Ending the life of fetuses has been the subject of intensive public and political debate in the US – even leading to bombings and killings at abortion clinics. While an estimated 50 million fetuses have been aborted in that country over the past four decades, the number has fallen to the lowest point since the Supreme Court’s landmark Roe vs.
Wade decision legalizing abortion within limits – largely because of better long-term contraception techniques.
A recent poll by the US Centers for Disease Control and Prevention found that a quarter of women aborted because they wanted to postpone childbearing; a fifth said they “couldn’t afford” a baby; 14 percent had a “relationship problem” or their partner did not want a pregnancy; 12% were “too young”; 11% thought having a baby would interfere with their education or job; 3% involved a risk to fetal health; and 3% said the fetus risked maternal health.
Surprisingly, despite the usual frenzy raised over religious and ethical issues here, Israel has been spared such vitriolic debate and violence over abortion. Jewish law allows and even requires a woman to undergo abortion if her own life is endangered by her fetus, and there is a general consensus in the population that one can’t be forced to give birth or raise a seriously defective or unwanted baby.
The Health Ministry’s annual statistical report on legal abortion has shown almost a completely straight line at around 20,000 since the late 1990s, despite the considerable growth in the population. The main explanation for the continued status quo is the decline and aging of the massive immigrant population from the former Soviet Union, where abortion was more common; as younger women of FSU origin learn to use the pill, that element in abortion statistics has lost its prominence. In addition, the increase in the ultra-Orthodox Jewish sector, who avoid all but necessary abortions, has also prevented a rise in abortion.
The ministry estimates that a similar number of illegal abortions – without going through hospital abortion committees and performed by doctors “under the table in clinics or even by amateurs – take place every year. Illegal abortions continue largely because girls or women are ashamed and don’t want to go through exposure or because they absolutely don’t fit the criteria for a legal abortion (or don’t want to lie about their cases).
ALL THIS does not rule out trying to help women thinking of an abortion to change their minds. The organization called Efrat has become synonymous with such efforts.
The name comes from the biblical Chronicles 1, in which Efrat is the name of Caleb’s wife and, according to Jewish tradition, Miriam, the mother of Moses, who helped saved him from Egyptian infanticide.
The organization began when a Holocaust survivor named Herschel Feigenbaum arrived in Israel in the 1950s and regarded children as the future of the state. He decided to found, in memory of the over one-and- a-half million Jewish children murdered by the Nazis, to raise the Jewish birthrate in Israel – where the long-term future of the Jewish people lies.
Dr. Eli Schussheim, an Argentinian-born doctor who was for years the Knesset physician and a surgeon at Jerusalem hospitals, took over the non-profit organization and is now its president. One woman who brought her son to him for a routine checkup told the doctor that she owed him the boy’s life. Schussheim had no idea what she was referring to.
“Before I realized that I was pregnant,” she recalled, “I underwent a series of X-rays. Obviously, I was concerned about the possible effects on my unborn child. I consulted several doctors and each of them advised me to have an abortion, explaining that I would give birth to a severely disabled child,” she said.
“Dr. Schussheim, you were the only one to disagree. You explained that according to the most recent medical research, X-rays do not affect the fetus. You urged me not to abort my unborn child. I listened to you, and gave birth to a healthy boy – my son.”
“Her story changed my life,” said Schussheim in a recent interview with The Jerusalem Post. “I studied medicine to save lives. Here, with this simple piece of advice, I had saved this boy’s life and the life of his children and grandchildren.”
After Feigenbaum died, Schussheim revived the organization. Since 1977, he and a group of volunteers and professionals have provided thousands of Jewish women in Israel with accurate information about motherhood and abortions “so they could make an educated choice. As a result, over 50,000 children are alive today. No woman who decided not to give birth has told us that they regretted having the baby.”
Abortion was almost totally illegal in Israel until 1977, when Mapam Party MK Chaike Grossman proposed an amendment to liberalize existing laws; the bill was backed by all women and most all secular MKs and opposed by all Orthodox MKs, who called the measure “degenerate and leading to national suicide.”
It made abortion legal if approved on either medical or social grounds by a two-member committee of professionals – a general practitioner, a gynecologist, a public health nurse or social worker. The criteria for permissible abortion would be danger to the life of the mother (which was already the criterion for abortion under existing laws); danger to the life of the fetus; and danger of serious physical or psychological damage to mother or children because of family circumstances (meaning large families at the poverty level).
The law permitted abortions within the first three months of pregnancy and only in approved medical institutions. Abortions would also be justified in cases of pregnancy out of wedlock or resulting from rape or incestuous union or in cases where the mother is a minor.
“So many women still want an abortion for economic and educational reasons,” Schussheim said. “They don’t realize that a fetus is already a human being in womb. I said in lectures that in the first weeks, the embryo has a working heart and brain. Pregnant women’s maternal feelings had to be stimulated, and those who needed support had to be helped financially.”
Efrat’s volunteers make the rounds in schools, universities, the military and elsewhere to locate women who have become pregnant and are thinking of an abortion.
“Pregnancy is a medical condition. We are not political. We are pro-choice. The woman should decide,” explained Schussheim.
“We have never said we are against abortions. As a doctor, I have to tell women what choice they have. I can explain how an abortion can harm their mental and physical health. If they want to continue with the pregnancy and need help, I can give it. If not, go to the doctor and listen and then decide.”
EFRAT’S CHIEF social worker, Ruth Tidhar, who is a secular Jew, has been working for the organization for 13 years. “I’m in daily contact with women. The atmosphere is very dramatic, emotional and full of turmoil. They are faced with an important decision – yes or no.”
The organization advertises in the print media, on the Internet and on radio. “We make sure that all the social workers know about us. It reaches many women by word of mouth. Some of our 3,000 volunteers – not all of whom are religiously observant – went through the process themselves and decided not to abort their babies. They are always so grateful. Many of them,” said Tidhar,” had abortions in the past, and they are very grateful that our assistance made it possible for them to deliver.”
Tidhar always asks women if they have had an abortion before, and if so, what they remember of the experience. “Many say it was the worst thing that happened to them – a nightmare,” she says.
Those who decide not to abort despite their financial problems get monthly deliveries of formula (if needed), diapers, baby wipes, a blanket, baby linens, sets of undershirts and other clothing, toys, bottles – and if necessary, baby furniture from plastic baths to cribs.
“We don’t give monetary gifts. We want to make sure they will use our gifts for the baby,” she noted, adding that “everything we give is brand new.” Non-Jews who are in need of similar help are referred to other organizations, Tidhar said.
When Efrat hears of a minor who was raped or otherwise got pregnant and the family haven’t decided what to do, said Schussheim, volunteers are not used as counselors.
“Professionals are needed in cases when the woman or girl is on the edge of society. There is only a handful of such cases a year, but we don’t encourage the mother to put the baby up for adoption. The Labor and Social Welfare Ministry provides foster families when needed. We prefer that the family take care of the baby,” he continued.
Although the organization has a reputation among some sectors as being driven by Orthodoxy or extreme wackos, its president – who said he had performed medically required abortions many times – denied it.
“We are a Jewish organization, not an Orthodox one. We give explicit instructions to our volunteers not to bring God into the situation. And we are not political. We don’t send lobbyists to the Knesset. It’s a medical and emotional issue. We also don’t go to health fund clinics. We hand out flyers where young women congregate.”
Efrat receives no government support and depends on donations mostly from smallscale contributors; some of them are Evangelical Christians, but these are small in number, said Schussheim.
But when the Knesset Committee on the Status of Women had a session recently to discuss abortion, Schussheim and his colleagues did go to speak out against public abortion committees in the hospitals.
“As they approve over 95% of applications, we wonder what’s the point of giving approval? We believe that her doctor must do everything to save the fetus unless there are medical reasons for an abortion,” he continued. “Education is needed. Instead of abortion committees, Efrat supports requiring women considering an abortion to receive booklets, giving them 72 hours to think before they finally decide.”
But the Health Ministry opposed the abolition of abortion committees, stating that “they are needed to check that the criteria are being met. The level of authorizations is high because women apply almost only if they know they meet the legal criteria.”
Efrat’s current booklets explain: “What is an abortion? It means ending the life of child who is not sufficiently developed to survive outside its mother’s womb.
Although the vast majority of abortions are performed on socio-economic grounds, an abortion does not resolve financial or social difficulties. Economic and social problems can be worked out. Situations can – and do – change. But a life can never be restored...
Very often, the psychological scars caused by an abortion only serve to complicate existing problems. Sometimes, it takes women a lifetime to resolve these issues.
“When a doctor decides on an abortion for medical reasons or if the woman applies for an optional abortion, Efrat prefers that the abortion pill (Mifepristone) – which detaches the embryo from the uterus – be used instead of surgery, because it is less likely to harm future fertility. But the pill has to taken no later than eight weeks after conception.”
Asked whether there were cases in which low-income women who had no intention of aborting asked for the organization’s gifts, Schussheim and Tidhar said it was possible that it could happen.
“But if they tried to pull the wool over our eyes to get diapers and baby equipment, it means they really were needy. In any case, we depend to a great extent on social workers’ reports on each case.”
Tidhar said the vast majority of women who are about to undergo an abortion were pressured into it by their spouse, husband or father. “It’s unusual for a woman to decide on her own,” she said.
There has been a rise in abortions among Jewish women of Ethiopian origin. The higher the educational level, the lower the abortion rate. Most of the applicants for help from Efrat – about 70% – are married, with the rest either single or divorced (and pregnant from their former husbands). A minority are younger than 20 and older than 40 – the ages covered by the abortion law for automatic approval.
Among the babies it saved have been twins, triplets and even a set of quadruplets.
“The family of the quads keep sending us bar mitzva and other family photos,” said Tidhar.