Efrat, a nonpartisan, nonprofit pregnancy center founded by Herschel Feigenbaum, a Holocaust survivor who passionately believed that “children are our future," Based in a quiet Jerusalem neighborhood, the pregnancy center was built on the ashes of the Holocaust, striving to promote childbirth to raise up the next generation of Jewish children after so many were lost in the Holocaust.

Yet, the concept didn’t fully give birth until the late 1970s, when the late Dr. Eli Schussheim became involved. That's when Efrat really took off, not only providing professional advice related to pregnancy and prenatal care but also empowering women to choose life through various community resources and assistance. To date, Efrat is believed to have saved at least 83,000 babies (and possibly a higher number according to some sources) formed in the Image of God, knitted together in their mother’s wombs, from abortion.

“When a woman comes to us, we tell her, ‘You have an option to abort. It is legal in Israel. But you also have the option to have a child,'” said Nir Salomon, Executive Director of Efrat. “And that is the unique proposition of Efrat.”

While the organization has a core group of employees, much of the organization is run by some 3,000 volunteers, many of whom have gone through challenging pregnancies themselves and have chosen to keep their children, and thus are a source of inspiration to other women sharing similar struggles.

So many women throughout the world feel like they have no other recourse than pursuing an abortion and are often not familiar with alternative options and services that can help them through their distress. In Israel, specifically, many women do not believe they can follow through with delivering their babies due to financial concerns. Many are living in poverty, but over half the women considering abortion in Israel are married with children already and are concerned about the financial implications of having another child.

Efrat believes that the lack of money is not a reason to end another human being’s life and will help a woman navigating such financial difficulties seek assistance, whether it be through government programs, housing assistance, or other practical assistance such as infant formula, diapers, and other necessary items to raise a child through the first two years of a child’s life. Efrat may not be able to solve a family’s entire financial situation, but they do what they can to reduce the financial burden of childbirth and raising an infant.

Other women hesitate to continue their pregnancies because of abusive relationships, a lack of family support, or the father of the baby not being present or supportive of the pregnancy.

“We will never try to sway women with arguments based on ideological, moral, or religious grounds,” said Ruthy Tidhar, a social worker once employed by Efrat. “Rather, our goal is to empower them through information and assistance so that they can make the best decision for themselves. Women who come to us feel trapped into having an abortion. We show them that other options exist.”

Additionally, many women lack prior knowledge of the potential physical, emotional, and psychological implications of different choices. Dr. Schussheim founded Efrat on the premise of educating women on all the options available to them relating to their pregnancies, as well as the psychological trauma that can unfold after an abortion.

“There are physical complications that may result from an abortion, many of which are treatable,” Dr. Schussheim said. “However, the emotional fallout, in the form of regret, can be life-long and devastating.”

Dr. Schussheim not only launched the Efrat organization but also promoted alternatives to abortion as offered through Efrat through multiple means of communication, including radio, television, billboards, social media, schools, military bases, and anywhere one could legally hang a flyer or otherwise get the word. He also advanced the cause of life through lectures, not only in Israeli high schools, universities, and military bases, but took his message of life all over the world prior to his passing.

The organization operates a 24/7 emergency hotline able to assist women in need, connecting them with other relevant organizations as needed based on individual circumstances.

“From the hundreds of lectures Dr. Schussheim delivered and all the literature he’s distributed, his influence was far-reaching, beyond what we can imagine,” Chagai Goldschmidt, Dr. Schussheim’s son-in-law, said after his father-in-law’s passing. “Not a day goes by without a woman calling Efrat informing us that since hearing my father-in-law speak (for some, it was many years before), they had made a firm decision never to perform an abortion.”

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Since Roe v. Wade was overturned on June 24, 2022, many Jewish groups have challenged pro-life laws in various states on the premise of religious liberty. Many Jewish people will interpret Exodus 21:22–25 to make the case that the Bible does not grant the same status of life to an unborn child as to a human being already conceived. Since this Torah passage only stipulates monetary compensation for the loss of the unborn child but not capital punishment, it is argued that the unborn child is considered to be property rather than human life.

The Jewish people also draw their views on abortion from the Talmud. For example, Bekhorot 21b refers to “The formation of a fetus in a woman takes forty days,” while other passages in the Talmud refer to the unborn child being more “like water” than humans even in the first few weeks of pregnancy. Some Jewish people thus consider abortion to be banned after 40 days, whereas other rabbis contend that the unborn child is never deemed human (nefesh) prior to the birth of the baby’s head, despite advancements in ultrasound science.

Because those who subscribe to this view believe that the child is not human prior to birth, it is not murder if the child is not human. For those who consider abortion to be banned after 40 days, this almost perfectly coincides with six weeks of pregnancy, 42 days, which is the point in embryonic development that a fetal heartbeat can often first be detected via echocardiogram.

Later in Bekhorot 3, the rabbis expand on their commentary, stating that fetal development should be a byproduct of the size of the embryo rather than the gestational age as expressed in days or weeks. This same sentiment is reflected in Bekhorot 22a, which touches on topics of ritual impurity related to human corpses, and the Talmud states that for women who miscarry, the deceased child does not impart ritual impurity unless the child’s head is round and the size of a skein of yarn. However, the exact size of a skein of yarn and the thickness of the yarn in a skein have been controversially debated among the rabbis.

Another relevant passage to the Jewish view on abortion is Ohalot 7:6, which states that if a woman is having various difficulties during childbirth, a midwife is permitted to dismember the unborn child in utero with the goal of saving the mother’s life. This is, once again, based on the concept of the child being a pursuer (rodef) viewed as striving to kill the mother, and therefore the mother is clear per the Talmud to kill her child instead. Certain complications, such as an entrapped head during a breech birth, shoulder impaction, maternal hemorrhage, placenta previa, toxemia, underlying conditions such as but not limited to diabetes, or conjoined twins, for instance, are considered circumstances of difficult births.

Other passages (Hullin 58a, Bava Kama 78b-79a, Sanedrin 80a, Terumot 25a, Gittin 23B, and Nazir 51a) describe an unborn child as a “limb of its mother" and therefore not a separate, independent person. This concept is elaborated on in other Talmud texts in which a woman subject to capital punishment cannot delay her execution on the grounds of her pregnancy, as her unborn child is not deemed to be a separate, independent person in the eyes of the Talmud; the only exception for delaying an execution would be if she were actually in labor.

If a pregnant woman were to be executed per Arakhin 7a, the abdomen would be struck first to kill her unborn child first to prevent the woman from giving birth to the child post-mortem, especially as the uterine bleeding from childbirth would be considered unclean and disgraceful to the woman even in her death. However, Maimonides philosophically analyzes this concept in light of the prohibition in the Talmud to injure one’s self. If the unborn child is actually a limb of the mother, then does the mother have the right to injure that limb? Technically, the answer, per Jewish law, would be no.

Furthermore, it is considered a mitzvot in the Talmud to save the life of the mother. This concept is expounded upon by Maimonidies, who maintains the premise that a fetus is considered a human life at 40 days, but because the mother’s life is considered to be more important, the unborn child is a rodef (“pursuer” in Hebrew) who is actively trying to kill its host, the mother, another human being. Therefore, Maimonidies describe the right of the mother to kill her child for threatening her life.

However, the rodef status changes to human status once the head of the baby emerges from the birth canal (Sanhedrin 72b). In the case of a breech delivery, human status is conferred when most of the body has emerged from the birth canal (Niddah 3:5). At this time, the sages view the mother as no longer being pursued by the fetus but by Heaven.

There are different views, however, on the definition of a mother’s life being endangered and whether endangerment includes mental health, emotional wellbeing, chronic health issues, severe pain, whether the possibility of Tay-Sachs disease exists for the child, whether a child is suspected to have Down syndrome, or to what degree of suffering is considered “endangered.” There is nothing in Jewish law requiring mothers to endure difficult childbirths, and therefore many perceive the lack of clear statements in Jewish law as a green light to make their own choices on the matter.

This is theoretically not a problem with modern medical practices. In the rare cases where there are medical circumstances adversely affecting the health of the mother, medical practices have generally advanced enough that the baby can be delivered early if needed, or a cesarean if needed, and treated in the neonatal intensive care unit while doctors attend to the needs of both the mother and the child. If the child does perish, it is unfortunate and tragic, but the woman is at least not suffering from the physical and psychological issues associated with ending the life of her child.

There is no law in any state that prevents doctors from treating ectopic pregnancies, miscarriages, or other pregnancy complications. There is no law in any state, before or after the overturning of Roe v. Wade, that would deny a mother life-saving medical treatment in the event of any emergency.

Also, we must remember that while doctors have the ability to forecast many prenatal and fetal conditions, sometimes they are wrong in their diagnosis or prognosis. Women who were told in their pregnancy that their baby may not make it, may have various fetal or birth defects, or, if the baby was born, would not live long, have been relieved to give birth to a perfectly healthy baby who has gone on to live a perfectly healthy and normal life. Doctors, despite their years of training and advanced knowledge of allopathic medicine, are not always right. Many women would have been devastated to have aborted a child based on an incorrect prenatal diagnosis and perceived possible suffering when, in fact, the baby was healthy and not suffering.

It is often agreed upon within Judaism that loss of an organ or limb or suicidal tendencies sufficiently endangers a woman’s life, while the most contention on the issue remains within the realm of psychological, mental, and emotional damage—whether it be the psychological health of the mother or extrapolating possible psychological consequences to a child possibly to be born with mental or cognitive deficiencies. Sometimes having an older child who is nursing will factor into whether a woman would be suffering to give birth to another child.

Jewish people do not generally consider rape or incest as justification for abortion, but depending on the different views on the issue, the subsequent effects of rape or incest may fall under emotional or mental suffering, and therefore, some women are able to find a rabbi who will approve their abortion based on the psychological effects of rape or incest. Many rabbis will also determine that financial circumstances, issues related to family support or an unavailable partner, or issues related to housing are unacceptable reasons to pursue an abortion based on the Talmud. Abortion is not permitted for the purpose of extracting fetal organs for transplant.

Cases of adultery run the gamut of responses from rabbis; some advocate abortion, whereas others prohibit abortion in cases of adultery. The abortion of Mamzer is another situation that comes up in Jewish abortion discussions to prevent ongoing curses for the parents who were involved in adultery. However, if no adultery was involved, then abortion would be prohibited.

The Orthodox rabbis have been divided on the issue, with some rabbis contenting that abortion should be forbidden unless there was tremendous suffering involved on the part of the mother. Other rabbis believe there should be some leniency, especially with the prevalence of Tay-Sachs disease in Jewish communities and the Talmudic requirements to alleviate pain and suffering.

The impacts of the Holocaust, the feminist movement, the sexual revolution, and an era with women pursuing higher education and careers further split the Orthodox view on abortion. Over time, the Orthodox rabbis have generally been shifting toward the view of letting women decide for themselves on the issue.

Since the early 1980s, conservative Jewish rabbis have allowed abortion "if a continuation of pregnancy might cause the mother severe physical or psychological harm or when the fetus is judged by competent medical opinion as severely defective." The Committee on Jewish Law and Standards later released a statement adding on to this saying: "Neither viability nor a woman's right to choose is the basis of Jewish law on abortion, although they play a role only indirectly; what matters in Jewish law is the woman's life and health, both physical and mental."

Reform Jews tend to hold the viewpoint that one has complete autonomy over whether to continue with pregnancy or not, regardless of circumstances or whether one’s life is endangered. Jewish law generally permits abortion to save the life of the mother, as most Jewish scholars and rabbis believe that completely banning abortion is not kosher with Jewish laws and centuries of Jewish tradition. Similarly, humanistic Jews seem to be open to abortion for any reason.

Some rabbis in the 1960s became more lenient with abortion because of some drugs given in Israel at the time that caused significant psychological problems in the child that were deemed burdensome to the family. Furthermore, a child with such psychological issues was perceived to be incapable of performing mitzvot. Other rabbis permitted women to abort their children if the mother had possibly been exposed to German measles early in her pregnancy. This may have been exacerbated culturally in Israel because of a lack of medical and social infrastructure that would be needed to support children with potential disabilities.

Many rabbis who have formed pro-life positions have based their teachings on the teachings of various Christian groups, since Sanhedrin 59a in the Talmud states, “Whatever is forbidden to Gentiles should certainly be forbidden to Jews,” and therefore, if abortion is banned with Christianity, it should be banned within Judaism. The rabbis that hold this view often point to Genesis 9:6 (“Whosoever sheds the blood of a man, by a man shall his blood be shed”) as the Gentile basis for establishing abortion as criminal.

Other groups, meanwhile, have formed positions on the abortion issue based on personal opinions that have no substantial basis in either scripture, Talmud, or other Jewish writings. Some rabbis have been deemed more rigid on the abortion issue, trying to “punish” women for adultery or promiscuous activity, but children should never be seen as a punishment, for behold, children are a heritage from the Lord, the fruit of the womb a reward.

In Israel, women do not have an automatic right to an abortion, though the procedure is generally widely accessible without the same political overtones as in the United States. At one time, women controversially had to appear before a committee to gain permission to terminate their pregnancy and receive abortion pills through the national health system, but the requirement to present before a committee appears to have been lifted.

In 1977, the Israeli Criminal Law Amendment granted four circumstances in which abortion would be permitted: a woman would have to be between the ages of 17 and 40; her pregnancy would need to be a result of rape, incest, criminal activities, or similar; potential physical deformities or mental challenges possible with the child; and endangerment to a mother’s life, whether physically or psychologically.

Whether a woman met these conditions was reviewed by a committee comprised of two doctors, one of whom must be an OB/GYN, and a social worker. The law was later amended to clarify issues related to late-term abortions, which Israel defines as after 24 weeks, and to define concepts such as what qualifies as a fetal defect. Usually the committee approved abortions, and usually abortions were covered by the national healthcare system.

Many have viewed the committee process as humiliating, time-consuming, and invasive of one’s privacy. There is now an option to meet with a social worker if one would like, but that is optional. The application form to proceed with an abortion has been shortened in length. Access to abortion pills has expanded into local pharmacies and healthcare clinics across Israel.

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As some fun facts regarding embryonic development, primordial blood vessels are already beginning to form in the first 1-2 weeks, and development of the brain and neural plate is beginning by the second week after fertilization results in zygote formation. By the third and fourth weeks after fertilization, the right and left atria are starting to form, as well as the respiratory system and various aspects of the body’s vascular system.

A baby’s eyes first begin to appear around weeks four to five, along with further development of the lungs, the two hemispheres of the brain, and other embryological development. Tooth formation may begin as early as five to six weeks after fertilization. And so on and so forth throughout embryologic development; there are additional milestones not mentioned in this article as the baby continues to be knitted together in its mother’s womb.

In the United States, there are nearly 3,000 pregnancy centers and associated mobile medical units operating as Efrat does in Israel to provide free resources and referrals to women with various needs related to their pregnancies. These pregnancy centers focus on alternatives to abortion, helping women with financial needs, practical assistance with baby supplies, ultrasounds, medical services, testing and treatment of sexually transmitted diseases, pregnancy testing, prenatal and parenting classes, post-abortion trauma recovery support, housing needs, counseling, and referrals to other community resources she may need so she is confident about giving birth to her child.

These pregnancy centers are run by licensed medical professionals upholding the medical standards of the day, in addition to trained staff and volunteers who adhere to HIPAA and all associated confidentiality laws applicable at the federal, state, and local levels. Generally faith-based and non-profit, these pregnancy centers offer free services to women, men, children, and families in need.

Data from 2019 indicates that nearly 2 million people benefited from the services provided by pregnancy centers, with over $266 million in services and practical assistance donated to pregnant women and their families in their time of need.