Your patients’ communities and experiences impact their needs & perspectives.
You want to support better health outcomes.
We are here to help you understand local faith communities and learn to collaborate with patients for better maternal & fetal health.
Meet Our Panel
Marjan Moghaddam, D.O., is a family medicine physician at Henry Ford Health in southeast Michigan. She is also a Bahá’i and a parent, and gave birth to her first child in 2023.
Yaffa Rabin is the proud mother of eleven children and blessed with many grandchildren. She is the wife of Rabbi Yerachmiel Rabin, of Australia, and the two raised their children in Oak Park, Michigan. Yaffa is a writer and speaker, often asked to address topics relevant to Jewish women. She is an editor-at-large for The Tapestry magazine and is a wonderful asset to her community.
Shawn Bennis, MSN, R.N., CHC, has over 20 years of professional nursing experience. She is the Manager of the Faith Community Nursing Network at Henry Ford Health in Detroit, Michigan. She serves as the Parish Nurse at Guardian Angels Catholic Church in Clawson, Michigan. Shawn is experienced in helping people navigate community resources and provides community educational classes on advance directives. She has received numerous awards including the Clara Ford Award for Nursing Excellence and the Nightingale Award for Nursing Excellence in the Community.
Michelle Lorenc, RN, is a registered nurse and has worked in women’s health since 1995, most recently at Trinity Health. She grew up in the Church of Jesus Christ of Latter-day Saints in Utah and Idaho and met her husband at Brigham Young University.
They have three children and two grandchildren and live in Novi.
IHEP Patient Quick Start Questions Card
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For Healthcare Teams
We encourage you to acknowledge your patients’ faiths and start conversations about their preferences and needs.
Key Take-away
Each panel contributor speaks to their own perspective and experiences.
Always ask your patient about their own experiences and preferences. Each individual in a community is unique.
Bahá’i
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Provide Support
While Baháʼís do not have clergy, they may welcome a visit from a hospital chaplain, if offered.
“Can I ask Baháʼís if I can pray with them? Yes! An offer of prayer by the patient’s care team would be respected and welcomed. Baháʼís support all religions and believe that all faiths came from the same source. Baháʼís might say a Baháʼí prayer in addition to the prayers offered by providers. ”
– Marjan Moghaddam, D.O.
Consult Women About Their Birth Plan
A Baháʼí mother may have a birth plan that should be consulted and respected.
“Do Baháʼís prefer home or a hospital for births? This is individual choice. There is nothing in the faith that indicates a preference. ”
– Marjan Moghaddam, D.O.
Provide Advice With Respect
Baháʼí patients are open to following the advice of providers.
Treat Female Patients as Decision Makers
Women are empowered to make their own decisions regarding their care.
“What are the faith’s views on gender equality? Women and men, and husbands and wives, are equals. Humanity is a bird with two wings, one male and one female. Both wings must be equally strong for the bird to fly straight and for humanity to achieve its full potential.”
– Marjan Moghaddam, D.O.
Essential Beliefs and Practices
The Baháʼí faith embraces the unity of all people as its core teaching.
There are no clergy or churches in the Bahá’i faith. Gatherings often take place at a person’s home. Areas with larger communities may have Bahá’i community centers.
It is up to followers, Baháʼís, to teach their religion.
“Bahá’i is ever advancing and will advance with society. We build upon the foundations set before us to aid in the time we are living. It is a faith very much for this time and age.” – Marjan Moghaddam, D.O., Bahá’i Community
Baháʼí scriptures are a collection of writings and talks. The scriptures of other faiths are respected and also considered divine revelations.
God may be referred to as the All-Powerful or the All-Loving.
General Preferences
The faith does not have specific guidelines for health and healthcare. Decisions and choices are between patients and their providers.
Baháʼís choose not to drink alcohol or to take recreational drugs. Medications prescribed by a healthcare provider are accepted without concerns related to their faith.
Baha’is celebrate birth as a time of joy.
The Role of Prayer
Prayer is important to Baháʼís, who may pray several times a day.
“A woman in labor may wish to pray and meditate as she progresses, at her own discretion, and may pray with family members. Prayer is seen as a way to relieve stress and provide comfort.” – Marjan Moghaddam, D.O., Bahá’i Community
This prayer may be said during pregnancy:
- “I dedicate that which is in my womb unto Thee.”
This prayer may be said during labor, delivery and post-partum:
- “O Lord, my Lord! I praise Thee and thank Thee for the favor.”
Modesty and Privacy
There are no rules or guidelines about modesty or privacy. Women may have male physicians.
“There is nothing in the Baháʼí faith that says you cannot be yourself with your providers.” – Marjan Moghaddam, D.O., Bahá’i Community
Faith Expressions and Rituals
There are no faith expressions or rituals.
Important Items
A birthing mother may have a prayer book with her, or may use a prayer stored on her cell phone.
Infant Care
There are no Bahá’i-specific practices for infant care. Circumcision is optional and is the choice of the parents.
Abortion and Medical Termination of Pregnancy
Medical termination of pregnancy is acceptable. Abortion is not to be used as a form of birth control, but there is no official guidance on abortion. The choice is between a woman, God, and her healthcare provider.
Fertility Treatment
There are no guidelines for fertility treatments; all are acceptable and individual choice.
Contraception
Contraception decisions are between a patient and her healthcare provider. While the primary purpose of marriage is to bring forth children, all forms of contraception are acceptable if individuals are not ready to become parents. Premarital sex is not allowed, but contraception may be used before marriage for medical reasons, such as regulating periods.
There are no rules or guidelines about diet in the Baháʼí faith, but patients may have cultural or traditional food preferences consistent with their heritage. Many Baháʼís have a middle eastern cultural background.
Baháʼís cannot be cremated or embalmed, and should be buried within an hour from where they passed away. This practice upholds the belief that humans came from earth and should return earth. Most Baháʼís will not want to delay a funeral for a person who passes away.
The family may wish to pray with the body after death, but there are no obligatory prayers at the time of death.
Visit https://www.bahai.org, the website of the worldwide Bahá’í community, and https://www.bahai.us, the website of the United States Bahá’í community.
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Ask patients about their access to healthy food and educate them on nutritional needs.
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Seek to educate mothers about the care they are receiving and your recommendations.
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Ask if they have any concerns about getting access to care.
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Treat patients with respect no matter their socioeconomic situation. Do not demean them or their choices.
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Listen to their complaints with empathy and take their concerns seriously.
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If there are needs beyond medical care that impact the patient’s well being, refer the patient to a social worker in your hospital system to provide holistic healing.
Prayer
For practicing Black Protestant women, prayer is a way of life. Individuals are encouraged to seek God directly. Women may elect to have their pastor or spiritual guide attend to them in distressing circumstances, but there is emphasis on the strength that comes from a direct relationship with the Divine.
For many Black women, there are no specific rituals or practices relating to childbirth that must be done in the hospital or with providers present, but, again, prayer is fundamental.
Modesty and Gender Roles
There are no specific guidelines or rules beyond respect for the mother and her wishes.
For Black Protestants, faith, identity, and community lives are inseparable. The Black American experience has shaped all three simultaneously. Followers of this Christian tradition live according to the dictates of their own conscience with the Bible as the final authority for individual members. American Baptists, for example, as an organized body has “rejected creeds or other statements that might compromise each believer’s obligation to interpret Scripture under the guidance of the Holy Spirit and within the community of faith.”1
For Black Protestant women, maternal and infant medical decisions are made on an individual basis with prevalent historically-based mistrust of medical authority. Decision makers are the women themselves, and it is generally the mothers and grandmothers of these women who act as guides when necessary. Education and access to quality resources and care are paramount in supporting better outcomes for Black mothers and their babies.
Abortion
For many Black women, life is sacred and abortion is not condoned as a primary means of birth control or avoiding responsibility for egregious sexual behavior. However, the church acknowledges the difficult circumstances women may find themselves in and “the freedom of each individual to advocate for a public policy on abortion that reflects his or her beliefs.”2 The church body takes a neutral stance, believing that individuals are accountable before God and not the church. There is greater focus on the societal causes and needs than on judging those who find themselves considering such actions. Compassionate ministry is seen as the best approach in confronting such issues as abortion.
Reverend Stancy Adams of Russell Street Missionary Baptist church describes how, “Many young women, particularly in the African American community have had abortions. Some have spoken of them, and others have not. It is taboo for the most part, [but] probably more accepting in today’s environment than when I was younger. But that’s because when I was younger, before abortion was legal, most of them were having them done in back alleys with hangers, and it was barbaric.”
For Black women in Detroit, economic pressures and lack of access to healthcare and choices can create life-altering dilemmas for pregnant women. Providers should approach patients with sensitivity and compassion when discussing options for medical termination.
Genetic testing
The availability and use of genetic testing in the Black diaspora is limited, and women may lack access to their family’s complete medical history. There are no specific teachings against it, but distrust in the medical community, lack of resources, and education may contribute to its use—or lack thereof.3
Reverend Adams explains, “I didn’t even think about genetics until I was pregnant with my son; and then I realized [how little I knew about my father’s family]. I asked him and he told me that his siblings died, one because of diabetes and one got hit by a car, but that the other five died because of things that should not have happened had they had [access to] good medical care. On my mother’s side, everyone lives forever, so I take good care of myself and hope that my genes are good. but I won’t do things like 23 and Me, because I don’t feel comfortable with people knowing that much information about me.”
Providers should discuss genetic testing with sensitivity, acknowledging their patients’ potential lack of access to family history and the medical profession’s complicated and, at times unethical, history of medical practice and bias in relation to the Black diaspora.
Fertility treatments
Black Protestants have no creed expressing whether these treatments are ethical or not. With a diverse set of viewpoints, there is no sanction for or against IVF or other fertility treatments in the body of the church. Providers should address this topic with sensitivity to the individual patient’s beliefs.
Contraception
For many Black women, contraception is accepted. There is a community-focused mission within the Black Protestant church to teach healthy sexuality.
Reverend Adams relates that, “As far as contraception is concerned, the sad news is that mothers don’t talk to their daughters before they become [sexually active] or even before marriage. They just don’t have those conversations. And why? The response from most mothers is, ‘My mother didn’t talk to me about it.’ So, you have only the public schools teaching these kids about the pill. . .and they are starting too early to begin with, [without knowing about sexuality or their bodies], and become mothers as young adults. . .There’s a lot of criticism [even within the Black community] but there’s not a lot of support.”
She continues, “There was one young unmarried woman that had six children. I said to her, ‘Have you ever considered birth control or some kind of contraception?’ And her answer to me? ‘No, I don’t want to use those chemicals because it will upset the chemistry of my body.’ I was dumbfounded. But you know, that’s what she thought.”
According to a study published in The American Journal Of Obstetrics and Gynecology in 2014, “Possible reasons for disparities in contraceptive use include differences in patient knowledge and higher levels of concerns about the safety of birth control. Disparities in contraceptive use could also result from differential access to medical care, as well as differences in the experience interfacing with the medical system, even when financial and access barriers are removed, as racial/ethnic minorities report more distrust of the healthcare system than whites. This distrust could be amplified in the context of contraception given a history in which some family planning programs in the United States were associated with coercion of minorities to use highly effective methods [and reduce minority power].”4
Providers should address contraception topics with care and consideration for the patient’s beliefs.
For Black women, the primary dietary need is the availability of healthy food. With the prevalence of high blood pressure, anemia, and pre-eclampsia in Black mothers, inadequate diets may require support. Many live in urban ‘food deserts’ where grocery stores are less accessible than fast food. This is one of many factors associated with greater risk for Black American Baptist mothers.1
Reverend Stancy Adams shares, “I’ll never forget being in a doctor’s office and hearing him yelling at the woman in the room next door. ‘You’ve gained too much weight! What are you eating?’ She said, ‘I’m eating for two.’ He cursed at her and asked again. She said, ‘Pizza.’ But you know what? Pizza was easy to get to. . . And here it is. [Sometimes women] don’t have great alternatives. You can tell me what to do and not do, but you have to help me have access to the right things and education about nutrition.”
Providers should address concerns with compassion and sensitivity. Ask patients about access to and educate them about healthy options rather than expressing judgment.
There is too much unnecessary loss in the Black community. According to a recent Mayo Clinic article (8/2023), “Based on most recent estimates, non-Hispanic Black women are 2.6 times more likely to die from pregnancy-related complications than white women. For Black women 25 and older, pregnancy-related mortality is about four times higher than it is for white women of similar ages, according to data from 2007 to 2016.”
“The maternal mortality rate for Black mothers doesn’t improve with socioeconomic status or educational level. For example, data from 2007 to 2016 show that among women with a college degree or higher, the pregnancy-related mortality ratio was five times higher for Black mothers compared with white mothers.”1
This higher rate of mortality is attributed to multiple factors including lack of access to affordable health care, delayed recognition of risk and complications, systemic discrimination, and implicit bias.
Local pastor and founder of the nonprofit “Safe Sacred Space,” Reverend Stancy Adams says, “There remains a distrust in the African American community because we don’t receive the same medical care and attention that others do, and I don’t care how much money you have, because Serena Williams and Beyonce each have enough money to buy a hospital, and both of them almost died in childbirth; and it was [due to] things that could have been dealt with before it got to that point. It is evident that there is disparity [in care], and I have a problem with that.”
The same disparity in outcomes is also evident among black infants. Black infants are nearly four more times likely to die from complications related to low birthweight, and almost three times more likely to die from SIDS than their non-hispanic, white peers.2
In order to help prevent unnecessary and tragic loss of life, providers can listen to mothers with empathy, give their concerns credibility, and refrain from making assumptions or trying to fit the patient into established criteria for care (as it’s not serving this set of mothers well).
American Baptist:
Greater Detroit Baptist Association
Moderator – Roland Caldwell JR.; Vice Moderator – Stanley Turner
GDBA Office
24250 Joy Rd, Redford, MI 48239
(313) 533-2663
American Baptist national website:
Buddhism
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Be open to getting to know Buddhist patients and taking time to connect with them.
Recognize that they are Buddhist, that pregnancy and birth are a sacred time, and that giving birth is considered a spiritual awakening
for the mother and infant
When possible, provide a calm, quiet environment for prenatal visits, labor and delivery.
Offer quiet and low lighting when possible. Ask if the patient would like music to create a more harmonious environment. She may have music she could play on her phone.
“A Buddhist mother might not ask for something like music or quiet because she may consider imposing on the medical staff rude. But when offered, she would appreciate the thoughtfulness and may share other ways providers can help meet her needs.”
— Myungju Sunim
Prayer
Buddhists strive to rest in a peaceful state of mind in harmony with their belief that the mind influences all conditions. Buddhist practice emphasizes broad awareness and mindfulness – being present and engaged in the moment – while recognizing the larger context of all situations. Demonstrating kindness and empathy is important. A Buddhist might not reveal their faith unless asked.
There are many different Buddhist traditions. Buddhism generally lacks dogma, or specific etiquette related to spiritual beliefs. However, cultural norms and practices are observed within Buddhist communities and countries.
An emphasis on a simple lifestyle focused on meditation, work and prayer is common, as well as protecting the mind and the minds of others.
Buddhists typically do not believe in a god or gods, but try to realize enlightenment (Buddha nature), inner peace and wisdom in their lives.
Birth is a celebration of new life, a spiritual experience, and considered noble by many Buddhists.
“Buddhism is a lifestyle. It is an approach to life that is centered around a person’s spiritual awakening, and having a child can be a major part of that process.”
– Myungju Sunim
General Preferences
Buddhists are generally open to modern science and medical care. A Buddhist patient would prefer a calm, quiet environment that is not rushed.
“During pregnancy, a child is absorbing the content of and harmonizing with the mother. It is important that the mother live harmoniously and relieve stress.”
— Myungju Sunim
When a mother welcomes his involvement, the father should be included in the birth experience.
Cultural Buddhists from Asia may defer to their healthcare providers’ decisions and choose not to question a provider’s guidance.
Passing through the birth canal is considered a rite of passage and a deep spiritual experience for a Buddhist. For this reason, a Buddhist patient would prefer a natural birth over caesarian section, although modern attitudes may shift this perspective.
Medications and Pain Relief
Vegetarian medications may be preferred.
Buddhists may use sparingly or avoid medications that alter their state of consciousness, such as anti- depressants or narcotics. During post-partum, a woman experiencing depression or anxiety may prefer non-pharmacologic option, but this preference can vary as modern attitudes are evolving.
The Role of Prayer
Buddhists engage in devotional meditation rather than prayer. A woman in labor may wish to meditate, chant or repeat mantras, but this will vary depending on the background and training of the individual.
Modesty and Privacy
There are no specific modesty or privacy rules or guidelines.
Faith Expressions and Rituals
A Buddhist patient’s preferences related to a quiet atmosphere, vegetarian diet and meditation during labor are important for providers to recognize.
Infant Care
A harmonious and quiet, unrushed environment is appreciated during pregnancy, birth and while in the hospital. Newborns should be handled gently and kept with the mother as soon and as often as possible unless medically required.
Rituals and Practices Around Childbirth
Many Buddhists are given a spiritual name in addition to their legal name.
Buddhists may wait to choose a name for the infant until they see the child’s personality and feel assured the child is healthy. However, most Buddhists will understand if they need to name the child before leaving the hospital for the birth certificate. A monk will perform a naming ceremony several weeks or months after birth.
Important Items
- Malas are prayer beads made from wood or stone that are worn as a necklace or bracelet. A woman in labor and her support persons might use them during times of anxiety and as an aid in meditation. They should be treated respectfully.
- The Dhamapdda (multiple spellings) is a book of poetry written by the Buddha. It is an inspirational text
common in most Buddhist traditions. - The Tao Te Ching is an important philosophical text for Chinese and East Asian Buddhists.
Personal Perspectives
Would a Buddhist mother prefer a home or hospital birth?
While Buddhists, as followers of natural laws, may be expected to favor “natural births,” this is not always the case.
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Western Buddhists: A Buddhist woman who was born or raised in the West (for example, the U.S., Canada or Europe) may indeed be more likely to prefer home birth. Due to lower levels of maternal and child mortality in western countries, she may have a favorable view of home birth (with a doula or midwife), and consider it more desired or noble, wanting the experience to be as natural as possible.
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Eastern/Cultural Buddhists: Buddhists born and/or raised in Asia generally have an extremely high level of trust in western medicine, and may prefer a hospital birth. It is viewed as a safer option and access to the most advanced medical treatment available is preferred. This may be due to high maternal and fetal mortality in Eastern countries.
Is an offer of pain relief (for example, medication or an epidural) appropriate?
Yes, you can offer pain relief. While Buddhists typically minimize medications that would alter their consciousness, available and appropriate pain medication can and should be offered. It may be helpful to point out if a medication will not change her mental state.
What should I say if a Buddhist patient needs a caesarian section?
Caesarian section is accepted, when necessary, but should be approached with sensitivity based on the belief that canal birth is a deeply spiritual experience. Providers can acknowledge the significance of natural birth, then explain why, in this situation, a natural birth would endanger the health of the mother or infant.
“Buddhists teach that passing from the womb through the birth canal is a rite of passage for the mother and child. Going through a tunnel and coming into the light has deep, spiritual meaning and is the a primary experience imprinted into the consciousness of the self.” – Myungju Sunim, Zen Buddhist monk, Hamtramck, MI
Can I offer to meditate with my patient?
Yes! If you are comfortable, an offer to meditate with a Buddhist patient would generally be welcomed.
Fertility Treatment
Buddhists are typically open to fertility treatment. This is considered individual choice.
Contraception
Contraception is generally accepted. Buddhists believe life begins when an egg is fertilized, creating no conflict with contraception.
Abortion
While there is not a philosophical or religious prohibition against abortion, Buddhist leaders do not promote it or take it lightly. Buddhist women might discuss their situation individually with a monastic to determine the path forward that creates the least amount of suffering. A woman would be supported regardless of their decision without judgment, while recognizing the laws of karma (cause and effect). Buddhists believe a child is an extension of the self, and choosing an abortion could lead to karmic repercussions and deep spiritual trauma for the mother. Medical termination of pregnancy for health reasons of the mother or child would be supported. Ultimately, ending a pregnancy would be considered a decision between the mother, father and physician.
Most Buddhists are vegetarian, but during pregnancy, may be open to eating animal protein. Nutrition from plants grown without pesticides and whole, unprocessed foods is preferred.
There is a strong tradition within Buddhist groups of using herbal medicine in caring for women in pregnancy, and the mother may work with an herbalist and follow the advice of family members. This should be taken into consideration when prescribing medications to avoid harmful interactions. Nettle, mugwort and motherwort may be taken during pregnancy and post-partum.
Seaweed and sea vegetables are commonly used by pregnant and lactating women for their high mineral content and are commonly ingested in teas and soups.
“The seaweed tradition for new mothers is based on the belief that eating and drinking sea vegetables helps with milk production and hormonal balance.”
— Myungju Sunim
Prenatal vitamins are acceptable as a complement to herbal therapies; vegetarian vitamins should be offered.
A period of observation is given for 49 days after death. It is important to return the remains of a deceased person to their loved ones. This includes remains from a miscarriage or stillbirth.
Buddhists traditionally use cremation accompanied by a family gathering. A monk will lead a ritual at the time of cremation. Depending on local laws, such a ceremony could be performed elsewhere. At a later time, traditionally on the 49th day after death, a final funeral with a eulogy and ritual will be performed by a monk, with the family gathered to offer gratitude and final blessings for the deceased. The 49 days of observation is referred to as the
“bardo,” or the period between death and re-birth.
In the case of dying or death, the family may contact any monk or Dharma teacher who could come to the hospital for support, offer a ritual, or simply help ground and guide the dying person or the family.
If the care team has resources, they could offer to reach out to a monk or Dharma teacher on the family’s behalf, and would be welcome to contact a nearby Buddhist temple or center and describe the situation and the family’s request.
An offer for a visit from the hospital chaplain could also be extended.
Visit https://buddhism.net.
Catholic
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Connect the patient to church support
- Ask what parish the patient belongs to and whether she would like a priest called to minister to her in the hospital.
- Refer Catholic moms who are struggling to their parish for resources and support.
When the baby is in known distress, ask the parents if they would like to baptize their infant or have someone do it on their behalf.
In the Hospital
There should be little to no medically significant impact from daily or weekly observance. Laboring mothers may bring rosary beads to pray with, or not.
For Catholic families, the laboring woman may request either Holy Communion or an Anointing of the Sick prior to childbirth from her parish priest.
“This [Anointing] is open to anyone who is undergoing surgery, has a life-threatening illness, or is in any life-threatening situation like childbirth”
– Shawn Bennis, a Catholic MSN, RN in the Detroit area.
Respecting the mother’s wishes and allowing space and privacy, as available, for these acts of healing are a respectful way to acknowledge the impact of faith throughout the mother’s journey to give birth.
For hospitalized patients who can’t have anything by mouth, Bennis clarifies that for Holy Communion,
“even the smallest amount of the Host, of what we regard as the body of Jesus, is important in order for her to receive Holy Communion, and will give her peace of mind and make her feel better about the situation that she’s in.”
Infant Baptism
Baptism is an essential Catholic rite of new life, and in most cases, follows a few weeks after birth. But in situations where the baby’s life is endangered or in distress, mothers may wish to have the baby baptized immediately upon birth. In extreme circumstances, this blessing can be administered by any person of any faith, using these words: “[Baby’s name], I baptize you in the name of the Father, and of the Son, and of the Holy Spirit.”
This rite is encouraged in any situation where there is life, however faint, after birth. As stated in the rites for Pastoral Care of the Sick, “sacraments are celebrated for the living, not the dead… the dead are effectively helped by the prayers of the living.” 1 This means that a person who has died is not capable of receiving the sacrament of baptism, so attention in a timely manner when infants are under duress is best.
Bennis recognizes that this isn’t always possible in highly-charged situations, but encourages her peers to consider offering this service on behalf of Catholic families.
“Sometimes, the mom might be in surgery and the dad might be somewhere else; so, there’s nobody around. In that case, a nurse could baptize the baby. But, if the baby doesn’t get baptized [because it’s impossible], Catholics believe that Jesus is going to wrap His arms around that child, and their baby will be lifted up in the grace of God and the soul of the child will not be lost. Still, baptism offers the grieving parents great comfort. It’s a compassionate service that many nurses have done.”
– Shawn Bennis
Stillborn or miscarried babies need no baptism, but their bodies may be blessed. Priests may offer comfort and blessings for the parents in these times as well.
In matters that are related to maternal and infant health, the Catholic Church holds as its guiding principles the sacredness of human life and the responsibility to invite and protect that life within the sanctimony of marriage. For Catholics, life begins at conception, and these principles guide
decisions regarding that life.
Abortion
For Catholics, abortion transgresses a cardinal rule to exhibit love and respect for all human life—created in the image and likeness of God—from conception to natural death.
Because of this belief,
“the Archdiocese of Detroit is committed to walking with and supporting women and families in need—with open arms and no judgment. It is through such spiritual, emotional, and practical support that we can create a world in which abortion is unnecessary and unthinkable, and all women are empowered to choose life for their children.” 1
There are many church resources aimed at helping Catholic mothers who may be overwhelmed by an unplanned pregnancy. Walking With Moms in Need is one which the Archdiocese of Detroit supports that providers may direct patients to.
See: Walking with Moms in Need Initiative – Archdiocese of Detroit (aod.org)
Genetic Testing
Many times, Catholic women will refuse procedures such as amniotic testing, which carry any risk of abortion. Even if a family history of abnormalities indicates a need for caution, post-conception genetic screening is generally viewed as unnecessary except to prepare for all eventualities and is only done when procedural risks are minimal.
Fertility Treatments
The Catholic guideline for matters pertaining to fertility treatments is a document issued in 1987 known as Donum Vitae (“The Gift of Life”), which addressed the morality of modern fertility procedures.
Donum Vitae teaches that
“if a given medical intervention helps or assists the marriage act to achieve pregnancy, it may be considered moral; if the intervention replaces the marriage act in order to engender life, it is not moral.” 2
Therefore, modern practices to treat underlying problems such as PCOS or endometriosis are encouraged. Hormone or other treatments that may result in multiple fetuses are able to be used with caution, for they may endanger the mother or the fetuses by putting too great a strain on the mother’s body.
Other practices, such as IVF and surrogacy are illicit. This is based on the belief that conception should be within the sanctimony of the marital act, as well as concern over practices such as “elective reduction” and the disposal of unused embryos which are the beginnings of life. 3 Surrogacy is also rejected by the Catholic church on these principles and as exploitative in its commercialization of the human body.
Pope Francis stated, in January of 2024,
“The path to peace calls for respect for life, for every human life, starting with the life of the unborn child in the mother’s womb, which cannot be suppressed or turned into an object of trafficking. In this regard, I deem deplorable the practice of so-called surrogate motherhood, which represents a grave violation of the dignity of the woman and the child, based on the exploitation of situations of the mother’s material needs. A child is always a gift and never the basis of a commercial contract.” 4
Contraception
For Catholics, both temporary measures (such as pills or IUDs) and absolute methods (like tubal ligation or vasectomies) are illicit. Only natural family planning methods are encouraged.
“We don’t believe in any means to stop conception [beyond natural family planning],” Shawn Bennis, a Detroit-area nurse, explains. “As a Catholic couple, when you marry, one of the vows that you take is that you are open to Life. So, if you are open to Life, contraception is not allowed because that would mean you were actively trying to prevent Life from happening. Men and women can seek additional support.”
The Archdiocese of Detroit maintains a website with resources, class registrations, and teachings about Natural Family Planning (NFP). That website explains that NFP “is a natural and open method of Fertility Awareness that allows husbands and wives to identify times of fertility and infertility in order to achieve or avoid pregnancy, while prayerfully discerning God’s will for their families.” 5
See: Natural Family Planning – Archdiocese of Detroit (aod.org)
1.Pro-Life Ministry Resources – Archdiocese of Detroit (aod.org)
2.Begotten Not Made: A Catholic View of Reproductive Technology | USCCB
3.The ethics of IVF: Where Catholics and Baptists can agree – Catholic World Report
4.Church’s surrogacy teaching rooted in the primacy of the rights of the child – Catholic Review
5.Natural Family Planning – Archdiocese of Detroit (aod.org)
For Catholics, the only faith-based issue that may arise is iron deficiency while fasting from meat during Lent or on Fridays if the patient is a strict adherent. Prenatal supplements will prevent this in most cases. While fasting is observed on Ash Wednesday and Good Friday, any expectant or nursing mothers are exempt.
For Catholic women, losing the life you have conceived and carried is devastating. No matter the gestational age of a natural pregnancy loss, Catholic women are encouraged to name their child and grieve the loss as if it were a full-term birth, since that child’s life began at conception. The
home parish may be an excellent support to families, especially those without local family networks.
Funeral rites and liturgies can be held for miscarried, stillborn, or deceased infants, though the readings will change based on circumstances. 1 Some rites can be celebrated in the hospital or in the family home. Other rites are better celebrated in a church, home or funeral home. The Funeral Mass is to be celebrated in a church. The cemetery is the appropriate site for the “Rite of Committal.” It should be noted that the special rite for “Final Commendation for an Infant” (Order of Christian Funerals # 337-342) is particularly suited to the committal of stillborns and infants who have died soon after birth. 2 Parishioners should contact their priest for details.
1.Bereavement and Funerals | USCCB
2. Saginaw Diocese Pastoral Guidelines for Mourning Loss of Unborn infant
Catholic Archdiocese of Detroit website:
www.aod.org
United States Conference of Catholic Bishops website:
www.usccb.org
Christian Science
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Allow Time, Space and Support for your Patient to Pray
Ask if your patient would like to pray before making choices or decisions, when in pain or fearful.
Respect a patient’s desire to pray, and when prayer is beneficial, recognize that it was effective.
If you feel comfortable, you may ask if your patient would like you to pray with them. The Lord’s Prayer is considered a universal prayer and would be appropriate for most situations.
What can the care team do to be helpful? Give time and space to pray, respect that a Christian Scientist has experienced success with prayer, and acknowledge that prayer is helpful.
– Susan Tish, Christian Scientist, Northville, MI
Understand that Christian Scientists Look at Medical Challenges Differently than You
Christian Scientist looks at medical challenges from a different perspective. They see God’s
steady and flawless spiritual creation and know they could never be in danger or outside of God’s care,
whereas a medical professional may perceive difficulty or danger. Christian Scientists aren’t in denial of their
condition, but embrace a different understanding of the spiritual nature of mankind.
What if the mother/parents do not want medical intervention? Some people may not yield to intervention and be unwilling to give up on God’s support and their confidence in prayer. After explaining health risk and available treatment options, ask if they need time to pray. If the family rejects medical intervention, it is necessary to respect their choice. Many Christian Scientists recognize this is difficult for healthcare providers.
– Susan Tish, Christian Scientist, Northville, MI
Support Their Relationships with Their Practitioner
Give your patient time and privacy to contact their practitioner for prayerful guidance.
Minimize Monitoring and Physical Examination
Ask if your patient would prefer medical equipment be kept out of sight.
Place monitors and equipment behind a curtain, in a closet or outside the patient’s room so they are not visible but readily available.
“I delivered at a hospital that had a natural birthing center, so there was no medical equipment in the room, which was incredibly calming. It was a natural, home-like setting, and was wonderful.“
– Susan Tish, Christian Scientist, Northville, MI
Essential Beliefs and Practices
At the heart of Christian Science is the belief that God is love and the source of all good.
Two texts are central to Christian Science: The Bible and Mary Baker Eddy’s Science and Health with Key to the Scriptures, which describes how healings in the Bible were accomplished through the example of Christ Jesus.
Christian Science is a Christian religion and involves a life practice centered in prayer and healing. Daily prayer informs and guides the person through life. Prayer is considered healing and able to relieve suffering and pain.
Birth is spiritual. Mother and baby are both perfect, complete beings, created spiritually as is described in Genesis I in the Bible. Birth is not considered a medical procedure but a spiritual unfoldment in which God sets parent(s) and child in a family together.
General Preferences
Patients will typically prefer the most natural birth experience possible. Many feel that through prayer, they will be relieved of the need for medical intervention during labor and delivery.
However, most Christian Scientists will typically choose an obstetrician or nurse midwife for care during pregnancy, delivery and post-partum, and are open to following the advice of their provider.
“I put myself in the care of my doctor or midwife. I prayed for them and trusted them to do their best to care for me and my baby.”
– Susan Tish, Christian Scientist, Northville, MI
Medical interventions, including prenatal vitamins, medication, and monitoring during the birth process, are often not desired and are considered secondary to prayer. While Christian Scientists are not against medical interventions, their preference is usually to use prayer first and they trust that their needs and those of the baby will be met through Christian Science prayer.
Christian Scientists may prefer limited or no monitoring during the birth process, and limited or no visible medical equipment in the birthing room. Some mothers prefer to give birth at home.
The Role of the Christian Science Practitioner
Many expectant mothers have a Christian Science practitioner, a person who is a spiritual healing professional and has been trained to pray with individuals to heal any kind of physical or emotional challenge. The Practitioner prays with them from the beginning of pregnancy through post-partum. A mother or her partner may wish to contact their practitioner by phone during the birth process. In some cases, the mother may request the practitioner be present at the birth.
Christian Science Practitioners care for the family much like the healthcare team and are viewed similarly to healthcare providers. It is not uncommon for a Christian Scientist to have a midwife and a practitioner.
The Role of Prayer
Prayer is a great comfort for the mother and child and the preferred initial approach for healing and relief of pain and fear. Christian Scientists believe God cares for them fully and will provide everything they need to be healed and comforted. They will pray vigorously for understanding and acceptance that humans are created in the likeness of God, are complete, and have everything they need. Prayer is the trusted, preferred and they believe the most proven and reliable form of healthcare.
If prayer has been conducted and the patient’s condition is not improved, a Christian Scientist may choose medical intervention. Their beliefs are that God cares for them fully, and if medical intervention is needed, God never leaves them and they will be cared for, and safe.
Modesty and Privacy
There are no rules or guidelines about modesty or privacy.
Faith Expressions and Rituals
Prayer and the Christian Science practitioner are important during pregnancy and birth.
Important Items
During birth, a mother will typically have with her the Bible and Science and Health with Key to the Scriptures. This is a comforting book that explains how Christian Science prayer and practice work and how to pray spiritually, in the manner taught by Christ Jesus. Both texts are cherished and should be treated respectfully.
Infant Care
The most important care for a baby is prayerful support, and Christian Scientists will follow the best wisdom in the moment for the care of their newborns. Parents may ask to pray before treatment is given or for time to call their practitioner for prayerful guidance.
“God leads us with the wisdom we need to care for the body. We believe that with God, all things are possible.”
– Susan Tish, Christian Scientist, Northville, MI
Abortion and Medical Termination of Pregnancy
The church has no official position on abortion or medical termination of pregnancy. It is an individual choice, although it is unlikely to be the path a Christian Scientist chooses. A Christian Scientist will prefer time to find guidance and a solution through prayer when dealing with any challenge to the life or health of a baby or mother.
Fertility Treatment
While prayer is the preferred and initial approach, there is no official position regarding fertility treatment. Choices may range from no fertility treatment to full acceptance of all available approaches. Some individuals may choose fertility treatment after a period of prayer. It is a completely individual choice.
Contraception
The church has no official position on contraception. It is an individual choice.
There are no rules or guidelines about diet. Christian Scientists rely on God through prayer to know and understand the diet a mother and baby need.
At a time of loss, a family will need time and space for prayer. They will likely call their Christian Science practitioner. You may ask if they would like to see the hospital chaplain.
In the moments after death, Christian Scientists will envelop the person who has passed in prayer. Before the body is taken, they will want time to pray and support the infant as the child moves on.
Cremation, in-ground burial, and entombment are all permissible and depend on the wishes of the family.
Visit https://www.christianscience.com.
Science and Health with Key to the Scriptures by Mary Baker Eddy is an important text and considered a
companion to the Bible.
The Church of Jesus Christ of Latter-day Saints
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Be sensitive to a patient’s need for modesty.
Protect her modesty by keeping her covered as much as possible and limiting the people in the room when
she is exposed.
Allow time and space for your patient to pray and for church priests to perform blessings for the mother and
infant.
Essential Beliefs and Practices
Found worldwide, the Church of Jesus Christ of Latter-day Saints is a Christian faith.
While sometimes called “The Mormons,” members prefer the official name, which can be shortened to the Church of Jesus Christ or sometimes Latter-day Saints (LDS).
- The name emphasizes the importance of members’ relationships to Jesus Christ.
- Latter-day refers to the church’s establishment by Jesus Christ when he lived and its restoration in these “latter days.”
Members treasure the sanctity of life and believe suicide, euthanasia and abortion are not in accordance with God’s laws.
General Preferences
Many guidelines are purposely vague, enabling members to have “agency” and make decisions that are best for themselves and their families.
Church members are typically receptive to the advice and guidance of their medical care team.
Children and family relationships are very important.
“Most members are open to talking about their faith and welcome questions and acknowledgement of their faith from their care team.”
– Michelle Lorenc, RN
The Role of Prayer
Prayer is personal communication between the individual and God. Few prayers are formal. A family may pray together, but there is no prescribed structure.
The Priesthood Blessing
The family may request a priesthood blessing if the mother or infant are sick or need support, comfort, or healing. They will reach out to their congregation and contacts in their church for this blessing.
The blessing can be given by their bishop or another man holding the priesthood. Latter-day Saints believe the priesthood power is God’s power restored from ancient times.
A priesthood blessing is not seen as a replacement for medical care, but as a supplement that offers comfort and may result in divine intervention. Typically, two priests from the church will visit, pray with the patient and family, place their hands on the patient’s head, and apply healing olive oil. Only men have priesthood roles and serve on a rotating, lay basis.
“We also have ministering brothers and sisters who are available for advice, assistance and support. We look out for each other. A woman may want her ministering sister, and the father his ministering brother, to come to the hospital during labor or after delivery, but typically they provide meals and support once the family returns home.”
– Michelle Lorenc, RN
Modesty and Privacy
Modesty is reflected in dress, grooming, language and behavior. Church members avoid revealing clothing or extremes in appearance, hairstyle, dress or manners so they do not draw undue attention to themselves. The purpose of modesty is to glorify God in body and spirit.
The care team should limit exposing the patient and keep people to a minimum in the patient’s room when she is exposed.
The Temple Garment
Members may wear a garment similar to a tank top and bike shorts next to the skin as a reminder of their covenant with God. The garment should be treated respectfully.
“A woman may want to wear her temple garment during labor. The care team can offer to work around the garment as much as possible, and ask her to remove the bottom only when necessary.”
– Michelle Lorenc, RN
Faith Expressions and Rituals
A patient may request a religious leader from her church bring in the sacrament, similar to taking communion. Bread and water are ingested as a symbol of the body and blood of Jesus Christ. This would mostly likely be requested on a Sunday.
Infant Care
There are no unique guidelines for infant care while in the hospital. The family may ask a priest to perform a blessing, especially if there are health concerns for the infant.
Important Items
- A patient may wish to read the Book of Mormon, an official text of the church, and the Bible. Many women will have these texts on their phones to access scriptures.
- The Word of Wisdom is a law of health revealed by God; a patient may reference this text when discussing health and wellness.
Personal Perspectives
Could I ask a Church of Jesus Christ member if they would like a visit from the hospital chaplain?
Most would be open to talking with a chaplain from another faith. They would likely want to connect with a bishop from their own congregation, as well.
Do church members have big families?
In the past it was common for families to be very large, but today most couples use birth control and have between two and five children.
Are gender roles rigid in the Church of Jesus Christ?
Gender roles are evolving. In the past, many married women stayed home with children and husbands worked outside the home. This has shifted to many dual income families with both partners working together to balance work and the needs of the family.
“We believe women should be educated, have a career and fulfill their own goals in addition to having children. Gender roles are flexible, and while it’s still not unusual for a woman to stay home and care for the children, today, husbands can also care for children while the wife works.”
– Michelle Lorenc
Can women be religious leaders?
Women are leaders in the church although they are not ordained with the priesthood. They are usually active in service and can sit on the general board of the church and participate in the councils of the church. Only men hold the priesthood and serve as bishops (like pastors) and provide the sacrament to
members of the church. (The sacrament is bread and water that are blessed and shared to remember the body and blood of Jesus Christ.)
Can I offer to pray with a member of the Church of Jesus Christ?
Yes, it would be welcomed regardless of your faith.
Fertility Treatment
This is an individual choice. Fertility drugs are widely accepted. For in-vitro fertilization or artificial insemination, it is preferred that the egg, sperm and embryos come from the parents rather than a donor, but this is also individual choice. A Church of Jesus Christ member would have concerns with disposal of unused embryos due to their respect for the sanctity of life.
Contraception
This is individual choice but widely accepted. Vasectomy and tubal ligation would require prayerful consideration, but are personal decisions for a man and woman.
Premarital Sex
Sex outside of marriage is not in accordance with God’s laws. The church does not encourage couples living together before marriage. As a result, some members marry and start having children in their early 20s.
Abortion and Medical Termination of Pregnancy
Church members have a strong belief in the sanctity of life and do not support abortion. Exceptions are made in situations involving rape or incest, or when the fetus is not expected to survive after birth.
Medical termination of a pregnancy is accepted when the health or life of the mother is at risk and advised by the patient’s medical team.
When considering terminating a pregnancy, a woman may wish to meet with her bishop and seek guidance through prayer. Whenever possible, providers should allow time and space for a woman to reach a decision.
The Word of Wisdom is a text outlining laws of health determined by God. It prohibits the use of alcohol, tobacco, coffee, tea and recreational drugs. It supports a healthy lifestyle, such as sparing use of meat, a healthy diet, regular exercise, proper hygiene and adequate rest.
A pregnant woman would follow these guidelines and the advice of her healthcare providers.
Cremation and burial are accepted.
At a time of sickness or loss, including miscarriage, a Church of Jesus Christ member would likely request a priesthood blessing or a visit from the family’s ministering sister or brother. Members are not baptized as infants.
Hindu
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Jain
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Ask what dietary preference the patient has.
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Ask what synagogue/ Temple they attend and who to contact, if needed.
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Ask parents if they are comfortable to share their newborn’s name, instead, give them the contact information for the registry office.
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Refer grieving parents to local support groups. Temple Israel in West Bloomfield is an example.
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Ask the parents how the dad would like to be involved in the delivery. Should there be a mirror? Does he want to cut the umbilical cord? Or just be by the head of the bed?
Prayer
Practicing Reform Jewish women may pray three times a day, like the men. Allowing them time and space to do so is respectful.
Modesty and Gender Roles
Most Reform Jewish women dress like the rest of society and have few actual laws that providers should be aware of. Some may cover their hair or wear a cap (kippah, like observant Jewish men), but most don’t.
Most Reform men participate in their wives’ labor and delivery. While in Judaic law, Jewish women become a Niddah or are in a state of being unclean due to the vaginal discharge in active labor and delivery, there are exceptions to the teaching that they must be separate from their partner in this time of blood. For
Reform Jews, this traditional law is overridden by the husband’s need to aid his wife in her distress during labor. Therefore, Reform Jewish men will touch and support their wives through the entire process of labor and birth.
Rituals
Circumcision is practiced for males at eight days old. Many groups are evolving their views on circumcision, and some will request circumcision completed at the hospital to save themselves from the expense and trauma associated with the traditional practice. There is a great variation in this topic, and it is evolving rapidly. 1 Naming ceremonies are traditionally practiced at the first Torah reading following birth for girls and eight days after birth for boys. 2 Jews will traditionally not even speak their child’s name before these events. There are many modern naming rituals for Jewish boys and girls that have evolved outside of the male circumcision (Brit Milah) and female baby naming (Simchat Bat). Asking a family that is trying to preserve the name until the official naming might cause tension, as they may feel superstitious and not choose to share the name.
Jill Gutmann, a practicing Jew and Rebbetzin (Rabbi’s spouse) explains, “This tradition is related to earlier times when many infants died in the first week after birth. Once they survived the first seven days, they were given a name since their potential for life was stronger.” Many Jews are named after family members to prolong the memory of those family members. Gutmann adds, “The highest value for Jewish individuals is to have their actions and deeds remembered.” When a Jewish person dies, we respond, “May his (or her) memory be for a blessing.”
The Judaic concept of life is viewed in terms of potential life rather than absolutes of life/not-life. Conception is not the beginning of life, but rather, the beginning of potential life. This viewpoint governs all medical choices and ethics, with human potential growing in tandem with the developing fetus. The first forty days from conception are equated with water, this means embryos are in equal status to water. Even after then, the potential for life is not complete. Life is defined as beginning with the baby crowning or “the greater part” leaving the mother. While interpretation of Jewish laws varies widely between traditions, this perspective focuses on a mainstream viewpoint. Reform Jewish women practice Judaism by Choice Through Knowledge—studying Jewish laws and their intrinsic intentions to allow them to live as Jews in a modern world.
Contraception
Mainstream Jews have no problem with using contraception to space children or to prevent unwanted pregnancies. Preventative means include all modern preemptive methods (birth-control pills, IUDs, condoms, etc.) as well as morning-after pills because the first forty days after conception are viewed as Water, non-corporal, or of small consequence (regarding potential). 1
Fertility
The basic premise of Jewish care is to do no harm to the mother, so experimental treatments that may endanger the mother are not permitted. “IVF and other proven treatments are permissible,” explains Jill Gutmann, a practicing Jewish Ethicist and Rebbetzin (Rabbi’s spouse). “Some of these treatments were
pioneered by Jewish physicians because Judaism values and believes in being fruitful and having children. The Biblical story of Abraham and Sarah guides our desires.” 2
Genetic Testing
The prevalence of genetic testing among mainstream Jews is high. Rather than attempting to prevent common Ashkenazi (Jewish Genetic Diseases) by restricting marriage partners, as in some Ultra-Orthodox traditions, mainstream Jews consider testing either after natural conception or as part of IVF. 3
“Diseases like Tay-Sachs are known Jewish recessive genes. That condition has a one-to-two- year lifespan with a horrible quality of life. That leads many Jews to use genetic testing so that they can make appropriate choices regarding potential life,” Gutmann says.
Abortion
In Judaic tradition, for the first forty days after conception, the developing embryo is akin to water. The potential for life is barely discernible, and so that leaves a lot of space for consideration and choice for mainstream Jews. 5
“The longer that potential has to develop, the more weight is placed considering termination of a fetus,” explains Gutmann. “There are reasons that have more weight than others for having an abortion. If testing shows that that fetus has markers for life-altering and life-ending abnormalities, abortion is commonly
practiced among Jewish people. If, like in my case, my family has a recessive gene for hearing loss; in that case, hearing loss is not necessarily a reason to abort, but this is a family decision.”
Reform women are, overall, less likely than other more orthodox Jewish groups to abort, given that they may be more influenced by modern societal norms in viewing a fetus like a baby, and may name and celebrate potential life in ways different than traditional Jewish practices.
1.The Contraception Debate 46 Years Later | Reform Judaism
2.Why Infertility is a Jewish Issue – and What We Can Do About It | Reform Judaism
3.7 Things to Know About Jewish Genetic Diseases | Union for Reform Judaism (urj.org)
4.The Contraception Debate 46 Years Later | Reform Judaism
5.Abortion and Reproductive Justice: A Jewish Perspective | Religious Action Center of Reform
Judaism (rac.org)
Keeping Dietary laws and practices is a relevant concern for any practicing Jewish woman. There is a spectrum of Kosher practice for mainstream Jews. Providers should ask what patients’ preferences are. Some may eat traditional Kosher, vegetarian (warm or cold), vegan, or pescatarian diets. Most will not eat Pork or shellfish. Most Kosher observing Jews will abstain from mixing meat and dairy products. Jill Gutmann, a practicing Jew and Rebbetzin (Rabbi’s spouse), explains that liberal Jewish traditions follow stricter husbandry standards and consider the intent of ancient laws to improve common practices paramount
to practicing Kosher. “I will sometimes choose halal food or pasture-raised meat or eggs over Kosher labeled ones, because I want the animals I consume to have been treated well and their workers to have been paid fair wages. That is more Kosher to me than some big Jewish-owned operations which provide neither to their animals or workers.”
Most women will be fine with vegetarian meals at the hospital. Not all Jews are concerned with dietary laws, so providers should ask patients to confirm their preferences. 1
The Judaic perspective of potential for life also governs the rituals and practices surrounding loss. A miscarriage at five weeks, while perhaps disappointing to the parents, is treated as a small loss because the potential for life was still small. A stillborn is traditionally buried in an unmarked grave in a separate section of
the cemetery; but then, a two-month-old’s death has all the rites and burial of an adult. In Judaism, theology governs all these practices. A stillborn infant has performed no actions or drawn breath.
“It’s as if it never existed,” explains Gutmann. “It’s why we don’t congratulate women on becoming pregnant. Instead, we say, ‘May it be your hour of good’ because we are acknowledging the potential. But that potential hasn’t happened yet.”
A month-old child is not only named but has inheritance claims to its parent’s resources. The potential is defined and so is the loss. For Reform Jewish women, they may struggle the most with early loss. “The more secular a Jewish woman is, the more devastated they may feel since they are attuned [to the western world’s ideas of loss],” Gutmann explains. Some local Reform synagogues have begun to provide support groups for these mothers. 1
See a local Reform Jewish group for grieving mothers: Temple Israel Bereavement Support Group
1.A Jewish space to mourn pregnancy loss opens -The Forward
Temple Israel
Questions about beliefs or practices? Email the Women of Temple Israel (WoTI) Co-Presidents, Laila Cohen
& Diane Okun: Diane.Laila.tisisterhood@gmail.com
Website for understanding Reform Jewish tradition.
Orthodox Jewish
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Greet the opposite gender appropriately
If greeting an Orthodox woman, and you are a male provider, don’t extend your hand for a handshake or touch their shoulder or arm in greeting. A simple hello and introduction are appropriate.
Don’t judge choices
Don’t assume that you know why women make the choices they do, ask women with curiosity instead of assigning reasons with judgement.
Support their observance of the Jewish Sabbath
If it is Friday evening or Saturday (the Jewish Sabbath), providers should ask women what accommodations or help they may need to keep their Sabbath
observance.
Offer resources for support around miscarriage, stillbirth or infant loss as needed.
In the cases of miscarriage, stillbirth, or infant loss, be aware of the mother’s mental health and Jewish laws regarding physical contact that limit her access to her spouse’s comfort. Offer extra resources for support if needed.
Support the needs of patients by asking what they need.
If chaplains or other faith providers are making rounds at their hospitals, please be conscientious of other faith traditions and offer support in terms of what would make them comfortable instead of what you feel most comfortable with. Ask what they need, rather than if they want you to pray or bless or read to them (etc.).
Modesty or Dress
Orthodox women are very conscious to observe rules of modesty. Their elbows, knees and hair must be covered. Necklines of clothing are high and many wear wigs outside the home. Many prefer female providers but may use a male when necessary. In surgical settings, a surgical bonnet may suffice as hair covering.
“We don’t touch, or shake hands with, men except for our spouses. So, when a doctor comes in and wants to shake your hand, it’s extremely uncomfortable. I’ve always said, ‘I’m sorry, I don’t shake hands with men for religious reasons.’ Usually everybody backs off right away, but if they knew beforehand, that would make everyone more comfortable.”
– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
In Pregnancy
Orthodox Jews celebrate six fast days. Jewish women who are pregnant or nursing (for up to two years) are exempted from fasting, except for Yom Kippur and Tisha B’Av. Even then, providers can help advise when fasting may be unwise. Some pregnant women may gain dispensations to abstain from fasting due to medical conditions or constitution. Depending on their physician’s recommendations and rabbi’s directions they can be allowed to eat and drink.
“In those cases, Yaffa Rabin explains, “You can’t sit down and have a feast, but you can nourish yourself. [For example], my youngest son was born on Yom Kippur, and there is a dispensation for a woman who has a baby, that for the first three days after birth she is considered like a person who is ill or in danger, and, that Yom Kippur I was allowed to eat after my labor.””
– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
In the Hospital
Prayer is a common Orthodox practice in times of distress or thankfulness, and birth is often both. Providers may note that a prayer card is posted for protection, and the father may recite Psalms during labor or after birth. If an Orthodox woman is in the hospital over a Sabbath (Friday evening at sundown to Saturday after dark) she would require two bread rolls and kosher grape juice for Kiddish observance, Friday evening as well as Saturday lunch.
Also, since the Sabbath is a day of rest from industrial creative work, which includes driving, using electricity, or using electronic devices. Staff should ask an orthodox patient what they can do to help the patient keep the Sabbath.
“We aren’t allowed to carry on the Sabbath, but the uber driver could carry my bag for me and give it to the hospital personnel who takes me in the wheelchair; These laws have nothing to do with the physical ability to carry something, but everything to do with it being the Sabbath.”
– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
At Delivery
Please note that some Orthodox men will leave the delivery room for the actual birth and will refrain from touching their wives afterward, as Orthodox women are considered spiritually impure (niddah) from the time of bloody show, or active labor until approximately five to six weeks after birth.
“Once a woman becomes a niddah, her husband may not see the parts of her body that are normally covered, and therefore, must not watch the actual birth of his child. Obviously, if there is no one else to aid his wife (doula or female relative), he may remain in the room but will not look at private parts of her body.”
– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
This in no way denotes a lack of affection or concern, but a regard for, and respect for their wives.
Postpartum
In Orthodox tradition, babies are not named right away.
“We don’t say male names to anyone until the eighth day. And females are named on a Monday, Thursday or Saturday at the reading of the Torah in the Synagogue. So, if providers could understand that we will probably not give the baby a name during the short stay in the hospital, it could save a lot of aggravation on both ends.”
– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
Circumcision is performed at eight days; and spiritual cleansing for the woman in a Mikva—ritual bath—is performed at approximately six weeks postpartum.
More Information:
1. Laws of Childbirth – Parshat Tazria – Chabad.org
2. Shabbat in Thought, Speech and Action – Parsha Yitro – Chabad.org
A significant tenet of Judaism is being fruitful and having children. Orthodox Jews value the sanctity of life and consider it a blessing from God, whatever potential that life form possesses at any given moment. Jews recognize a difference in value, if not potential, within the first forty days of conception than afterward. Children who are miscarried or stillborn are not considered to have lived and are unnamed. Another Jewish tenet that may intersect at times with the concept of bearing many children is that flourishing life should be saved before unproven life. Thus, in all cases where the health of the mother is at risk because of her fetus, the life of the mother takes priority.
Abortion and Medical Termination of Pregnancy
Abortion is prohibited. Only in cases where the mother’s life is endangered, and that physical or severe mental health threat (suicidal) is confirmed by doctors, may a dispensation (or allowance) be granted after speaking with a rabbi.
“In general, it’s prohibited. However, [there’s] a principle that saving the mother’s life comes before saving the child. Therefore, in extreme situations, if there is danger to the mother’s life, and with Rabbinical consultation, abortion could be permitted. Otherwise, we don’t condone it.
Another child can, at times, be a difficult blessing to accept; but it is a blessing.”– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
Genetic Testing
Due to the intrinsic Judaic values of parenthood, and the close genetic relationships within Orthodox Jewish society, the question of genetic testing is one that Orthodox families take seriously. At least one in three “healthy” Jews are carriers of at least one severe, recessive Jewish Genetic Disorder [JGD]. While practicing Orthodox Jews will, for the most part, decline prenatal genetic testing, since abortion is prohibited in terms of a solution to abnormalities, many are proactive in preventing problems by screening marriages.
“Many Orthodox children, around the age of eighteen, are tested for a number of genetic diseases that are found among the Jewish people,” explains Yaffa Rabin. She utilized a Jewish genetic screening service called Dor Yeshorim, which allows Jewish parents to determine the genetic
viability of potential marriage partners. “With my son’s test results number, I could call and request that his results be compared to a prospective young lady’s, to know if he should proceed to meet her and date, for the purpose of marriage. Dor Yeshorim will tell me if the pair were a healthy genetic match or not—this can avoid many tragic scenarios.”– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
Fertility Treatment
For Orthodox Jews, any supportive medications or treatments are encouraged to help the couple conceive naturally. The advent of IVF treatments, though, raised questions about what parentage means, especially when one of the parties involved (egg donor or gestational carrier) is not Jewish. Tracing lineage becomes problematic in those cases because the Torah (Jewish sacred text) explicitly states that Jewish heritage follows only the matrilineal line. One solution is to have IVF done under specific supervision by a recognized Jewish Authority.
“There are a lot of things that weren’t available fifty years ago. There is an organization called Bonei Olam [and others] that offers fertility treatments under the auspices of rabbinic supervision, so that the embryo that’s implanted and so on, is supervised from beginning to the end—which would ensure [that] later in life, there are no questions as to [the child’s] Judaism.”
– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
Contraception
Contraception is not encouraged in Orthodox Jewish tradition but is allowed under certain circumstances. When women struggle physically or mentally, due to health or other situations, they may speak with their rabbi to be granted dispensation to use certain forms of birth control. There are limitations on the method, since Orthodox Torah law states that men’s semen may not be harmed, wasted, or spilt. So, options are limited to a female-based methods
such as pills, a diaphragm, or an IUD. Rabin explains that since the mother’s health is paramount to the family, there are times when rabbis acknowledge a need for a rest.
“In biblical times, women weaned their babies at around two years old, and that prevented pregnancy. Nowadays, you don’t necessarily get a two-year window. Bodies have changed and this natural window does not necessarily apply. If a woman is having mental health issues, and they need some time between children, a rabbi may facilitate the use of contraception after an in-depth discussion as to the reasons.”
Because of their strong belief in the blessing of children, many Orthodox families are larger than average. This reluctance to curtail size may surprise some providers, and unwittingly cause frustration on their patients’ part.
“It can be disturbing to show up to a prenatal appointment a year after giving birth to hear, ‘Oh, so we are doing this again are we?’ It takes faith to allow God to determine when, and how my children enter this world. Part of our belief is to happily accept God’s blessings when they come; at the same time, recognizing that it can be challenging and difficult to raise a large family. And for me, considering the long-term rewards of the joy of grandchildren, that decision has been extremely fulfilling and worth it. Providers should support Orthodox mothers in that faith choice, even if it’s a choice others might not make.”
– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
More Information:
1. Judaism and Abortion – The Jewish View of Abortion – Chabad.org
2. I Have Enough Blessings. Should I Abort? – Chabad.org
3. What Are Jewish Genetic Diseases? | My Jewish Learning
4. Is Genetic Testing Kosher? – Chabad.org
5. In Vitro Fertilization (IVF) – Chabad.org
6. What is the Torah’s view on birth control? – Chabad.org
Orthodox Jews follow strict Kosher dietary laws. This includes: no pork; all other meats must be slaughtered and processed in specific ways; maintaining a separation of meat and dairy; and the preparation and storage of all commercial foods must be under Rabbinic supervision. If Kosher-labeled food is unavailable in medical settings, non-processed fruit and vegetables may be eaten. For example, a fruit cup is not permitted, but an uncut, whole apple or banana is.
“Everything that is freshly grown is Kosher,” Yaffa explains, “unless it has been prepared in a way that we can’t verify its Kosher status.”
On a related note, some patients may refuse medicine with animal byproducts (pork-derived gelatin, other animal fillers). Practice may vary individually.
For example, Yaffa explains that“each person must consult their rabbi, as some rabbis are of the opinion that if medication is in a vegetarian capsule, then nothing inside it is touching the mouth, and that would be permissible to swallow.”
However, if non-kosher medication is required to save a life in an emergency, it is permissible and should be taken.
More information: Medicine, Kosher, and Practical Jewish Law – Chabad.org
In unfortunate circumstances, the chevra kadisha (Jewish burial society) will ensure proper care and rites are undertaken. For infants who die before birth, or within thirty days of birth, funeral rites are usually not attended by the parents and the traditional seven days of mourning (shiva) are not observed. The infant is interred in an unmarked grave. Even though the procedure of burial is different in these cases, the feelings and connection in the heart can still be very strong. Grieving the loss is not minimized. Patients usually consult their rabbi for detailed guidance in these areas. Staff should be as supportive as possible.
“My mother lost a baby, and we never spoke about it, though everyone remembered. Times have changed, and people are able to grieve a little more freely now.”
– Yaffa Rabin, Orthodox Jewish mother, Oak Park, MI
Providers should note that since Orthodox Jewish husbands are not able to touch their wives after birth. this means that when Orthodox women miscarry, deliver stillborn, or lose newborns, their spouse cannot provide physical comfort despite their shared loss. This can be challenging for grieving mothers’ mental and emotional health.
More Information: Why Are Stillborns’ Graves Unmarked? – Chabad.org
The Detroit Council of Rabbis in Southfield (Orthodox) www.cordetroit.com
or Mikvah Israel, a Mikvah for women in Oak Park at (248) 967-5403
Online: www.chabad.org
More Resources:
- Judaism and Abortion – The Jewish View of Abortion – Chabad.org
- I Have Enough Blessings. Should I Abort? – Chabad.org
- What Are Jewish Genetic Diseases? | My Jewish Learning
- Is Genetic Testing Kosher? – Chabad.org
- In Vitro Fertilization (IVF) – Chabad.org
- What is the Torah’s view on birth control? – Chabad.org
- Medicine, Kosher, and Practical Jewish Law – Chabad.org
- Laws of Childbirth – Parshat Tazria – Chabad.org
- Shabbat in Thought, Speech and Action – Parsha Yitro – Chabad.org
- Why Are Stillborns’ Graves Unmarked? – Chabad.org
Muslim
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Ask who the patient is comfortable having in the room, whether it’s a prenatal appointment, ultrasound
exam, or labor and delivery room.
If a patient wears a hijab, ask if she’d like a sign put on the door for any visitors to knock.
Draw the curtain as well to give her time to prepare herself to receive visitors who knock.
Don’t brush aside the efforts of family members to help new mothers, they feel it is their role and right to
help after delivery.
Ask if the patient needs their bed or chair turned toward Mecca for prayers during a hospital stay.
Inquire if they’d like the curtain drawn as well.
Ask if they would like to wash the newborn baby themselves or have you do it under their guidance.
Prayer
Prayer is a pillar of Islamic practice, and most women will desire space and privacy to perform their prayers facing east-toward Mecca. This can be accomplished simply by turning a chair or bed and closing a door or drawing a curtain. Also, cleansing before prayers and after using the bathroom may need some accommodation for bed-bound patients with a bowl of water left by the bed or sanctified dust if water is not allowed.
Also to note: Women are exempt from prayer when they have discharge, so women are exempt from prayer during postpartum bleeding.
Fasting
Pregnant and nursing mothers have to consider if fasting is safe for mom and infant before making the decision to fast. They can be exempt from the usual fasting if it’s unsafe for both mother and infant. Even during Ramadan, mothers can tithe in place of their fast. These tithes support the less fortunate.
Childbirth Traditions and Rituals
In pregnancy and labor, there is nothing specifically related to a physician’s work, though there are traditions like consuming dates during labor, reading the Surah Mariam (Quaran, Maryam, chapter nineteen), using Holy Water to ease the pangs of labor, but these depend on culture.
After childbirth, the child is recommended to be washed ritually, and the father or mother is happy to do so or explain to providers (first, wash the head, then right and left sides). A registered nurse at a local hospital, Shadia Hamka shares,
“as nurses we bathe the infants and if a Muslim mom asks if they can wash the baby a certain way or to perform it themselves it’s important to ask to understand and to learn instead of misunderstanding their request and taking it personally. In a situation like this, you would learn that this is a recommended act within their religion and how you can help honor it. Sometimes, in certain cultures, women don’t advocate as loudly and [being in western hospitals] it can be difficult if we don’t understand the culture and religious practices of our patients in order to help fulfill these rituals.”
After the cleaned baby is returned to its mother, either the parents or a close relative will recite the azān (call to prayer) in the newborn’s right ear and then the Iqamah (beginning of prayer) in the left. Circumcision of male babies is also practiced in Islam.
Postpartum and Infant Care
It is important to note that breastfeeding is highly preferred to age two. Regarding breast milk banks, Islam forbids the use of unknown donor milk because, under Islamic law, babies that suckle from the same breast become ‘siblings of the milk’ and cannot marry. Therefore, only identified donors can be used. 1
1.Islamic Beliefs About Milk Kinship and Donor Human Milk in the United States | Pediatrics |American Academy
of Pediatrics (aap.org)
Hijab and Privacy
Hijab is a traditional head covering worn by many Muslim women. It is a symbol of modesty and emulates the virgin Mary, mother of Jesus. The hijab may be worn during prayers, in the presence of men other than family, and with strangers or friends of other faiths. 1
Placing a sign on the door asking providers to knock before entering would be considerate to allow hijab-wearing mothers adequate time to prepare for visitors and providers. Patients may also refuse entrance to male guests or medical students based on their comfort at a vulnerable time.
There is a strong to absolute preference for female providers depending on observance. Patients may prefer to reschedule appointments rather than see a male provider if the genitals will be exposed. It’s a good idea to ask ahead of time who the patient does and doesn’t want in their room. 2
Gender Roles
A local nurse explains,
“[For example,] those from extremely conservative cultures, especially more recent immigrants, usually request to have only female providers or female family members in the labor room. Whereas others from different cultural backgrounds or religious practice might have a different preference. Islam allows for the husband to be in the labor room. There’s no religious issue with it whatsoever. I think it is hard for providers to be able to tease out the differences between [religious and cultural] issues. But it shouldn’t change how they treat people, and instead of assigning whether it’s a faith thing or a cultural thing, and not understanding, they should just ask, ‘what works for you?’”
Cultural Roles
There are strong Muslim traditions around childbirth and intergenerational help. 3 While western providers encourage new mothers to be up and moving and provide for themselves, yet many Muslim grandmothers consider their role during the first few weeks of new motherhood to be that of nurturer of the new mother. By directing the new mother to do it herself, providers may inadvertently invalidate the desires and wishes of the family to show support.
1. Understanding Hijab: Frequently Asked Questions Answered on World Hijab Day – Muslim American Society
2.Modesty Among Muslim Women: Implications for Nursing Care – PubMed (nih.gov)
3. Nursing care of the Childbearing Muslim Family – Journal of Obstetric, Gynecologic & Neonatal Nursing (jognn.org)
Islam embraces science as a rule. “The family is the basic unit in Islam. Safe motherhood, family planning, and quality reproductive and sexual health information and services and assisted reproductive technology are all encouraged within the frame of marriage.” 1 In difficult or complicated decisions, Imams (or religious scholars) are usually consulted on how to best apply the laws of jurisprudence (found in the sharia).
“Unless a Muslim woman were to be experienced in Islamic law, they usually will seek guidance from a spiritual leader. One needs to be sure they are understanding the ruling correctly. Our scholars have studied these laws extensively and have a strong background to help guide us. It is important to take precautions and ask a spiritual leader to help guide you in making the best/safest decision.”
— Shadia Hamka
Abortion
Abortion is forbidden in Islam, except in the strictest of circumstances. In instances of rape, incest or other abuse, it may be allowed but must be reviewed with the Imam beforehand. In any case, medical termination must occur before 120 days (about sixteen weeks), or the time of ensoulment in Islam—when the soul of that child is believed to have entered the fetus. 2 Anything after that date becomes difficult to justify by jurisprudence, except in rare cases where the mother’s life is in danger, or the fetus has been proven with surety to be unviable and the pregnancy detrimental to the mother’s mental or physical health.
Hamka explains that while,
“Many might say, what if you are pregnant and they’re telling you that the baby has a defect? For us, it’s not a reason to abort. What if they are saying the baby is going to die or won’t be able to survive? It’s still not a reason. That fetus has the right to be born. It’s not easy raising a child with a medical condition; but it might just be our test from God. There are many stories you hear about a mother that is told her infant won’t survive and it does or that her infant will have a medical condition and it’s born perfectly healthy. It’s all in the miracle of God, he knows what’s best.”
In the Quran, chapter two verse 286, believers are reminded that God does not burden a soul beyond what it can bear.
Genetic Testing
If testing does not endanger the fetus, it is generally accepted. Most Muslim women would not choose to abort based on findings, unless they were conclusive and verified by multiple tests; and even then, may rather allow God to choose how and when to take life. This choice is based on Islamic belief that submitting to Allah’s will, even if the baby will not make it, allows for the woman to be compensated for her efforts and patience in trusting
Allah’s timing. Again, the mother’s life is paramount in any medical emergency.
“I was told at six months [gestation] that my son would be born with a chromosomal abnormality—which would
mean that he wouldn’t survive long past his birth. But it wasn’t conclusive, so I sat with my doctor, and he talked
me through it. I had some genetic counseling. I spoke with my Imam. But even though I went through all of that, I
knew that I would carry the baby to term.
“It is always advisable to seek medical and spiritual expertise in challenging situations. You have to be told by
experts that this is the situation, and then you seek counsel from your Iman. For the most part, you are counseled
two ways. First, you are advised that if you can carry [the pregnancy] through, even knowing that the baby might
have abnormalities or might not live past a certain age, that God will compensate you and reward you heavily, and
that that baby will be waiting at the gates of heaven for you. But in the case that the mother’s life is at stake, then
there’s more leeway and a lot of support-not to force her to carry but to help her figure out what is best.“In my case, my son was born perfect, and so even though I was given the option to abort, there’s no way I would
have done it. I’m so thankful that I didn’t even do an amniocentesis to confirm he was healthy, [because I might
have lost him.]”–Local nurse
Fertility Treatments
Supportive conception medications are absolutely allowed under Islamic law. Regarding IVF, it is permissible as long as two requirements are met. First, there must not be a donor egg or sperm. According to the laws of inheritance and personhood, the child has the right to know and live with its parents. Secondly, the sperm must be gathered in a halal way by the wife (masturbation is unlawful). 3 Surrogacy outside of marriage is not lawful. Surrogacy within a sacred covenant may be allowable by an Imam depending on circumstances.
Contraception
Contraception is allowed if the means are preventative, not permanent (unless medically necessary), and not abortive (IUDs, pills, condoms, diaphragms). Islamic teaching recognizes the pitfalls of overburdened parents. “The preservation of the human species is unquestionably the primary objective of marriage, and such preservation of the species requires continued reproduction. Accordingly, Islam encourages having many children and has blessed
both male and female progeny. However, it allows the Muslim to plan his family due to valid reasons and recognized necessities.” 4
Permanent contraception for men or women may be allowed if the mother’s life is at risk after speaking to an Imam.
1. Serour GI. Ethical issues in human reproduction: Islamic perspectives. Gynecol Endocrinol. 2013;29(11):949– 952.
2.When does Ensoulment occur in the Human Foetus | Journal of the British Islamic Medical Association (jbima.com).
3.Assisted Reproductive Technology: Islamic Perspective – Contemporary Bioethics – NCBI Bookshelf (nih.gov)
4.The Islamic View of Contraception – Fiqh (islamonline.net)
Observant Muslim women may follow halal dietary requirements. Refraining from pork and alcohol are mandatory. Halal dietary consumption must meet the criteria of proper laws around the treatment and slaughter of other animals (beef, chicken, lamb, etc.). If in doubt, fish, fresh fruits and vegetables are acceptable alternatives. Regarding medication, sometimes gelatin and alcohol are issues for practicing Muslims. If gelatin is from a pork source it is forbidden. Otherwise, non-pork animal sources could be from a non-halal source, but the chemical change turns it into a different substance which then is allowable. Pork-derived insulin for gestational diabetes would also be unacceptable for most women.
Consulting with individual patients is best as Shadia Hamka, a local postpartum nurse and mother of four, relates,
“It’s important we look into why a patient is refusing medication. The doctor or nurse caring for the patient should be asking why; if language is a barrier, we should be using a translator to get the information. If their refusal is because of things like gelatin, or alcohol in the ingredient then that helps us to find alternatives so they can still be taking their medication. Something as simple as asking to understand helps to address the issue and find an alternative.”
Any loss after twelve weeks gestation is considered a loss of a child, and parents will grieve that loss. Funeral services may vary based on tradition if the required rituals marking new life, washing and funeral prayers are not able to be performed on a living child before death. While Islam prefers burials within twenty-four hours, families can take time to be with the body of their child and have that closure even as arrangements are being made. While Muslim women are endeavoring to accept the will of God in any circumstances, these are certainly difficult ones to process and come to terms with. Family and spiritual comfort are invaluable. Mosques and funeral homes can plan services for the families and provide the required showering and shrouding.
Islamic Center of America
19500 Ford Rd, Dearborn, MI 48128
(313) 593-0000
www.icofa.com
Online FAQs and Question Forum click here
Al-Islah Mosque
2733 Caniff St, Hamtramck, MI 48212
Imam: Shaykh-Ul-Hadith Muhammad Kutbuzzaman
Masjid Number: (313) 365-9000
www.al-islah.us
Sikh
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