Certain gynecological procedures may render a woman niddah:
- Bleeding during or after a procedure that cannot be attributed to non-uterine causes or to trauma from the procedure makes a woman niddah.
- A procedure that involves a significant opening of the uterus may make a woman niddah even if no bleeding is detected. Opinions vary as to the degree of uterine opening that would render a woman niddah without bleeding. The halachic supervisors for this website rule that an instrument with a diameter of 19mm (¾ inch) or more inserted into the cervix would make a woman niddah.
It is therefore important for a woman to discuss with her physician the details of any gynecological examination, procedure or therapy. In general, it is helpful to ask if any bleeding should be expected afterwards: roughly how much and for how long, as well as the most probable source and cause. She may also need to consult with a halachic authority to determine the halachic implications. It is best to do so in advance, since she may be able to schedule the procedure so as to minimize her time as a niddah or to reduce her chances of becoming niddah at all.
A woman has no obligation to ask the healthcare provider performing a procedure if they saw blood, nor does she need to look at anything that was inserted internally. If the healthcare provider tells her that they did see blood, or if she herself notices blood on gloves or an instrument, she should ask for details about what was seen, where, and its likely source.
Scheduling of Gynecological Examinations
A woman is presumed not to be niddah (she has a chezkat taharah) from the time she immerses in the mikveh until her next anticipated menses. Therefore, when gynecological procedures are performed during this part of her cycle, it is easier for a halachic authority to rule that any bleeding is of traumatic origin and does not render her niddah.
It is usually preferable to avoid scheduling gynecological exams during the shivah neki’im (seven clean days). This can create complications with bedikot. Halachic rulings also tend to be stricter during this time, especially (according to Ashkenazi traditions) during the first three of the seven days. Similarly, it is best to avoid scheduling exams for days of anticipated menses (vesatot), on which a woman performs bedikot.
Some procedures (e.g., many of those done with sedation or anesthesia) will render a woman niddah because they entail significant opening of the uterus. They are often best scheduled for the days before performing the hefsek taharah.
When a procedure is performed during the shivah neki’im, a woman should do a bedikah in the morning, before the procedure, and may omit the afternoon bedikah afterwards. For some procedures, a woman may be advised to omit bedikot on the day or days following the procedure. In general, the minimum number of bedikot for a valid shivah neki’im is: the hefsek taharah, one bedikah on day 1, and one bedikah on day 7.
Even in situations that call for performing the minimum number of bedikot, it is strongly recommended to perform at least one additional bedikah on one of the intermediate days. This can sometimes allow for delaying the day 7 bedikah (and immersion). It also reduces the consequences of forgetting the day 7 bedikah.
Whenever a procedure is performed, a woman should not independently assume that she is niddah or that she has invalidated her shivah neki’im. Rather, she should consult a halachic authority.
This article was updated in December, 2021.