Early one morning last December, Avigail Bailey was pacing the floor of her Jerusalem apartment, awaiting the results of a pregnancy test. When two blue lines appeared, she woke her partner with news that neither of them wanted: The test was positive. They both agreed to terminate the pregnancy.

“It was an unplanned pregnancy. Our contraception failed. We live together but felt we were too young, not economically stable and that this was really not part of our plans,” says Bailey, 27, who studies philosophy at Shalem College in Jerusalem. “For both of us, the choice was very clear.”

Bailey, who was in her first trimester, immediately went into planning mode. “Who do I need to call? What’s the process for getting an abortion?” she recalls asking herself before reaching out to Lada’at-Choose Well, a Jerusalem-based reproductive and sexual health nonprofit. “The shock quickly turned to, ‘How can we deal with this? And quickly.’ ”

For Bailey and other women in Israel who choose to end their pregnancies, abortion is legal, accessible at hospitals and clinics throughout the country and subsidized under the national health care system. It is nevertheless a sensitive topic, and many of the medical professionals approached for this article declined to be interviewed or share their names.

“Abortion is something that is relatively easy to get in Israel but not easy to talk about,” explains a hospital insider who asked to remain anonymous. Some 98 percent of those who apply for an abortion ultimately receive one, according to Israel’s Central Bureau of Statistics.

Despite its accessibility, abortion is not an automatic right. Israel’s abortion law, passed in 1977, includes criteria for allowing the procedure: If the woman is under 18 or over 40; if the fetus is not viable or would have severe medical problems if brought to term; if the pregnancy is the result of rape, incest or an “illicit union” (including not being married or having a relationship outside of marriage); and if the woman’s mental or physical health is at risk.

As part of the law, a pregnant woman must receive approval from a termination of pregnancy committee comprised of two physicians and a social worker (one of whom must be a woman) that determines if she meets the legal criteria for an abortion. The committee appointment itself can take two weeks or more to schedule, and the meeting has been described as humiliating, intrusive and paternalistic by critics and activists. Consequently, some women choose to undergo the procedure through private doctors, paying the costs—about $1,000—out of pocket and without committee approval, which is illegal, although the authorities do not monitor or discipline private abortion providers.

It is reforms to these committees that are the focus of activists, even as they acknowledge the pitfalls in attempting to change, or even draw attention to, a fairly permissive and liberal system in a country that is becoming increasingly traditional and socially conservative.

“It really bothered me that I had to go through a committee, that other people had to give their approval,” says Bailey. While the committee discussed her abortion case, she and her boyfriend sat in the adjacent hallway, hands clasped, waiting for the door to open, and with it, an answer.

Being unmarried, Bailey met the criteria for approval, and she was able to have an abortion.

“For women, often the most stressful part of the process is appearing before the committee, more so than the abortion itself,” Dina Shalev, director of Lada’at, says. “That’s why we are working so hard to change things.” Lada’at’s hotline for information about reproductive health and abortion—including the country’s only one in Arabic—fields calls from across the country.

The push for reform in Israel comes amid an existential battle for reproductive rights in the United States. In 2021, 19 states passed more than 100 new reproductive health restrictions. Texas, for example, passed a controversial abortion law banning the procedure in almost all cases after six weeks of a pregnancy, around the same time that most women realize they are pregnant. More recently, other states, including Oklahoma, Kentucky and Florida, have adopted their own restrictions and bans. State laws governing abortion will become paramount if the United States Supreme Court overturns Roe v. Wade, which it reportedly appears poised to do, according to a leaked draft of the majority opinion in a case the court was expected to decide by the end of its current term this summer. The leaked draft was obtained by and published in Politico.

The case, Dobbs v. Jackson Women’s Health Organization, concerns the constitutionality of a Mississippi state law that prohibits most abortions after the 15th week of pregnancy; viability is generally considered to be around 24 weeks.

Pro-choice activists in the United States worry that if the Supreme Court overturns the constitutional right to pre-viability abortions, a precedent established in Roe v. Wade, the landmark 1972 case that legalized abortion in the United States, this could mean the end of abortion access for women living in states where their reproductive rights are not protected.

The discourse over abortion differs dramatically between the United States and Israel. In Israel, reproductive rights barely register as a political issue and abortions are legal throughout gestation. There is a separate committee for those seeking the procedure after 24 weeks, usually for complex medical reasons. This committee is typically comprised of the director of the hospital or clinic and senior doctors.

In Israel, reform efforts are less about access and more about concerns regarding a woman’s right to dignity, respect and agency over her own body. Indeed, even doctors and social workers who sit on the committees are deeply uncomfortable with the process, according to one insider.

“The United States is going backward. I think we are in a very different place, and we have laws to protect us from that kind of extremism,” says Silvina Freund, executive director of Open Door, or Delet Petucha in Hebrew, which serves as an Israeli parallel to Planned Parenthood, a leading United States health care provider and reproductive health organization. “We will fight to make sure that nothing like that can happen here.”

“They tell us, ‘This is not why I studied medicine, to put a woman in such an impossible situation,’ ” says Roni Ben-Cnaan, advocacy coordinator for Physicians for Human Rights-Israel.

Those seeking an abortion may fabricate the information they present to the committee to meet the legal criteria, adds Ben-Cnaan. She has heard from married women who falsely claim that a pregnancy was conceived out of wedlock. “A woman does not want to lie,” says Ben-Cnaan, “but she will do so if there’s no other option.” Government statistics show that pregnancy out of wedlock or from rape or incest were the most cited reasons in 2020 given to the committee, representing 49 percent of termination requests.

Even in cases where a fetus is not developing or would not survive outside the womb, termination requires committee approval. Fourteen years ago, Nurit Daniels, a resident of Kibbutz Maabarot near Netanya, was told by her doctor to apply to a committee when, at 12 weeks pregnant, a scan found the fetus she was carrying was not viable because its digestive system was developing outside of its abdominal wall.

“I remember sitting facing [the committee],” says Daniels, now 49. “It was deeply unpleasant. Here I was carrying a baby that could not survive. I think my situation should have been treated like a medical procedure. If you have cancer, you don’t have to go to a committee to get the treatment you need, so why not in this case?”

Dr. Susan Warchaizer, an obstetrician-gynecologist in Tel Aviv who has performed abortions in the past, agrees. “I think it’s absolutely outrageous that any woman cannot get an abortion on demand when she wants or needs it,” she says, noting that many committees just “rubber stamp” the procedure, making the approval process legalized fiction.

But she is hesitant about lobbying for change. “If you put scrutiny on what’s going on, there’s a fear it could open a Pandora’s box and the situation could get worse, not better,” says Dr. Warchaizer. “So it makes me nervous to say ‘Let’s fight for this,’ because basically every woman seeking an abortion gets one.”

Despite these concerns, human rights, feminist and pro-choice groups, including Lada’at and Open Door, an organization that counsels young men and women about pregnancy and sexuality, have come together to press for reforms.

They note opportunities for change in the diverse, though currently fragile, ruling government coalition that includes a progressive health minister, Nitzan Horowitz of the Meretz Party. The coalition also, for the first time in over a decade, does not include ultra-Orthodox parties, such as Shas or United Torah Judaism, that have historically blocked any reform.

“It should be a given that the rights to a woman’s body are the woman’s alone,” Horowitz was quoted saying by Ynet, an Israeli news site. “Any decision, or medical procedure, such as the choice of whether to perform an abortion, must be in the hands of the woman.”

Under Horowitz, the ministry plans to amend the questionnaire that is part of the committee procedure, deleting questions deemed medically unnecessary or intrusive, such as those about contraceptive use. The ministry also wants to redress lengthy wait times for committee hearings. Furthermore, Meretz lawmakers have proposed amending the abortion law to do away with committees for first-trimester abortions as well as changing the role of the committee during the second trimester from approval to advisory.

Any debate around Israel’s abortion policy plays out in a society that encourages its citizens to have children and, in some ways, sees offspring as a response to current and historical trauma. Indeed, many Israeli Jews see children as essential to rebuilding the Jewish people after the Holocaust and as an answer to demographic fears around the Arab population of Israel. The government has historically offered economic incentives for large families, and Israel is one of the few countries in the world to subsidize fertility treatments, including in vitro fertilization.

Israel has among the highest birthrates per capita in the developed world, with an average of more than 3.01 kids per family, compared to 1.6 in other Organisation for Economic Co-operation and Development countries.

According to the Health Ministry, abortion rates have steadily decreased over the past 30 years, staying largely at 20,000 abortions annually even as the number of pregnancies has risen—from 103,000 per year in 1990 to 182,000 in 2019. The drop in abortion rates is attributed to better sex education in schools and access to contraception, says reproductive rights activist Sharon Orshalimy, a doctoral student at Ben-Gurion University of the Negev who researches contraception in Israel.

In 2020, Israel’s statistics bureau found that 85 percent of abortions in Israel were performed in the first trimester and that most undergoing the procedure already had one child. (Similarly, most of those seeking an abortion in the United States are already mothers and over 90 percent are in their first trimester, according to the United States Centers for Disease Control and Prevention.)

Over the years, it has been religious parties, from ultra-Orthodox to national religious, that have blocked attempts to reform the abortion law, noted Rebecca Steinfeld, Ph.D., an England-based researcher and political scientist who has written about abortion and reproductive policy in Israel. Ultra-Orthodox parties also have attempted to ban late-term abortions in the past, but never with any success.

According to Lada’at and other women’s rights groups, a handful of anti-abortion groups are attempting to influence the current discourse, including Efrat-C.R.I.B., Committee for the Rescue of Israel’s Babies, which offers economic aid and counseling to women considering an abortion.

Founded in 1977 by a Holocaust survivor who wanted to promote childbirth in the Jewish world, Efrat’s goal has never been to become a political force, according to Ruth Tidhar, the group’s chief social worker. “We have no qualms with the idea that abortion is accessible,” she says, adding that their focus is helping women make an informed choice and providing financial support.

These organizations “speak to some of the more (socially) conservative and religious Jews, but there is a majority of Israelis that have a more liberal approach to abortion, especially in the early stages,” says Shalev of Lada’at.

This attitude reflects Jewish law, which states that life or personhood begins at birth. Moreover, the Talmud states in Yevamot 69b that “until 40 days from conception the fetus is merely water. It is not yet considered a living being.” Furthermore, in halacha, a threat to a woman’s life takes priority over the continuation of her pregnancy. These precepts allow more flexibility, not to mention a range of Jewish opinions, around the issue of abortion.

Nowhere is that reality more present than in the United States. In general, the major liberal Jewish denominations are vocally supportive of legal access to abortions, upholding the pro-choice position that it is up to the woman to decide.

Orthodox rabbis are cautious about publicly discussing abortion. Nevertheless, two mainstream Orthodox groups, the Rabbinical Council of America, an umbrella group for Orthodox rabbis, and the ultra-Orthodox Agudath Israel of America, released statements opposing a 2019 New York State law, the Reproductive Health Act, which enacted further legal protections for abortions.

In their statements, both groups asserted that Jewish law allows abortion in certain cases, for example if the expectant mother’s life is at risk, but maintained that the New York law makes overly broad allowances for termination of pregnancy.

(The Orthodox Union, one of the largest Orthodox organizations in the United States, said in a recent statement regarding the leaked draft of the Supreme Court decision on Roe v. Wade that the group does not support “absolute bans on abortion” or “legislation that permits ‘abortion on demand.’ ” It also affirmed that “Jewish law prioritizes the life of the pregnant mother over the life of the fetus such that where the pregnancy critically endangers the physical health or mental health of the mother, an abortion may be authorized, if not mandated, by Halacha….” )

Still, in Israel, “there are no lack of religious rulings that authorize abortions,” says Rabbi Yuval Cherlow, director of the Ethics Department at Tzohar, an Israeli group of Orthodox rabbis that works to bridge the gap between religious and secular Jews in the country. “Halacha is more liberal than its image.”

Cherlow thinks that Israel’s abortion law is optimal at balancing protecting the woman and the fetus. “I think the situation today works, and if by chance some committees are overstepping boundaries, then we need to make them more sensitive,” he says. “But the fact that abortion is not an automatic procedure is something I support.”

Several storylines in the hit Israeli television show Shtisel, about a haredi family in the Geula neighborhood of Jerusalem, offer insight into ultra-Orthodox attitudes on abortion. In its third and most recent season, the young and married Ruchami (played by Shira Haas) is revealed to have had an abortion; she has a condition that makes pregnancy dangerous, and her rabbi insisted she have an abortion to save her life. Her husband, Hanina, is shown consulting with the rabbi about whether they should now try to have a child via surrogacy, which the rabbi allows, noting that Jewish law in most cases would advise against any pregnancy that could endanger a mother’s health—with health being defined as both mental and physical health. Season one touches on the subject, too. Ruchami’s mother, Giti, abandoned by her husband and with five children to raise, considers having an abortion and even goes before a committee, though she ultimately decides against the procedure.

Several years ago, Tamar, a Modern Orthodox married mother of three living on a moshav outside of Jerusalem, had to make a decision seven weeks into an unplanned pregnancy. Her youngest was 18 months old and had health problems.

“We had just had a very troubling and challenging year in all ways, and when I found out I was pregnant, my husband was certain he did not want to go through with it,” says Tamar, 35, who had had a previous abortion for a fetus that was not developing. “I still took time though to decide on my own.”

As a married woman, Tamar knew a committee would automatically grant her an abortion if she claimed that she had conceived out of wedlock. But she did not want to have that lie “on my record,” as she puts it. Instead, she opted for proof that a pregnancy would cause her mental distress. She met with a psychiatrist and secured a letter for the committee stating just that.

She did not tell her mother about the pregnancy and subsequent abortion, fearing she would not be accepting of her decision. “But I have a daughter, and I’ll tell her about it and my other children as well one day,” she says, keen to speak out against abortion stigma that exists in religious communities.
“I think the committee system needs to end. But at the end of the day, we are a country where women have a say over their own bodies,” says Tamar. “What we have is good enough—not perfect, but good enough.”

As for Avigail Bailey, the college student who ended her pregnancy in December, “I know I want a family in the future, I’ve always wanted that,” she says. “But I want to start a family when it’s the right time for me.”

 

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Dina Kraft is The Christian Science Monitor’s Israel correspondent, hosted Hadassah’s The Branch podcast and co-host of Groundwork, a new podcast about Israeli and Palestinian peace and social justice activism.