Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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CURRENT GUIDELINES

Nearly two years from the beginning of the Covid pandemic, we have become accustomed to constant developments, with new variants and vaccines, outbreaks and lulls.

This page offers some general guidance. The situation remains dynamic, and calls for caution, consideration, and common sense.

Please consult your healthcare provider or local health authorities about relevant guidelines.

1 Edelman, Alison MD, MPH; Boniface, Emily R. MPH, et al. “Association Between Menstrual Cycle Length and Coronavirus Disease 2019 (COVID-19) Vaccination.” Obstetrics & Gynecology January 5, 2022. Available here: https://journals.lww.com/greenjournal/Fulltext/9900/Association_Between_Menstrual_Cycle_Length_and.357.aspx

2 Laurentina Schaler and Mary Wingfield, “COVID-19 vaccine — can it affect fertility?” International Journal of Medical Sciences October 15,2021, pp. 1-3. Available here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8516490/

3 Aitken, Robert John, “COVID‐19 and male infertility: An update.” Andrology August 31, 2021. Available here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8444928/

Ding Ting and Wang Tian, et al. “Analysis of Ovarian Injury Associated With COVID-19 Disease in Reproductive-Aged Women in Wuhan, China: An Observational Study.” Frontiers in Medicine, March, 2021. Available here: https://www.researchgate.net/publication/350181689_Analysis_of_Ovarian_Injury_Associated_With_COVID-19_Disease_in_Reproductive-Aged_Women_in_Wuhan_China_An_Observational_Study

Fangyuan Li, Hua Lu, et al. “Impact of COVID-19 on female fertility: a systematic review and meta-analysis protocol” BMJ Open Feb 25, 2021. Available here: https://pubmed.ncbi.nlm.nih.gov/33632754/

4 CDC, “COVID-19 Vaccines While Pregnant or Breastfeeding” December 6, 2021. Available here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html

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1Edelman, Alison MD, MPH; Boniface, Emily R. MPH, et al. “Association Between Menstrual Cycle Length and Coronavirus Disease 2019 (COVID-19) Vaccination.” Obstetrics & Gynecology January 5, 2022.
Available here: https://journals.lww.com/greenjournal/Fulltext/9900/Association_Between_Menstrual_Cycle_Length_and.357.aspx

2Laurentina Schaler and Mary Wingfield, “COVID-19 vaccine — can it affect fertility?” International Journal of Medical Sciences October 15,2021, pp. 1-3. Available here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8516490/

3Aitken, Robert John, “COVID‐19 and male infertility: An update.” Andrology August 31, 2021. Available here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8444928/

Ding Ting and Wang Tian, et al. “Analysis of Ovarian Injury Associated With COVID-19 Disease in Reproductive-Aged Women in Wuhan, China: An Observational Study.” Frontiers in Medicine, March, 2021. Available here: https://www.researchgate.net/publication/350181689_Analysis_of_Ovarian_Injury_Associated_With_COVID-19_Disease_in_Reproductive-Aged_Women_in_Wuhan_China_An_Observational_Study

Fangyuan Li, Hua Lu, et al. “Impact of COVID-19 on female fertility: a systematic review and meta-analysis protocol” BMJ Open Feb 25, 2021. Available here: https://pubmed.ncbi.nlm.nih.gov/33632754/

4CDC, “COVID-19 Vaccines While Pregnant or Breastfeeding” December 6, 2021.
Available here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html

RELATED Q&A

Accordion Content

You may add chlorine or bromine tablets to the water even on Shabbat. You may also use a pool tester or indicator strips to check chlorine levels as needed. Although indicators that involve changing colors can raise halachic questions on Shabbat, their use is permissible under the current circumstances.
Yashar Ko’ach and Shabbat Shalom!

We appreciate how difficult it can be to spend an extended amount of time in niddah, especially when facing the uncertainties of the current pandemic.
On the whole, the harchakot remain in place. This is the time, though, to review the harchakot, as by reading our site’s articles, to ensure that you are not being overly stringent.

When there are specific marital difficulties or mental health concerns during this pandemic and immersion has been delayed, a couple can be lenient with most harchakot that do not involve direct physical contact (e.g. passing objects directly and serving food).
Since the specifics of a situation make a difference, please get back to us or consult a local halachic authority with any follow up questions.
May we all merit good health and good news.

We appreciate the sensitive nature of this question.
Given the situation, it is legitimate for you to make a personal decision not to immerse. Even if your husband insists that you go to mikveh, that does not halachically obligate you to do so.
That being said, not immersing means abstinence for an indefinite period of time, which requires both spouses working together to preserve shalom bayit.
It would be best if the two of you could come to a joint decision about mikveh, looking together at the materials we’ve made available on our site, inquiring about the precautions your local mikveh is taking, and talking out both of your concerns.
You may want to talk personally with a Yoetzet Halacha to discuss some of the halachic and practical aspects of working this out. As always, Yoatzot Halacha are available through our phone hotline or in the community. If you and your husband need more assistance in building healthy communication around this decision, you may also find it helpful to consult with a counseling professional.
May we all merit good health and good news.

We appreciate your concerns about mikveh safety during the pandemic. Learning more about mikveh protocol at this time may address some of your anxiety. Please read through the guidelines above on Mikveh and Coronavirus.
Beaches present their own dangers, so we still recommend immersion in a mikveh.
If a woman does use the ocean as a mikveh, she must first make sure that she is in a safe place, as safety is an important halachic consideration. The place that she selects for immersion also needs to be sufficiently well-lit for the person watching to see that all the woman’s hair went under the water. In addition, the ocean floor may not be made of a substance such as thick mud that will adhere to the feet.
The time and place should allow for privacy, since a less private setting might lead to a rushed and imperfect immersion. It is permissible to immerse in a loose-fitting robe.
As with any tevilah, all preparations should be done in an unhurried manner, in a lit room where the woman can check herself properly, with a mirror to see her back.
Any Jewish woman over the age of twelve can serve as an attendant to ensure that all hair goes underwater.
If imperative for safety, then immersion on the eighth day during the daytime is permissible.
Please let us know if we can be of further assistance

For halachic and water safety reasons, it is preferable for an attendant to observe your immersion. An option to minimize contact would be as follows:
You can ask the attendant to allow you to enter the mikveh room on your own. Either bring your bag with you and put the towel down on it, or place the towel on a freshly disinfected surface. Call to the attendant when your body is in the water, and ask her to observe the immersion itself from the doorway. She can then leave until you are out of the room.
We suggest discussing this with the attendant by phone before leaving for the mikveh.
May we all merit good health and good news!

Ashkenazi practice is to count the five-day minimum wait from the onset of niddah status or of halachic prohibition. This applies even if the couple could not have had relations for some time beforehand (e.g., they were in different cities). So your husband’s quarantine should not affect this halacha.
In cases such as yours however, where you have endured a prolonged separation and where shortening the five-day wait would make a material difference, given the unique stresses surrounding immersion, you may perform a hefsek taharah as early as you can get one and begin counting the clean days that evening.
May we all merit good health and good news.

Halachically, you are required to adhere carefully to health directives, intended to prevent danger to others’ lives. So you should refrain from relations until after he completes his quarantine. (In general, it is permissible for a couple to make a joint decision not to have relations on mikveh night.)
We do still recommend immersing on time, although if your scheduled night is particularly inconvenient you can put it off.
Note: Even if a couple are in quarantine together (e.g., because they have young children in quarantine), intimate relations are not recommended during quarantine. This is because one person may become ill and the other not, and relations are a form of close contact that can easily spread Covid-19. Of course, a woman in quarantine may not visit the mikveh, so this would be relevant only if she were already tehorah.

Medical consensus is that the Corona vaccine and booster may slightly affect a woman’s cycle, but that any effects are short term.
The 5 day minimum begins when you consider yourself niddah. If the staining becomes heavy enough that you need a tampon or full pad to contain the bleeding, you should assume you are niddah. If a light pantyliner is sufficient, you may continue treating it as staining.
Please feel free to get back to us with any further questions.

Medical consensus is that the Corona vaccine and booster may slightly affect a woman’s cycle, but that any effects are short term.
If you have observed all of your vesatot, including (at minimum) a bedika on or following your veset kavua (if you have one) or onah beinonit (if you don’t), then you and your husband may resume relations as usual and no further steps need be taken. In that case, though, you should keep an eye out for signs of impending bleeding such as staining, and consider abstaining if you have them.
Please let us know if we can be of further assistance.

Guidelines for the Public and Mikvaot

As we face this pandemic together, we have the opportunity to fulfill crucial mitzvot. One who vigilantly follows the instructions of the health authorities fulfills the mitzvot of “be most careful for your life” (Devarim 4:15) and “love your fellow as yourself” (Vayikra 19:18), which is an overarching principle in the Torah (Bereishit Raba 24:7). 

 

The Torah holds protecting public health paramount, commanding us: “Do not bring blood upon your house,” (Devarim 22:8) and “Do not stand idly by the blood of your fellow.” (Vayikra 19:16).

 

Official medical guidelines of your local health authorities are halachically binding. Stay informed about local guidelines designed to prevent new cases of Coronavirus and follow them, even if the instructions sound overly cautious.

 

Vaccination

Please follow recommendations of your local health authorities regarding vaccination.

Corona vaccines are considered safe for pregnant and breastfeeding women. Pregnant women are at higher-than-average risk for complications of COVID. In general, Corona vaccinations can be given at any stage of pregnancy, but please consult with your physician regarding vaccination type and timing.


Some Corona vaccines have been anecdotally associated with staining and/or temporary changes in the menstrual cycle for some women. These side effects are not medically significant, but it is wise to take precautions against unnecessarily becoming nidda by reviewing the laws of stains.

These instructions and FAQs were prepared for women residing in Israel, in accordance with Israel’s Ministry of Health guidelines, and last updated on 26 October, 2021. Please keep an eye out for further updates.

 

If you reside outside of Israel, please consult local health authorities on any matters dependent on local health policies. We hope that these instructions and FAQ’s help you formulate your questions for your local authorities.

Nishmat’s Yoatzot Halacha in Israel, with a distinguished honorary Rabbinic committee, released a position paper regarding mikveh immersion during the current pandemic.

Yoatzot Hotline

Toll free from the United States and Canada:
1-877-YOETZET (1-877-963-8938)
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הקו הפתוח ע"ש גולדה קושיצקי ישראל:
02-640-4343

MIKVEH ATTENDANTS​

It is a halachic requirement to follow Health Ministry/Department regulations. Mikva’ot must be extra scrupulous at this time with keeping distance between women, hygiene, disinfecting, and keeping out women in quarantine or with symptoms of illness, all in strict compliance with the regulations of Israel’s Ministry of Health or local health authorities.   Women are not permitted to break quarantine to immerse, and Mikveh attendants must resist any pressure brought upon them to bend the rules. If a mikveh attendant or worker is herself is not feeling well, she may not enter the mikveh at this time.

Related Q&A

In this case, it is safe to allow the nurse exposed to COVID-positive patients to use your mikveh, since she uses personal protection at work. As an additional precaution, she should take her temperature and check for any symptoms prior to arrival.

As an extra safety measure to prevent any potential asymptomatic spread, we recommend setting an appointment for her to be last on a given night, when no one else will be present, even in other preparation rooms.

Assuming your community does not yet have specific mikveh protocols for Corona, you may want to consult with your rabbi and local authorities about establishing them.

Kol hakavod on your efforts to keep women safe!

You may add chlorine or bromine tablets to the water even on Shabbat. You may also use a pool tester or indicator strips to check chlorine levels as needed. Although indicators that involve changing colors can raise halachic questions on Shabbat, their use is permissible under the current circumstances.

Mikveh surfaces should be cleaned using disinfectant wipes and/or disposable rags with a bleach or alcohol liquid solution.

Yashar Ko’ach and Shabbat Shalom!

You must follow the Health Ministry’s directives. From a halachic perspective, we are required both to follow the rules of government authorities and to protect public health.

A woman who has been ordered to quarantine herself is absolutely prohibited from leaving her home, except in situations in which it is medically necessary. Even then, she must inform the medical authorities. Additionally, family members are forbidden from coming close to her, and any physical contact is prohibited, even when the couple are halachically permitted to each other.

Immersion of a woman who is potentially a carrier of the Coronavirus could endanger the health of other women at the mikveh, particularly those who are at high risk.

For these reasons, you must adhere to all instructions from the Ministry of Health, and not to permit immersion of any woman who has been instructed to enter quarantine.

If someone seeks your advice, you can explain the importance of strict adherence to the rules. A woman in this situation should finish her seven clean days as planned, and then wait until the quarantine period finishes to immerse. After counting the clean days, she need not perform any more bedikot, and should switch to colored undergarments.

GENERAL PUBLIC​​

Related Q&A

QUARANTINE

1.     A woman in quarantine may not have contact with her husband or use the mikveh until her quarantine is over. As difficult as it can be to delay mikveh immersion, the halachic imperative to prevent the spread of disease is greater than considerations of immersing on time.

2.     A woman whose husband is in quarantine may immerse on time or delay immersion to a more convenient time. If they are not observing quarantine scrupulously within the home, she should delay mikveh until after quarantine. As long as her husband is in quarantine, physical contact between them is medically and halachically prohibited.

3.     A woman with a household member in quarantine need not delay immersion. If they are not observing quarantine scrupulously within the home, she should delay mikveh until after quarantine.

4.     A woman who immersed and was subsequently put in quarantine need not notify the mikveh at this stage.

5.     A woman in quarantine may dispose of bedikah cloths in the garbage, as usual. If she has a halachic question about a bedikah or stain, then she should not bring the cloth or garment to a halachic authority. Rather, she should call to consult. In cases that require visual evaluation, she can seek to have it evaluated online through Tahor App (available on iPhone and some models of Android phones), which uses special color calibration technology to ensure that the stain is photographed and transmitted accurately. If a woman in this situation cannot use the app, she can save the cloth or stain and have it evaluated following her quarantine. She should keep careful track of the dates of any cloths or stains that she saves for future evaluation.

6.     In consultation with her physician, a woman in quarantine or with a husband in quarantine might consider manipulating her cycle hormonally so that quarantine overlaps with niddah as much as possible, or to push off niddah for a while after quarantine.

Related Q&A

We’re sorry to hear that you are in quarantine, and wish you good health.

According to Israel’s Ministry of Health, a person is not considered fully vaccinated until 7 days after the second dose of Corona vaccine. Until that point, all the usual rules of quarantine apply. It is still unclear if or how they will change once full vaccination becomes more widespread.

To protect everyone’s health, it is essential that women in quarantine follow all instructions, remain at home, and refrain from immersing in the mikveh until the quarantine is over. Therefore, you should immerse in the mikveh only after you are released from quarantine.

In the meanwhile, you should complete counting your clean days as scheduled. After the clean days are over, you should switch to colored underwear and sheets. In this case, there is no need for further bedikot.

Please feel free to get back to us with any further questions.

We appreciate the challenging nature of this situation.

It is illegal and potentially dangerous to immerse when required to be in quarantine. These rules and regulations are in place for a reason, and help ensure the safety of all the women who use the mikveh. Halacha requires us to follow local laws and to take precautions for health. Therefore, you absolutely should not immerse when you are in quarantine.

Though safety measures at the mikveh are designed to keep women safe even if an asymptomatic carrier of Covid-19 immerses unawares, we need to try to keep those numbers down to a minimum, in order to minimize risk — and that means not having women in quarantine immerse.

If your husband is with you abroad, you might consider delaying your trip back to Israel by a few days so that you can immerse before returning. Another possibility would be to discuss with your physician the possibility of using hormones to delay your next period so that you don’t become niddah again close to when you come out of quarantine. Otherwise, you and your husband will need to be patient, knowing that you are acting for the public good.

You are definitely facing a number of challenges, and these questions only begin to touch on them. Our hearts go out to you, and we are here to assist you in any way possible.

Your dedication to immersing on time is extraordinary, and it’s clear from what you wrote how important it is to you to immerse on time.

The halachic ruling in this case, though, is that you must delay immersion.

The instructions of Israel’s Ministry of Health are very clear: You may not exit quarantine at all, and that definitely includes going to places like the mikveh, where you might endanger other women if it turns out you are carrying the virus. These instructions also have halachic implications, because not endangering the lives of others is a halachic obligation.

Immersing in the sea is off the table, since you are forbidden to leave your home. Even if there were a way for you to reach the sea without any contact with others, it would likely be in an area in which entering the water is dangerous, which itself raises halachic issues for immersion.

It is truly praiseworthy that you have never had to postpone mikveh immersion. In this case, however, halacha requires you to take a different course, and that will be no less praiseworthy. Please note that you should finish your seven clean days as planned. After completing the clean days, you need not perform any more bedikot, and should switch to colored undergarments.

We have a halachic obligation to follow the instructions of Israel’s Ministry of Health and to prevent a situation of possibly endangering other’s lives.

Women who are in quarantine for potential exposure to the Coronavirus are prohibited medically and halachically from leaving their homes. That precludes going to mikveh, which could potentially endanger other women there, even if the woman in quarantine plans to immerse last.

If you must delay mikveh immersion, please complete your clean days as planned. After the clean days, you need not perform any more bedikot, and you should switch to colored garments.

You are definitely facing a number of challenges, and these questions only begin to touch on them. Our hearts go out to you, and we are here to assist you in any way possible.

Counting the seven clean days and immersing in the mikveh are distinct mitzvot. There is usually no break between them, but halacha does allow for one when necessary.

You are correct that you cannot immerse before your quarantine period finishes, but it’s important for you to finish your seven clean days as planned, even though you won’t be able to immerse right after you finish them.

Between completing your count and immersion, no further bedikot are necessary, and you should switch to colored undergarments. On the night immediately after the quarantine period finishes, you can immerse.

You are definitely facing a number of challenges, and these questions only begin to touch on them. Our hearts go out to you, and we are here to assist you in any way possible.

You are correct that there is no way for you to bring the cloth to a halachic authority for evaluation right now.

We recommend that you call the halachic authority to whom you usually bring such questions to consult. (You could also contact a yoetzet halacha through Nishmat’s Golda Koschitzky hotline, or a local Yoetzet Halacha.) Explain that you cannot bring in the cloth because you are in quarantine, and give as many details about it as possible.

Another possibility is to seek to have it evaluated by a rabbi online through the Tahor App (available on iPhone and some models of Android phones), which uses special color calibration technology to ensure that the stain is photographed and transmitted accurately.

In this situation, you might try to perform another bedikah prior to sunset, to serve as a new hefsek taharah should one be necessary.

Please note that if your seven clean days finish before you exit quarantine, you will need to wait until you finish quarantine before immersing. You should complete the clean days on time as usual, even if you will need to delay immersion. After counting the clean days, you need not perform any more bedikot, and you should switch to colored undergarments.  

You are definitely facing a number of challenges, and these questions only begin to touch on them. Our hearts go out to you, and we are here to assist you in any way possible.

If you feel that performing internal examinations will be particularly stressful for you, or if you have reason to believe that they will raise many halachic questions, then you are permitted to perform fewer bedikot this cycle.

Please note that, at minimum, you must perform a hefsek taharah and one bedikah each on days one and seven. We recommend performing at least one more bedikah on one of the intermediate days.

Should any questions arise, please consult a halachic authority, as explained below, as soon as possible. In this situation, you might try to make another bedikah prior to sunset, to serve as a new hefsek taharah should one be necessary.

If you do have a questionable bedikah, we recommend that you call the halachic authority to whom you usually bring such questions to consult. (You could also contact a yoetzet halacha through Nishmat’s Golda Koschitzky hotline, or a local Yoetzet Halacha.) Explain that you cannot bring in the cloth because you are in quarantine, and give as many details about it as possible.

Another possibility is to seek to have it evaluated by a rabbi online through Tahor App (available on iPhone and some models of Android phones), which uses special color calibration technology to ensure that the stain is photographed and transmitted accurately.

We wish you good health and a smooth conclusion to your quarantine.

We understand that quarantine presents a number of challenges, and appreciate your commitment to following the instructions.

Generally speaking, mikveh immersion can only take place at night. In fact, a mikveh attendant often is required to receive explicit halachic permission from the supervising rabbi before she can open the mikveh during the day.

We need more details about your situation in order to determine if there are sufficient grounds to allow for daytime immersion. Please get back to us with more details, by calling our hotline, or contacting a local Yoetzet Halacha

In this case, you may delay immersion. You should finish counting your seven clean days as planned. After completing the clean days, you do not perform any more bedikot, and you should switch to colored undergarments.

Keep in mind that even once you do immerse, it will be critical to follow the rules of Israel’s Ministry of Health, which limit any physical contact with someone in quarantine.

Ashkenazi practice is to count the five-day minimum wait from the onset of niddah status or of halachic prohibition. This applies even if the couple could not have had relations for some time beforehand (e.g., they were in different cities). So your husband’s quarantine should not affect this halacha.

In cases such as yours however, where you have endured a prolonged separation and where shortening the five-day wait would make a material difference, given the unique stresses surrounding immersion, you may perform a hefsek taharah as early as you can get one and begin counting the clean days that evening.

May we all merit good health and good news.

According to Israel’s Ministry of Health directives, a person in quarantine is to remain in a separate room and have no physical contact at all with other members of the family.

Halachically, you are required to adhere carefully to instructions like these, intended to prevent danger to others’ lives. Accordingly, having relations with your husband in quarantine would be prohibited.

We do still recommend immersing on time, although if your scheduled night is particularly inconvenient you can put it off.

Note: Even if a couple are in quarantine together (e.g., because they were exposed at the same time or returned together from a trip abroad, or because they have young children in quarantine), intimate relations are not recommended during quarantine. This is because one person may become ill and the other not, and relations are a form of close contact that can easily spread Covid-19. Of course, a woman in quarantine may not visit the mikveh, so this would be relevant only if she were already tehorah.

We appreciate your concern. At this time, according to the guidelines of Israel’s Ministry of Health, you do not need to report that you were at the mikveh at the same time or to enter quarantine. No further action on your part is required.

Should the woman turn out to be positive for Coronavirus, the Ministry of Health will notify the public and issue instructions.

If a mikveh finds out that a woman broke quarantine and immersed, they must close the mikveh immediately, and report the infraction to the Ministry of Religion.  The mikveh will only be reopened in coordination with Israel’s Ministry of Health.

May it be G-d’s will that we should all merit to have good health and good news.

We are there for you in support in any way we can help.

If you are reading this from outside of Israel, rules are different from place to place. We recommend double checking this information with your local public health authority. 

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