Childbirth in Israel: Home birth and newborn screening

INTRODUCTION Demographic transitions accompany economic success. This is borne out by marked changes in health indices, especially infant and maternal mortality rates. The poorer the community, the higher its infant mortality rates. From the eighteenth century throughout the first decades of the twentieth century, infant mortality in the West ranged above 20 percent, sometimes 30 percent (Klaus 1993: ch. 1; Ross 1993: 183; Rose 1986: 7). Even though the Jews were poorer than their non-Jewish neighbors, wherever records survive, contrary to expectations, infant mortality among the Jews was significantly lower. Demographers who study this paradox hypothesize that lower levels of alcohol use and abuse, as well as a “pro-active mentality” among the Jews in relation to the protection of babies’ health, accounts for the gap (Derosas 2003). The story of the Jewish community of Palestine is especially impressive. Not only was infant mortality among the Jews lower relative to the local population, but it also stood at the level of technologically advanced nations. Already in 1939, Jewish infant mortality in Palestine was on par with U.S. and UK levels. In this chapter, we explore two periods and two practices of neonatal health care. The episodes are the first attempt at neonatal public health in traditional Jewish society in Palestine, during the first half of the twentieth century, and the corresponding high-tech regulation and practices of contemporary Israel. The practices are elective home birth and newborn screening. The proactive and “life-saving” mentality of the traditional Jewish communities was part of a cultural ethos and a psychosocial makeup – a mentalité – that is irreducible to communal institutions and laws (Barilan 2014; Derosas 2003). In this chapter, we argue that the Zionist vision of breaking away from the traditional ways of life has remained loyal to the communal refrainment from enforcement, especially when it expanded the proactive mentality into the spheres of public health law and practice. It seems that the Jews have always been open to novel technologies. Large-scale public services, from unionized work to school chains and health care and health insurances, have always been part of political Zionism. Israeli public health especially relies on information technologies (IT). The Israeli public is already used to certain levels of infringements into private life, in contexts such as universal conscription and homeland security measures.