we are able to give you thanks.

5. Rav Acha bar Yaakov: So may you continue to keep us alive and find favor in us and may you bring us together and gather our exiles to the courtyards of your sanctuary to observe your decrees and to do your will with a whole heart, for the fact that we are able to give you thanks.

Unable to decide between them, (and not wanting to hurt anyone's feelings,) Rav Pappa ruled that all should be said, (אמר רב פפא הילכך נימרינהו לכולהו)  which is what is done to this day. And this is one explanation of why this prayer is called מודים דרבנן  - it is a prayer of thanks of several rabbis.

As you no doubt will have noted, the one common thread in the five versions is that they all end with the phrase “for the fact that we are able to give you thanks.” As we have seen, evidence from the social sciences suggests that there are numerous health benefits associated with expressing gratitude. Perhaps then, acknowledging the ability to express gratitude is acknowledging that on top of everything else, we are thankful for a way of improving our well-being. Expressing gratitude isn’t just a good idea; it might also improve your mental and physical health. That sounds like something worth doing twice a day.

“I would maintain that thanks are the highest form of thought; and that gratitude is happiness doubled by wonder.”

— G.K. Chesterton. A Short History of England, chapter 6.

Sotah 31a ~ What Can a Fetus See?

In tomorrow’s post we will study an aggadic statement, that is to say, a homiletic teaching, that is not to be taken literally - or so one would think.  In that daf the Talmud discusses the miracles which occurred as the Children of Israel crossed through the parted waters of the Red Sea. Rabbi Meir taught that even a fetus in its mother's womb praised God, saying "This is my God and I will glorify him." Now we might have considered this a homiletic teaching that is meant to simply express a degree of amazement and thanks.  But the Talmud then asks a question that suggests Rabbi Meir meant what he said more literally:

סוטה לא, א

והא לא חזו! אמר רבי תנחום כרס נעשה להן כאספקלריא המאירה וראו

These fetuses in the womb could not see the Divine presence, so how could they sing praise? Rabbi Tanchum said: Their mother's abdomen became as clear as glass for them and they were able to see.

While Rabbi Tanchum suggested that it takes physical sight rather than emotional insight to see the divine, it turns out that the fetus can see - and hear, while still in the womb.

Increased Fetal Heart Rate in Response to Light

In 1980, two Israelis published a preliminary report on the response to light of ten fetuses between 38 and 43 weeks' gestation. They inserted an amnioscope through the cervix and shone a light into the womb for thirty seconds while monitoring the heart rate of the little fetus. They found that eight of the ten little fetuses had an acceleration of their heartbeat in response to the light. That's interesting you say, but hardly what Rabbi Tanchum was describing. And you'd be correct.  So let's turn to some other studies.

Increased Fetal Brain Activity in Response to Light

A review in the European Journal of Obstetrics and Gynecology and Reproductive Biology published in 1996 was sceptical that the fetus could see much of anything while inside the womb: 

In utero visual stimulation appears to be very limited...in a dark room the amniotic cavity may be candled with a torch light, especially in the case of a polyhydramnios [an excess of amniotic fluid]. Measurements performed during rat and guinea-pig gestation have demonstrated that if only 2% of incoming light was transmitted in utero below 550 nm, this value increases with wavelength of the signal to reach 10% around 650 nm. Thus, a limited portion of external light may reach the human fetal retina when eyelids are open (this behavior starts at 20 weeks) or through the eyelids. 

But in 2003 a group of researchers from the United Kingdom (with apparently nothing else to do for amusement) built a light source from a "cardboard tube lined with non-conducting aluminised plastic, resulting in a light intensity of 1,100–1,200 Lux at the maternal abdomen as measured with a hand-held light meter." After an ultra-sound confirmed that the fetus was looking forward (really, they did this too) they turned the light on and off. And all this took place while the mother and her in-utero child were lying in a functional MRI scanner, which was used to look for activation of the little fetal brain in response to the light. Of the nine subjects they tortured in this way, one could not be analyzed due to motion, three did not show any significant activation, and five showed significant activation. Oddly, none of the fetal brains that responded showed any activation of the occipital lobe, that part of the brain in which the primary visual cortex is located and which responds to light.  Instead, it was the fetal frontal cortex showed a response to the light being shone.  Hmmm.

The Fetal Response to Sound

So much for vision. Researchers have also studied what - if anything - a fetus may be able to hear.  A group from Rambam Hospital and the Technion in Haifa studied the effect of music on fetal activity. Back in 1982 they took twenty pregnant women and played them either 25 minutes of nothing, or 25 minutes of classical or pop music through headphones. If you are wondering, the music was either a canon and songs composed by Pachelbel, or "the pop-hits of the [sic] Boney-M." (Give yourself an extra point if you can recall any of the pop hits of the Boney M.) Anyway, they played the music in random sequence and monitored the fetus for breathing and body movements.  They found that compared to no music, when music was piped into the mothers' ears there was a significant increase in the breathing movements of the fetus, but there was no difference between classical and pop music.  

“..it seems that the fetus moves into a more active state when music is played to the mother.”

— Zimmer, EZ. et al. Maternal Exposure to music and fetal activity. Europ. J. Obstet. Gyec. Reprod. Biol. 1982 (13) 210.

And remember the experiments with cardboard tubes shining light into the womb of forward facing fetuses? Well that same group also performed functional MRI scanning of the brains of a group of fetuses but this time they strapped "an MRI compatible headphone" to the maternal abdomen (or the maternal ears, as a control) and played 15 seconds of music. (The paper does not specify the kind of music that was chosen. I do hope it wasn't the Boney-M.) Five of the twelve fetuses that had music piped into their mother's abdomen showed activation of the temporal lobes, but despite this low number the authors enthusiastically concluded that their study showed "...that brain activity can be detected in response to stimulation prenatally..." 

“A ray of hope flitters in the sky
A tiny star lights up way up high
All across the land dawns a brand new morn
This comes to pass when a child is born”

— Boney M. When a Child is Born, 1981.

Giving Thanks - Thanksgiving

The Talmud describes how the Crossing of the Red Sea was a miracle of such extraordinary nature that even in-utero fetuses joined in singing a prayer of thanks with the Children of Israel. In his famous introduction to the tenth chapter of Sanhedrin, Maimonides describes how aggadah should not be taken literally. Instead, a deeper message should be sought. And so, over Shabbat, perhaps you can discuss what you are thankful for. For what blessings in your life might a fetus open its eyes and see, or say thanks while still in its mother's  womb? Now that I think of it, that's a question that everyone should answer.

“Human fetuses are, to a certain extent, able to memorize certain sensory properties...Despite the fact that they have only very short periods of wakefulness and that their brain is not mature enough to integrate sensory experiences, several experiments suggest that this does not prevent pre- and perinatal learning.”

— Lecanuet, J, Schaal B. Fetal Sensory Competencies. European Jopurnal of Obstetrics and Gynecology and Reproductive Biology 1996. 68: 1-23

The Nobel Prize, the Paratrooper, and the Maimonides Rule

Last year, we celebrated Yom Ha’atzmaut (Israel Independence Day) with a discussion of Israel’s many winners of the Nobel Prize. This year we will focus on just one of them, the economist Joshua Angrist.

Joshua Angrist.

Angrist was born in 1960, grew up in Pittsburgh, and from 1982-1985 he served in the Israel Defence Forces as a paratrooper. He then came back to the US where he earned a PhD from Princeton. (His thesis was on the Vietnam Draft Lottery.) He returned to Israel as a lecturer at the Hebrew University, and in 1996 he was appointed MIT's Ford Professor of Economics. He holds dual US-Israeli nationality, and has spent most of his career analyzing the economics of schooling and the effect of class size on academic achievement. One of his papers looks at the “Maimonides Rule,” named for, well, Maimonides, who apparently noted a correlation between class size and student achievement.

The Maimonides Rule

Angrist noted that the Talmudic sage Rava limited the size of a class of students to twenty-five. Any more than that, and the school must provide a second teacher:

בבא בתרא כא, א

וְאָמַר רָבָא סַךְ מַקְרֵי דַרְדְּקֵי עֶשְׂרִין וְחַמְשָׁה יָנוֹקֵי וְאִי אִיכָּא חַמְשִׁין מוֹתְבִינַן תְּרֵי וְאִי אִיכָּא אַרְבְּעִין מוֹקְמִינַן רֵישׁ דּוּכְנָא וּמְסַיְּיעִין לֵיהּ מִמָּתָא

Rava said: The maximum number of students for one teacher of children is twenty-five children. And if there are fifty children in a single place, one establishes two teachers, so that each one teaches twenty-five students. And if there are forty children, one establishes an assistant, and the teacher receives help from the residents of the town to pay the salary of the assistant.

This ruling was later codified by Maimonides:

משנה תורה, הלכות תלמוד תורה 2:5

עֶשְׂרִים וַחֲמִשָּׁה תִּינוֹקוֹת לְמֵדִים אֵצֶל מְלַמֵּד אֶחָד. הָיוּ יוֹתֵר עַל עֶשְׂרִים וַחֲמִשָּׁה עַד אַרְבָּעִים מוֹשִׁיבִין עִמּוֹ אַחֵר לְסַיְּעוֹ בְּלִמּוּדָם. הָיוּ יוֹתֵר עַל אַרְבָּעִים מַעֲמִידִין לָהֶם שְׁנֵי מְלַמְּדֵי תִּינוֹקוֹת

[A maximum of] 25 students should study under one teacher. If there are more than 25, but fewer than 40, an assistant should be appointed to help him in their instruction. If there are more than forty students, two teachers should be appointed.

Angrist noted that Maimonides’ ruling leads to smaller class sizes and a lower student-teacher ratio, and that “this rule induces a nonlinear and non-monotonic relationship between enrollment size and class size.” Angrist used this rule as a basis for an investigation between the class size of fourth and fifth graders in Israel and the scores of their tests in math and reading. His work which you can read here, showed that reductions in class size induced a significant and substantial increase in reading and math scores.

“Besides being of methodological interest and providing new evidence on the class size question, these findings are of immediate policy interest in Israel where legislation to reduce the maximum class size is pending.”

— Angrist, J. D.; Lavy, V. (1999). "Using Maimonides' Rule to Estimate the Effect of Class Size on Scholastic Achievement". Quarterly Journal of Economics. 114 (2): 533–575.

Who would have thought that the Rava’s ruling as codified by Maimonides would play a role in the awarding of a Nobel prize to an Israeli ex-paratrooper?

Happy Yom Ha’atzmaut from Talmudology

Sotah 27 ~ When is a Woman Most Fertile?

Today's daf  has a gynecological theme. The Talmud describes a dispute about when a  woman is most fertile. One opinion is that "a woman only conceives close to her period"  (אין אשה מתעברת אלה סמוך לווסתה), and a second opinion is that "a woman only conceives close to her immersion in a mikvah" (אין אשה מתעברת אלה סמוך לטבילתה).  Today, we will figure out which of these competing medical theories is correct.

Medical students spend many hours learning the hormones whose rise and fall causes ovulation.  But understanding the ovulation cycle is the key to understanding this passage in the Talmud, so let's spend a paragraph on...

Ovulation in women

There are two important hormones that regulate ovulation in a woman. One is called Follicle Stimulation Hormone, or FSH. This is produced in the pituitary gland deep in the brain and it acts on the ovaries to produce follicles, which are little groups of cells that may produce an egg. Under the action of FSH, the ovaries produce many follicles, but usually only one will go on to produce and release an egg. (If more than one follicle releases an egg, and both are fertilized, the result is non-identical twins.)  

A sudden spike in FSH and another hormone called Luteinizing Hormone (LH) causes the winning follicle to release its egg, which floats down the Fallopian tube and into the uterus. If the egg meets a sperm cell, they unite and start down the pathway to producing a baby. But if no sperm cell is encountered, there is a drop in the level of two other critical hormones, progesterone and estrogen (also known as oestrogen for our British readers). This causes the lining of the uterus to slough off, and menstrual bleeding begins, until the whole cycle begins again.

Diagram from here.

Assuming a twenty-eight day cycle, the FSH-LH level peaks just before or around day fourteen, and these hormones trigger ovulation - the release of the egg from the ovaries - soon after.

“Scholars of the ancient world thought that menstruation represented an excess of blood from which the woman must periodically rid herself in order to cleanse her body from noxious substances. Only during the twentieth century has the scientific basis for the menstrual cycle and its hormonal relationships been clarified.”

— Avraham Steinberg. Encyclopedia of Jewish Medical Ethics. Feldehim 2003. Vol II p650.

Counting the Days to Mikveh

As outlined in the Torah (Leviticus 15:19), a menstruating woman is ritually unclean - Niddah - for seven days. After that she undergoes a ritual bathing in a mikveh, and she may resume physical and intimate contact with her husband. However the biblical seven day period was transformed in talmudic and later rabbinic tradition. The result was the addition of another (minimum) of five days to the length of time that a couple must abstain from physical intimacy. As a result, if we assume that day one of the onset of menstruation is the first day of the 28 day average menstrual cycle we discussed above, then the earliest day for a woman to immerse in the mikveh is on day twelve, or two days before ovulation is likely to occur.

The length of the menstrual cycle varies to a remarkable degree among different populations and in different age groups. In women age 19-41 in the US it varies from about 23 to 38 days (with a mean of 31 days.) In Danish women aged 20-35, however, the cycle is about 26-31 days, with a mean of 28 days. And each different cycle length will have its own ovulation day, and each varied ovulation day will affect the day on which conception is most likely.

Cycle length distributions for selected samples from various human populations. The numbers at the far left of each sample identify the corresponding sample and data. From Amy L. Harris & Virginia J. Vitzthum. Darwin's Legacy: An Evolutionary View of Women's Reproductive and Sexual Functioning, The Journal of Sex Research 2013. 50:3-4, 207-246.

The Timing of Sexual Intercourse and the Probability of Conception

The next issue in deciding which of the two opinions in today's page of  Talmud might be correct is this:  on which days around ovulation is a woman most fertile?  This question was addressed in a study published in the esteemed New England Journal of Medicine in 1995. The authors followed 221 healthy woman who were trying to become pregnant (for a total of 625 menstrual cycles!!).  The women kept records of when they had sexual intercourse, and their urine was tested for hormone metabolites to estimate the day of ovulation.  The study found that  "conception occurred only when intercourse took place during a six-day period that ended on the estimated day of ovulation." The authors note that couples who abstain from sexual intercourse until they have evidence of ovulation may miss the opportunity for conception.   

Probability of Conception on Specific Days near the Day of Ovulation.
The bars represent probabilities calculated from data on 129 menstrual cycles in which sexual intercourse was recorded to have occurred on only a single day during the six-day interval ending on the day of ovulation (day 0). The solid line shows daily probabilities based on all 625 cycles, as estimated by a statistical model. From Wilcox A. et al. Timing of sexual intercourse in relation to ovulation. N Engl J Med 1995;333:1517-21.

As you can see in the graph below, the day on which women are most likely to conceive is two to three days before ovulation. This is independent of their age.

Fertile window for four age groups. Probability of conception is highest for an act of intercourse occurring two days prior to ovulation. Redrawn from Dunson et al. (2002). Changes with age in the level and duration of fertility in the menstrual cycle. Human Reproduction, 17(5), 1399–1403, and cited in Amy L. Harris & Virginia J. Vitzthum. Darwin's Legacy: An Evolutionary View of Women's Reproductive and Sexual Functioning, The Journal of Sex Research 2013. 50:3-4, 207-246.

The chances of conception on a random day

In a review of the variability in ovarian function, Amy Harris and Virginia Vitzthum from Indiana University note that although it is the case that the fertile window is fairly narrow (about six days, ending within 24 hours after ovulation) “it does not follow that the fertile window occurs during a narrow range of days during the menstrual cycle. To the contrary, because the timing of ovulation during a cycle is quite variable, women have a 10% or greater probability of being in their fertile window on every day from cycle days 6 through 21, and more than 70% of women are in their fertile window before cycle day 10 or after cycle day 17.”

So they plotted the probability of conception on each cycle day and then calculated the mean probability of conception (i.e., clinical pregnancy following a single act of unprotected intercourse on a random day). What they found was that the average probability during cycle days 7-14 was 25% higher than that during cycle days 14-21. The average probability during the first two weeks of the cycle was 16% higher than that during the next two weeks. “Furthermore, in that subset of women who reported having irregular cycles, a not uncommon pattern, the average probability during cycle days 7-14 is less than half of that during cycle days 14 to 21.”

“Among healthy women trying to conceive, nearly all pregnancies can be attributed to intercourse during a six-day period ending on the day of ovulation. ”

— Wilcox A. et al. Timing of sexual intercourse in relation to ovulation. N Engl J Med 1995;333:1517-21.

Panel A: The probability of ovulation by cycle day. Normal variation in the length of the follicular phase of the menstrual cycle: effect of chronological age.

Panel B: Daily probability of conception on each cycle day; mean probability of conception during cycle days 7 to 14= 6% and during cycle days 14 to 21 = 4.8%

Panel C: Daily probability of conception on each cycle day for women reporting regular cycles (thick line) and for those reporting irregular cycles (thin line); in latter sample, the average probability of conception during cycle days 7 to 14 is 2.5% and during cycle days 14 to 21 it is 5.8%.

Halakhic Infertility

Sometimes, a woman may be biologically fertile, but unable to conceive because of halakhic considerations. If a woman has a menstrual cycle that is shorter than the average 28 days (and about 20% of women have just that), or if a woman bleeds for more than 5 days (resulting in a longer Niddah time, in which the couple may not have intercourse,) then  - and pay attention to this - then ovulation takes place during the Niddah time. And if that happens, as we noted above, then conception is all but impossible. This might be called halakhic infertility, and it is more common than you might have thought.    

In a study of the prevalence of halakhic infertility in a population of ultra-orthodox Jews seeking help from a fertility clinic, a group from Hadassah Hospital in Jerusalem studied 45 infertile women. They found that precoital ovulation was prevalent in one-fifth (21%) of the patients.  "Since not obeying the halachic code of conduct is non-negotiable, and in view of the void of halachic solutions, most couples (68%) seek medical advice and treatment."  Fortunately such treatment is available: taking an an oral estrogen can delay ovulation to after the time of mikveh, and allow intercourse to take place at a time when conception is more likely.  

“A fifth of infertile couples were diagnosed as suffering from infertility due to a religious rather than biological cause...This significant proportion of infertile couples who suffer from sociocultural infertility mandates special attention, primarily of the Rabbinate [sic] authorities.”

— Haimov-Kochman R. et al. Infertility associated with Precoital Ovulation in Observant Jewish Couples; Prevalence, Treatment, Efficacy, and Side Effects. Israel Medical Association Journal 14 (2011): 100-103.

Back to the Daf - Which Opinion is Correct?

Let's now return to the question with which we opened; which of the following two opinions is correct?

1. A woman only conceives close to her period(אין אשה מתעברת אלה סמוך לווסתה).

2. A woman only conceives close to her immersion in a mikvah (אין אשה מתעברת אלה סמוך לטבילתה).

The first opinion is most certainly not supported by modern medicine. The second opinion is often likely to be true, but - and this is a BIG BUT - only for women for whom both the menstrual cycle is not short and menstrual bleeding is not long. For a sizable number of women, conception is no longer possible when they are ready to go to the mikveh.

It is a remarkable fact (and one I have never seen addressed or even acknowledged) that orthodox Jewish practice has evolved to permit intercourse only in that part of the menstrual cycle which has a lower chance of conception. As a result, orthodox Jews have become in this respect, halachically subfertile. Fortunately that doesn’t seem to have made much of a dent in their rates of reproduction. “Being Orthodox” wrote Michelle Shain of the Center for Modern Jewish Studies at Brandeis, “increases the odds of having any births by a factor of 7.18 and, among women who have given birth, increases the expected number of births by a factor of 6.14.” Remarkably, this is in spite of, and not because of, the laws of ritual impurity that are a foundation of Jewish practice.

Mean expected number of births by age, education and Orthodoxy. From Michelle Shain, Understanding the Demographic Challenge: Education, Orthodoxy and the Fertility of American Jews. Contemporary Jewry 2019. 39: 273.

“Consultation with a Rabbinate [sic] authority was reported by 64% of women, but no halachic solution was provided to any of the applicants. ”

— Haimov-Kochman R. et al. Infertility associated with Precoital Ovulation in Observant Jewish Couples; Prevalence, Treatment, Efficacy, and Side Effects. Israel Medical Association Journal 14 (2011): 101.