✦ ❖ ✦

DAAT · LEVEL 2 — LAMDAN

Shulchan Arukh · Yoreh De'ah — Siman 194: the yoledet and the mappelet

Study and pilpul — what renders a yoledet impure, and from what moment there is a “birth”

סימן קצ״ד

יולדת בזוב ושבעה נקיים, פתיחת הקבר בלא דם, אין אנו בקיאין בצורות, הגדרת הלידה, ויוצא דופן

עיון, פלפול, שיטות הראשונים והאחרונים

⚡ For lamdanim and talmidei chakhamim ⚡

✦ ❖ ✦

Pilpul and in-depth study

Sugyot, sources, the underlying chakira, machlokot of Rishonim and Acharonim,
nafka minot for practice and examination of the shitot

A sensitive and painful subject — childbirth and miscarriage. Written in respectful language and with humility. Any practical question — and a miscarriage or a caesarean in particular — is an urgent question for a rav, together with the medical care required.

Subject:
Shulchan Arukh Yoreh De'ah siman 194 (14 seifim)
with the nosei kelim: Shakh (Siftei Kohen), Taz (Turei Zahav), Pitchei Teshuva

Roots of the sugya:
the yoledet “be-zov” nowadays · the opening of the womb without blood · we are no longer expert in the forms · the measures of birth · the yotse dofen

Written and edited by:
הרב יוסף חיים סממה · DAAT

📑 Contents

Opening of the sugya — the yoledet is impure as a niddah even with no sighting of blood (seif 1)
The yoledet “be-zov” nowadays — why every woman counts seven clean days, and the Torah's days of impurity and purity
The opening of the womb without blood — miscarriage within forty days, and the rule that the womb does not open without blood (seif 2)
“We are no longer expert in the forms” — the concern for a valad and the concern for a female, and the safek nekeva (seif 3)
The shilya and what it attaches to — attaching it to a child already born, and the days of a female's impurity (seifim 4–7)
Tumtum and androginos · “she felt that she had miscarried” — safek nekeva is resolved stringently (seifim 8–9)
Defining birth — the greater part, the forehead, the voice — the measures of birth (seifim 10–12)
Twins — the days of impurity are counted from the last (seif 13)
Yotse dofen and the caesarean — the machloket of the Sages and Rabbi Shimon, and blood passing by the natural route (seif 14)
Chakira and nafka mina for practice
Summary tables

📜 The text of the Shulchan Arukh — seif 1

Heading of the siman: דיני יולדת ומפלת. ובו י״ד סעיפים:

יולדת אפילו לא ראתה דם טמאה כנדה בין ילדה חי בין ילדה מת ואפילו נפל וכמה הם ימי טומאתה עכשיו בזמן הזה כל היולדות חשובות יולדות בזוב וצריכות לספור שבעה נקיים נמצאת אומר שיולדת זכר יושבת ז׳ ללידה וז׳ לנקיים לזיבה והיולדת נקבה יושבת שבועים ללידה וז׳ נקיים לזיבה ימי לידה שהם ז׳ לזכר וי״ד לנקבה אם לא ראתה בהן עולים לספירת זיבתה ואם שלמו ז׳ נקיים בתוך י״ד לנקבה הרי זו אסורה עד ליל ט״ו ואם טבלה קודם לכן לא עלתה לה טבילה:

הגה (Rama): ולאחר ז׳ לזכר וי״ד לנקבה מותרת לבעלה מיד מאחר שספרה ז׳ נקיים ולא חזרה וראתה מיהו יש מקומות שנוהגין שאין טובלין תוך מ׳ לזכר ושמונים לנקבה (בית יוסף בשם מהרי״ק שהביא התניא ובאגודה פרק ע״פ ובמהרי״ל) ואין להתיר במקום שנהגו להחמיר (ריב״ש) אבל במקום שאין מנהג אין להחמיר כלל רק מיד שלא ראתה דם אחר ז׳ לזכר וי״ד לנקבה וספרה ז׳ נקיים מותרת לבעלה (ת״ה סימן רנ״ה) אבל אם חזרה וראתה אפילו טפת דם כחרדל טמאה אע״ג דמדאורייתא דם טהור הוא כבר פשט המנהג בכל ישראל שאין בועלין על דם טהור (ב״י ואגור וטור ופוסקים בשם הגאונים) ודינו כשאר דם לכל דבר:

Translation — a yoledet, even if she saw no blood, is impure as a niddah, whether she bore a living child or a dead one, and even a nefel. How many are her days of impurity? Nowadays every yoledet is reckoned a yoledet “be-zov” and must count seven clean days. It follows that one who bears a male sits seven days for the birth and seven for the clean days of zivah, and one who bears a female sits two weeks for the birth and seven clean days for zivah. The days of birth — seven for a male, fourteen for a female — count towards her zivah reckoning if she saw no blood during them. And if the seven clean days were completed within the fourteen days of a female, she remains forbidden until the night of the fifteenth; and if she immersed before then, her immersion does not count. (שו״ע יו״ד קצ״ד ס״א)

1. Opening of the sugya — the yoledet is impure as a niddah even with no sighting of blood

The foundation — the womb does not open without blood

The foundation of the siman: the yoledet — even if she saw no blood — is impure as a niddah, whether she bore a living child or a dead one, and even a nefel. The root of it is that the womb does not open without blood issuing: the source having opened at the birth, it is established that blood came out with it, even if invisible to the eye. It follows that the impurity of birth does not depend on a perceptible sighting but on the opening itself — a gader distinct from ordinary impurity by sighting, and it governs every chapter of the siman.

The phrase is Rabbi Yehoshua's in the gemara. It should be known that it is disputed there: the Rabbanan hold that the womb can open without blood. The halakha here follows Rabbi Yehoshua, and it is on that basis that the Shakh writes, on seif 10, that even by Torah law she is impure as a niddah.

The two impurities of the yoledet. Two distinct dinim are found in the yoledet: (a) the days of impurity of the Torah — seven for a male, fourteen for a female (Vayikra 12); (b) within those days, the din of the blood that issues at the opening of the womb. And since the womb does not open without blood, she is impure even without having seen. The Mechaber's own chidush here: even before she has seen, and even if she bore a dead child or a nefel, she is within the impurity — for everything turns on the opening of the womb and not on the sighting of blood.

2. The yoledet “be-zov” nowadays — why every woman counts seven clean days

This is one of the foundations of the siman — why the din of the yoledet has changed from the time of the Temple to our own.

The chakira — the Torah's days of impurity and purity. The parashah divided them: one who bears a male — seven days of impurity and thirty-three days of purity (דם טוהר); one who bears a female — fourteen days of impurity and sixty-six of purity. And during the days of purity, even if she sees blood she is pure by Torah law. What, then, is the din of the yoledet in our time?

The foundation — “every yoledet is reckoned a yoledet be-zov”.
Since the daughters of Israel took upon themselves the stringency of Rabbi Zeira — any woman who sees blood, even a drop the size of a mustard seed, sits seven clean days — it follows that every yoledet falls into the category of a yoledet be-zov and must count seven clean days before immersing. Hence: one who bears a male — seven days for the birth and seven clean days; one who bears a female — fourteen days for the birth and seven clean days. In practice, the customs of the count and of immersion — to a rav.

The Taz, in the first of his three entries on this siman, presses that stringency to its end: if she saw blood during the second week of a female, that sighting obliges her to begin seven clean days afresh. The passage must be read knowing who speaks in it: when the Taz writes מו״ח he means his father-in-law, the Bayit Chadash, never himself. The Bach held that Rabbi Zeira's stringency applies only to blood fit for niddah and zivah; the Taz denies him that, by a kal va-chomer: if it applies to dam tohar, which is wholly pure, all the more so to impure blood.

What remains of dam tohar. In our time דם טוהר is not relied upon at all: any blood the yoledet sees forbids like niddah blood, and she requires a hefsek taharah and seven clean days. But the reckoning of the days of impurity of the Torah — seven for a male, fourteen for a female — remains in place for the date of immersion: even having completed her seven clean days, she does not immerse before the Torah's days of impurity have run out. The nafka mina is great in the case of a female, as below.

Nafka mina — the date of immersion for a female and for a safek female. One who bore a female (or a safek female), even having already counted seven clean days, does not immerse before the night of the fifteenth, since she is still within the fourteen days of a female's impurity. And so, if she completed her seven clean days within the fourteen and immersed before the night of the fifteenth — her immersion does not count. This is the core of what remains of the Torah's days of impurity. The Mechaber says it in so many words in seif 1. In practice — ask your rav, and for anything medical, your doctor.

Acharonim: the Chochmat Adam treats the yoledet in klal 115 — whose heading refers explicitly to simanim 192, 193 and 194 — and writes there ובזמ״הז חשבינן לכולם שהם יולדות בזב וצריכות ז״נ; he then refers the reader to the Shulchan Arukh for the remaining dinim of the yoledet. The Arukh HaShulchan (Yoreh De'ah 194) sets out why dam tohar is no longer relied upon today, and the practical reckoning of the days. The Sidrei Taharah are cited on this siman by the Pitchei Teshuva (under the siglum ס״ט).

3. The opening of the womb without blood — miscarriage within forty days

The Mechaber's text (seif 2)

המפלת בתוך מ׳ אינה חוששת לולד אבל חוששת משום נדה אפילו לא ראתה:

הגה (Rama): מפני שא״א לפתיחת הקבר בלא דם ונפקא מינה דמיד לאחר שספרה ז׳ נקיים מותרת ואינה חוששת לולד (ד״ע):

Translation — one who miscarries within forty days has no concern for a valad, but she has concern for niddah even if she saw nothing. Gloss of the Rama: because the womb does not open without blood; and the consequence is that as soon as she has counted seven clean days she is permitted, and has no concern for a valad. (שו״ע יו״ד קצ״ד ס״ב)

The foundation — two separate dinim in a miscarriage.
In a miscarriage occurring within forty days, two dinim come apart:

• the din of a valad — there is no valad at all, its formation not being complete; she therefore has no concern for a valad and no days of birth impurity.
• the din of niddah — she nonetheless has concern for niddah, even without having seen blood, since the womb does not open without blood.

That is the whole depth of the rule: the opening of the womb defiles of itself, even where there is no din of birth.

The Shakh gives the reason for the number, and it is worth noting: it is not that the concern is smaller before forty days, but that neither male nor female completes its formation in less than forty days. The root of it is in the gemara.

Chakira — what exactly is “the opening of the womb”? The Acharonim sought the gader of the opening that defiles: does the impurity rest on the blood that certainly issued (a sighting that was not seen), or is the very opening of the source an impurity, with no blood at all? The Pitchei Teshuva here brings the Noda BiYehuda on the point, who writes that the cause of the opening is immaterial — from within or from without, as when a physician introduced his finger or an instrument and opened the mouth of the source — and likewise the woman's age and state.

The same entry of the Pitchei Teshuva at once brings those who answer him, and that is what gives the chakira its nafka mina: the Binat Adam (siman 23) objects that a woman performing a bedikah also inserts her finger deeply, so that this cannot be what is meant; the Chatam Sofer (siman 179) writes that neither the woman nor the midwife ever reaches the mouth of the source; and the Noda BiYehuda himself, as brought in Teshuva me-Ahava (I, 116), restricts the rule to a case where a solid body came out, and not where nothing came out, or only something very thin, or a fluid — for otherwise, he asks, where would pure blood ever be found? The question stands as it is: we leave it open, as the commentators leave it.

The Rama's nafka mina. Since within forty days there is no concern for a valad but only for niddah — as soon as she has counted seven clean days she is permitted and need not observe the days of birth impurity (neither seven nor fourteen). In this the Rama is lenient, in not treating her as a yoledet proper. And even so, if there is any doubt as to the date of the miscarriage or as to what emerged — an urgent question for a rav; and for any medical direction — the doctor.

4. “We are no longer expert in the forms” — the concern for a valad and for a female

This is one of the foundations of the halakhah of our time — a stringent ruling drawn from the loss of an expertise.

The Mechaber's text (seif 3)

המפלת כמין בהמה חיה ועוף או כמין דגים וחגבים ושקצים ורמשים וכל צורת ולד או שפיר או שליא או חתיכה שקרעוה ויש בה עצם עכשיו שאין אנו בקיאין בצורות חוששת לולד ואם כלו ז׳ נקיים בתוך י״ד יום אם טבלה קודם ליל ט״ו לא עלתה לה טבילה:

Translation — one who miscarries something resembling a domestic animal, a wild animal or a bird, or resembling fish, locusts, creeping or crawling things, or any form of a valad, or a shafir, or a shilya, or a piece that was opened and has a bone in it — nowadays, when we are no longer expert in the forms, she has concern for a valad. And if the seven clean days were completed within fourteen days, if she immersed before the night of the fifteenth, her immersion does not count. (שו״ע יו״ד קצ״ד ס״ג)

The foundation — “we are no longer expert in the forms”.
In the time of the sages of the gemara they knew how to distinguish the form of the valad — whether its formation was complete and it counted as a valad, or not. But nowadays, when we are no longer expert in the forms, we are concerned for every miscarriage (a shafir, a shilya, a piece containing a bone, or any form) that it may be a valad, and she is given the days of birth impurity. This is a far-reaching rule for our time: the doubt is resolved stringently, the expertise that could have removed it being gone.

Concern for a valad and concern for a female — two doubts that compound:

The doubt	The ruling	Root of the stringency
Perhaps it is a valad	We are concerned for a valad — the days of birth impurity	We are no longer expert in the forms
Perhaps it is a female	We are concerned for a female — fourteen days for the birth, and no immersion before the night of the fifteenth	Safek male / safek female — stringently

The root of the din of “safek nekeva”. Since we are concerned that there may be a valad, and every valad is a safek male / safek female — the stringency of a female is applied to the reckoning of the days of impurity: she does not immerse until the fourteen days of a female's impurity have run out. And so, even if she completed her seven clean days within the fourteen, she will not immerse before the night of the fifteenth. The stringency born of the lack of expertise (we are concerned for a valad) thus carries with it the stringency of safek nekeva (the night of the fifteenth). The Shakh says it on the seif itself.

The Shakh, in the next entry, adds what is not in the body of the seif: she needs seven clean days after the fourteen days; and although nobody requires the eighty-one days of her, one who wishes to be stringent will separate from her on the night of the forty-first and the night of the eighty-first, on account of the doubt male or female.

The commentators on this seif: the Shakh has two entries here (ס״ק ג׳ and ס״ק ד׳) and the Pitchei Teshuva three (ס״ק ה׳ to ס״ק ז׳). Pitchei Teshuva ס״ק ו׳, on the words ויש בה עצם, brings the Me'il Tzedakah (siman 46) — where there is no bone she is impure with birth impurity only in a shafir — and the Sidrei Taharah, who set aside the opposing stringency. Every miscarriage remains a question for a moreh hora'ah, together with medical clarification.

5. The shilya and what it attaches to — attaching it to a child already born

The Mechaber's text (seifim 4 to 7)

סעיף ד׳: ילדה ולד חי ואח״כ הפילה שליא אינה חוששת לולד אחר אלא תולה אותה בולד שילדה כבר עד כ״ג יום אבל אם הפילה נפל תחילה אין תולין בו השליא שהפילה אחר כך וחוששת לשליא ליתן לה ימי טומאה של נקבה:

סעיף ה׳: יצאה השליא תחילה אין תולין אותה בולד שתלד אחר כך אפילו הוא בן קיימא וחוששת לשליא ליתן לה ימי טומאה של נקבה:

סעיף ו׳: יצאה מקצת שליא ביום ראשון ולא נגמרה יציאתה עד יום ב׳ חוששת מיום ראשון אבל אינה מונה אלא מיום שני:

סעיף ז׳: המפלת דמות בהמה חיה ועוף ושליא קשורה בה אינה חוששת לולד אחר ואם אינה קשורה בה חוששת לולד אחר ואף על פי שהולד הנדמה זכר חוששין ליתן לה ימי טומאה של נקבה בשביל השליא:

Translation — (seif 4) she bore a living child and afterwards expelled a shilya — she has no concern for another valad, but attributes the shilya to the child already born, up to twenty-three days; but if she first expelled a nefel, the shilya expelled afterwards is not attributed to it, and she has concern for the shilya, to which the days of a female's impurity are given. (seif 5) The shilya came out first — it is not attributed to the child she will bear afterwards, even a viable one, and she has concern for the shilya, to which the days of a female's impurity are given. (seif 6) Part of the shilya came out on the first day and its emergence was not completed until the second — she has concern from the first day, but counts only from the second. (seif 7) One who miscarries something resembling a domestic animal, a wild animal or a bird, with a shilya attached to it — she has no concern for another valad; and if it is not attached to it, she has concern for another valad, and even though the creature so formed is male, we are concerned to give her the days of a female's impurity on account of the shilya. (שו״ע יו״ד קצ״ד ס״ד–ז׳)

The foundation — “there is no shilya without a valad”.
A shilya comes only with a valad. Hence the rule of the mishnah. And consequently —
• she gave birth first and then expelled a shilya within twenty-three days → the shilya is attributed to that child, and she has no concern for a second;
• the shilya came out first (or she expelled a nefel and then a shilya that cannot be attributed to it) → an additional valad is feared, and the days of a female's impurity are given, out of doubt.

Chakira — why precisely “the days of a female's impurity”? Wherever a shilya is feared without knowing the sex of the valad, the days of a female's impurity are given. The root of it: safek male, safek female — and one is stringent for the larger number of days (fourteen). And even when the formed creature is male, it is nonetheless on account of the shilya with it (perhaps a female was there too) that a female is feared. The din of safek nekeva is thus the axis on which the seifim of the shilya turn.

The measure of time — twenty-three days, and the joining of the emergence. The measure of twenty-three days for attributing the shilya to the child has its source in the gemara (Niddah) — it is the span within which the shilya may still be delayed in following the child. The Shakh specifies on that very word what the seif does not say: the twenty-three days are counted without the day of the shilya's emergence, that is, twenty-four days including it. And in seif 6 (part of the shilya came out on the first day and its emergence was completed only on the second) — she has concern from the first day, stringently, but counts the days of impurity only from the second, the birth having been completed only then. In practice, every detail of the reckoning — to a rav.

On seif 7 the Shakh ties the matter back to seif 3 and closes the circle: for us, who are no longer expert in the forms, the days of a female's impurity are always given.

6. Tumtum and androginos · “she felt that she had miscarried”

The Mechaber's text (seifim 8 and 9)

סעיף ח׳: היולדת טומטום או אנדרוגינוס נותנין לה ימי טומאה של נקבה:

סעיף ט׳: הרגישה שהפילה ואינה יודעת מה אפילו לא היתה בחזקת מעוברת הרי זו טמאה לידה וחוששת שמא נקבה היתה:

Translation — (seif 8) one who bears a tumtum or an androginos — she is given the days of a female's impurity. (seif 9) She felt that she had miscarried and does not know what: even if she was not presumed pregnant, she is impure with the impurity of birth, and she has concern that it may have been a female. (שו״ע יו״ד קצ״ד ס״ח–ט׳)

The foundation — safek nekeva resolved stringently.
Wherever the sex of the valad is not established, one is stringent as for a female both for the reckoning of the days of impurity (fourteen) and for the bar on immersing before the night of the fifteenth. Hence:
• the טומטום (whose sex is covered) and the אנדרוגינוס (who bears signs of both) are a doubt, and the days of a female are given;
• “she felt that she had miscarried and does not know what” — even without having been presumed pregnant, she is impure with the impurity of birth, and has concern for a female.

Chakira — what “feeling” means here. The Acharonim sought the gader of the sensation that obligates: is it enough to feel the opening of the womb, with nothing seen to emerge, or must she see something? The Mechaber's language — הרגישה שהפילה — indicates that the very sensation that a valad has come out (although she does not know what) suffices to require the concern for a birth and for a female. What can be measured should be said here: in this siman neither the Shakh, nor the Taz, nor the Pitchei Teshuva has an entry on seifim 8 and 9 — the Mechaber's words stand alone. The nearest thing to it is the Pitchei Teshuva on seif 2, quoted above, which discusses precisely whether an opening of the womb with no body emerging falls within the rule. We do not decide: every doubt is a question for a rav.

7. Defining birth — the greater part, the forehead, the voice

The Mechaber's text (seifim 10 to 12)

סעיף י׳: נחתך הולד במעיה ויצא אבר אבר בין שיצא על סדר האברים כגון שיצא הרגל ואחריה השוק ואחריה הירך בין שיצא שלא על הסדר אינה טמאה לידה עד שיצא רובו ואם יצא ראשו כולו כאחד הרי זה כרובו ואם לא נתחתך ויצא כדרכו משתצא פדחתו ה״ז כילוד אף על פי שנחתך אח״כ ולא סוף דבר שיצא לחוץ ממש אלא אפילו משיצא חוץ לפרוזדור:

סעיף י״א: הוציא העובר את ידו והחזירה אמו טמאה לידה:

סעיף י״ב: היתה מקשה לילד ושמעה קולו של ולד חשוב כילוד שאי אפשר שלא הוציא ראשו חוץ לפרוזדור:

Translation — (seif 10) the valad was cut up within her and came out limb by limb, whether in the order of the limbs — the foot, then the shin, then the thigh — or out of that order: she is not impure with the impurity of birth until the greater part of it has come out; and if its whole head came out at once, that is as its greater part. And if it was not cut up and came out in the ordinary way, once its forehead has come out it is as born, even if it was cut up afterwards; and it need not have come right outside, it is enough that it came out beyond the vestibule. (seif 11) The fetus put out its hand and drew it back — its mother is impure with the impurity of birth. (seif 12) She was in hard labour and heard the voice of the valad — it is reckoned as born, for it is impossible that it did not put its head out beyond the vestibule. (שו״ע יו״ד קצ״ד ס״י–סי״ב)

The chakira — what is the “measure of birth”? From when does the emergence count as a birth that defiles? Three measures, according to the manner of emergence:

cut up, emerging limb by limb — she is not impure with birth impurity until רובו, its greater part, has emerged; and the emergence of the whole head at once is as the greater part.
emerging in the ordinary way (whole) — once the פדחתו, the forehead, emerges, it is as born, even though it has not emerged entirely.
hard labour, and she heard the voice of the valad — it is reckoned as born, for it is impossible that it did not put its head out beyond the vestibule.

The root of the distinction — the greater part for one cut up, the forehead for one emerging whole. Why, where the child was cut up, is the greater part required, while for one emerging in the ordinary way the forehead suffices? The foundation is this: when the child emerges whole, by the ordinary way of birth, the emergence of the forehead is the beginning of a true birth, and the whole body follows it — hence “as born” from the emergence of the forehead. But where it was cut up there is no birth in its ordinary way, and birth impurity does not attach before the emergence of the greater part of the body (or of the whole head, which is as the whole body). And as for a hand put out and drawn back — although there is no greater part there, she is impure with birth impurity. The Shakh ties it to its two headings: by Torah law she is not impure with birth impurity, but she is by rabbinic law once a limb has emerged and been drawn back; and she is in any case impure as a niddah, even by Torah law, since the womb does not open without blood.

It is here, and not in the Taz, that the machloket over the measure stands — this must be said, because the Taz's three entries in this siman all bear on seif 1. The Shakh, on the words משתצא פדחתו, reports that the Kesef Mishneh and the Bayit Chadash hold the Rambam's רוב פדחתו to be a copyist's error, while the Beit Yosef defends his reading; and since the Tur too writes רוב פדחתו, the Shakh concludes that the “forehead” of the mishnah means the greater part of the forehead.

The Pitchei Teshuva on these seifim: on רובו (seif 10) he brings the Nachalat Shiv'a (siman 9), who requires seven clean days of a woman who sat on the birthing stool and whose pangs then ceased, since the womb had opened; the Chavot Da'at disputes him and permits, and the Kreti u-Pleti together with the Sidrei Taharah agree with him — but where the custom is to forbid, it is not changed. On ושמעה קולו של ולד (seif 12) he brings a ruling of the Noda BiYehuda on a case where the child was heard weeping in its mother's womb.

8. Twins — the days of impurity are counted from the last

The Mechaber's text (seif 13)

היולדת תאומים ושהה ולד אחר חבירו כגון האחד קודם שקיעת החמה והאחר אחר שקיעת החמה משיצא הראשון טמאה לידה ומונין ימי טומאה משיצא האחרון ואם הראשון ניכר שהוא זכר והשני ניכר שהוא נקבה או שאינו ניכר שני זה אם הוא זכר או נקבה מונה משיצא השני ימי טומאה לנקבה:

Translation — one who bears twins, and one child was delayed after the other — for instance one before sunset and the other after sunset — from the moment the first emerged she is impure with birth impurity, and the days of impurity are counted from the emergence of the last. And if the first is recognised as a male and the second recognised as a female, or if it is not recognised of that second whether it is male or female — she counts, from the emergence of the second, the days of a female's impurity. (שו״ע יו״ד קצ״ד סי״ג)

The foundation — impure from the first, counted from the last.
Where twins emerged one after the other (even on two separate days, before and after sunset), two moments come apart:
• the onset of the impurity — from the emergence of the first, the womb having already opened and a birth having taken place;
• the reckoning of the days of impurity — from the emergence of the last, the birth continuing and being completed only at the emergence of the second.

Male and female together, stringently. Where the first is a male and the second a female (or their sex is not recognised), she counts from the last, and with the stringency of a female — fourteen days, and no immersion before the night of the fifteenth — since a safek nekeva is resolved stringently. The Mechaber in fact says it in so many words at the end of the seif: she counts, from the emergence of the second, “the days of a female's impurity”. The din of twins is thus itself a branch of the rule of safek nekeva, grafted onto the foundation “one counts from the last”. In this siman none of the three nosei kelim has an entry on this seif. In practice — to a rav.

9. Yotse dofen and the caesarean

The Mechaber's text (seif 14)

יוצא דופן אם לא יצא דם אלא דרך דופן אמו טהורה מלידה ומנדה ומזיבה:

Translation — yotse dofen: if no blood came out other than through the wall, his mother is pure — of the impurity of birth, of niddah and of zivah. (שו״ע יו״ד קצ״ד סי״ד)

The foundation — “if no blood came out other than through the wall”.
A יוצא דופן is a child that emerged through the wall of the abdomen and not by the natural route. If no blood came out other than through that wall, its mother is pure of birth impurity, of niddah and of zivah: there was here no opening of the womb in the way of a birth, and blood issuing through the wall does not defile. This is a gader that is a chidush in itself — birth impurity depends on emergence by the natural route, and not on the emergence of the child as such.

Machloket of the Sages and Rabbi Shimon (Mishnah Niddah):

Shitah	The yotse dofen	Root of the machloket
The Sages	One does not sit for it days of impurity or days of purity, and one is not liable to a korban for it	Birth depends on emergence through the womb
Rabbi Shimon	הֲרֵי זֶה כְיָלוּד — it is as one born	The name “birth” applies to a yotse dofen too

And for the halakhah the Mechaber followed the Sages — if no blood came out other than through the wall, its mother is pure of birth impurity.

The chakira for practice — the caesarean in our time. At first sight a woman who gives birth by caesarean is a yotse dofen in the literal sense, and by the Mechaber she would be pure of birth impurity. But the Mechaber's language must be weighed: if no blood came out other than through the wall. The Mechaber does not exempt the yotse dofen as such; he exempts it on a condition, and that condition is factual. Everything therefore turns on what actually happened in that particular birth — and that is not a matter for a page, but for observation.

What the Mechaber's condition commits us to, and what it does not. Where blood also came out by the natural route — as happens in many caesareans — the condition the Mechaber lays down (“not other than through the wall”) is not met: there has been a sighting of blood, and the reasoning of seif 14 no longer applies to that case. Where, on the contrary, nothing came out by the natural route, seif 14 is speaking. Two things must be said honestly. First, the question is one of fact before it is one of law: it calls for precise medical clarification of what emerged and by which route. Second, in this siman neither the Shakh, nor the Taz, nor the Pitchei Teshuva has an entry on seif 14 — a reader who wants the Acharonim on the caesarean must look for it among the poskim who treated it, and not here. ⚠️ One does not rule leniently from a page: every caesarean is a question for a moreh hora'ah and for the physician.

Where the commentators are to be found: the Pitchei Teshuva of this siman returns often to the Noda BiYehuda and the Chatam Sofer — notably on the opening of the womb (seif 2), on miscarriage (seif 3) and on the voice of the child heard (seif 12). But he has, in this siman, no entry at all on seif 14, and we shall not make those passages say what they do not say. Contemporary poskim have treated the caesarean for practice, and it is to them that one must go — Shevet HaLevi for the halakhah, Nishmat Avraham of Dr Avraham Sofer Abraham for the medical side. And in practice — ask your rav, and your doctor.

10. Chakira and nafka mina for practice

The overall chakira of the siman: from when is the yoledet impure, and on what do the days of impurity and the count of seven depend?

The foundation of the impurity — the womb does not open without blood; she is impure even with no sighting, and even for a nefel.
The yoledet “be-zov” nowadays — every woman needs seven clean days; and of the Torah's days of impurity there remains the din of the night of the fifteenth for a female.
Miscarriage within forty days — no concern for a valad, but concern for niddah; and as soon as seven clean days are counted she is permitted.
“We are no longer expert in the forms” — we are concerned for a valad and for a female (safek nekeva — the night of the fifteenth).
The measures of birth — cut up: the greater part (and the whole head is as much); emerging in the ordinary way: the forehead; hard labour and the voice heard: as born.
Yotse dofen — pure if no blood came out other than through the wall; and in a caesarean where blood also came out by the natural route, that condition is not met.

Nafka mina for practice:

Every yoledet is impure as a niddah even with no sighting of blood, and requires seven clean days (the yoledet “be-zov” in our time).
One who bore a female or a safek female — she does not immerse before the night of the fifteenth, even having counted her seven clean days.
Miscarriage within forty days — concern for niddah only; as soon as seven clean days are counted she is permitted (Rama).
Every miscarriage (a shafir, a shilya, a piece containing a bone) — we are concerned for a valad and for a female, since we are no longer expert in the forms.
The measure of birth — the greater part for a child cut up, the forehead for one emerging in the ordinary way, and the voice in hard labour.
Caesarean — the exemption of seif 14 is conditioned on no blood having come out other than through the wall; that is a finding to be established, and an urgent question for a rav.

In practice — ask your rav, and for anything medical, your doctor. A miscarriage and a caesarean are urgent questions, to be asked with sensitivity and compassion.

11. Summary tables

Table — the din of the yoledet and of the mappelet, in detail

Table — the central machlokot and chakirot of the siman

Table — the sources of the sugya

The case	The din	Source
Yoledet (living child / dead / nefel)	Impure as a niddah even with no sighting of blood; seven clean days	מחבר ס״א
One who bore a male / a female (nowadays)	Seven days (or fourteen) for the birth and seven clean days; for a female — not before the night of the fifteenth	מחבר ס״א · ס״ג
Miscarriage within forty days	No concern for a valad; concern for niddah; after seven clean days she is permitted	מחבר ורמ״א ס״ב
Miscarriage of a form / shafir / shilya / piece with a bone	Concern for a valad and for a female — we are no longer expert in the forms	מחבר ס״ג
Shilya after a child (up to twenty-three days)	It is attributed to the child; if it came out first — concern, and a female's days	מחבר ס״ד–ז׳
Tumtum / androginos / “she felt that she had miscarried”	The days of a female's impurity; she has concern that it may have been a female	מחבר ס״ח–ט׳
Cut up, emerging limb by limb	Impure with birth impurity once the greater part has emerged (the whole head is as much)	מחבר ס״י
Emerging in the ordinary way	As born once the forehead emerges	מחבר ס״י
Hard labour, and she heard the voice	Reckoned as born	מחבר סי״ב
Twins	Impure from the first, counted from the last; safek nekeva stringently	מחבר סי״ג
Yotse dofen (caesarean)	Pure if no blood came out other than through the wall; a condition of fact to be established	מחבר סי״ד

The subject	First term	Second term / the ruling
The days of impurity in our time	By Torah law — days of impurity and days of purity (male 7+33, female 14+66)	Nowadays — no dam tohar; all are “be-zov”, seven clean days
Expertise in the forms of the valad	In the time of the gemara — a valad could be told from what is not one	Nowadays — we no longer know; concern for every miscarriage (stringently)
The measure of birth	Cut up — the greater part (and the whole head is as much)	Emerging in the ordinary way — the forehead; hard labour — the voice
What “forehead” means (Shakh ס״ק י׳)	Kesef Mishneh and Bayit Chadash — the Rambam's “רוב פדחתו” is a copyist's error	Beit Yosef and Tur — and the Shakh concludes that the mishnah's forehead is the greater part of the forehead
Yotse dofen (Mishnah Niddah 5:1)	The Sages — one does not sit for it days of impurity or purity (and so is the halakhah)	Rabbi Shimon — it is as one born
The caesarean in practice	If no blood came out other than through the wall — pure (seif 14)	If blood also came out by the natural route — the condition of seif 14 is not met; a question for a rav

Acharonim: Shakh (eleven entries on this siman) · Taz (three entries, all on seif 1) · Pitchei Teshuva (nine entries) · Sidrei Taharah and Chavot Da'at, cited by the Pitchei Teshuva · Chochmat Adam klal 115 · Arukh HaShulchan Yoreh De'ah 194 · Noda BiYehuda and Chatam Sofer, cited by the Pitchei Teshuva · and, among contemporary poskim, Shevet HaLevi and Nishmat Avraham on the caesarean.