Shtisel Season 3: Episode 7 46:39-42:30
Miriam and Joel are married and have been struggling with infertility for several years. They seek medical help and are prescribed a type of fertility-stimulating drug called a gonadotropin for Miriam to take.
They are delighted when Miriam has a positive pregnancy test. Six weeks later, they visit their reproductive health clinician for their first ultrasound and are surprised to learn that Miriam is pregnant with triplets. They experience a range of emotions - joy, shock, and apprehension - this was not the plan.
The fertility specialist offers the couple a variety of choices. They can:
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Continue the triplet pregnancy (increased risks to all fetuses and increased risk to pregnant woman)
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Selectively reduce the pregnancies to twins or a single fetus
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Choose which pregnancies to reduce based on genetic screening.
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Choose which pregnancies to reduce based on technical or procedural factors (how positioned)
https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/multiple-pregnancy-and-birth-twins-triplets-and-high-order-multiples-booklet
Approximately 30% of pregnancies resulting from gonadotropins are multiples. While most of these pregnancies are twins, up to 5% are triplets or greater due to the release of more eggs than expected.
According to the US Department of Health and Human Services, the twin birth rate has increased by over 75% since 1980, and triplet, quadruplet, and high-order multiple births have increased at an even higher rate.
Although uncommon in twin deliveries, about 20% of triplet pregnancies will result in the delivery of at least one child with a major long-term handicap. The fetal mortality rate for triplet or higher-order multiples was 27 per 1,000 live births: 5 times that for single births.
When a triplet or high-order multiple pregnancy occurs, multifetal pregnancy reduction may be considered to improve the chance for survival of the fetuses. While multifetal pregnancy reduction carries some risk of a complete miscarriage, it also reduces the chances of extreme premature birth. For example, the risk of spontaneous loss of the entire pregnancy is 25% for quadruplets, 15% for triplets, and 8% for twins.
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/09/multifetal-pregnancy-reduction
Selective reduction is somewhat different than multifetal pregnancy reduction. In multifetal pregnancy reduction, the fetus(es) to be reduced is (are) chosen based on technical considerations, such as which is most accessible to intervention. In selective reduction, fetuses are chosen based on health status. As with all pregnancies, when a woman with a multifetal pregnancy has ultrasonography or genetic evaluation that identifies a fetus with an abnormality or disease risk, patient counseling should include the most current knowledge regarding the abnormality or disease risk as well as information about the available management options, thus allowing a woman to make the decision that is best for her. Although some will critique the appropriateness of selective reduction based on potential future disability, an analysis of such considerations is beyond the scope of this Committee Opinion. Physicians should be aware that state and federal laws may affect the provision of selective reduction and should consult legal counsel for the facility at which they provide care.
(22) When men fight, and one of them pushes a pregnant woman and a miscarriage results, but no other damage ensues, the one responsible shall be fined according as the woman’s husband may exact from him, the payment to be based on reckoning. (23) But if other damage ensues, the penalty shall be life for life, (24) eye for eye, tooth for tooth, hand for hand, foot for foot, (25) burn for burn, wound for wound, bruise for bruise.
(108) But if any one has a contest with a woman who is pregnant, and strike her a blow on her belly, and she miscarries, if the child which was conceived within her is still unfashioned and unformed, he shall be punished by a fine… But if the child which was conceived had assumed a distinct shape in all its parts, having received all its proper connective and distinctive qualities, he shall die; (109) for such a creature as that is a man…requiring nothing more than to be released and sent out into the world.
(ו) הָאִשָּׁה שֶׁהִיא מַקְשָׁה לֵילֵד, מְחַתְּכִין אֶת הַוָּלָד בְּמֵעֶיהָ וּמוֹצִיאִין אוֹתוֹ אֵבָרִים אֵבָרִים, מִפְּנֵי שֶׁחַיֶּיהָ קוֹדְמִין לְחַיָּיו. יָצָא רֻבּוֹ, אֵין נוֹגְעִין בּוֹ, שֶׁאֵין דּוֹחִין נֶפֶשׁ מִפְּנֵי נָפֶשׁ:
(6) If a woman is having trouble giving birth, they cut up the child in her womb and brings it forth limb by limb, because her life comes before the life of [the child]. But if the greater part has come out, one may not touch it, for one may not set aside one person's life for that of another.
משנה ערכין א׳:ד׳
(ד) האשה שהיא יוצאה להרג, אין ממתינין לה עד שתלד.ישבה על המשבר , ממתינין לה עד שתלד.
Mishnah Arakhin 1:4
(4) If a woman is about to be executed, they do not wait for her until she gives birth. But if she had already sat on the birthstool, they wait for her until she gives birth.
איתיביה רב חסדא לרב הונא יצא ראשו אין נוגעין בו לפי שאין דוחין נפש מפני נפש. ואמאי רודף הוא! שאני התם דמשמיא קא רדפי לה.
Rav Ḥisda raised an objection to Rav Huna from a baraita: If a woman was giving birth and her life was being endangered by the fetus, the life of the fetus may be sacrificed in order to save the mother. But once his head has emerged during the birthing process, he may not be harmed in order to save the mother, because one life may not be pushed aside to save another life. If one is permitted to save the pursued party by killing the minor who is pursuing him, why is this so? The fetus is a pursuer who is endangering his mother’s life! The Gemara answers: This is not difficult, as it is different there, with regard to the woman giving birth, since she is being pursued by Heaven. Since the fetus is not acting of his own volition and endangering his mother of his own will, his life may not be taken in order to save his mother.
יצא ראשו - באשה המקשה לילד ומסוכנת וקתני רישא החיה פושטת ידה וחותכתו ומוציאתו לאברים דכל זמן שלא יצא לאויר העולם לאו נפש הוא וניתן להורגו ולהציל את אמו אבל יצא ראשו אין נוגעים בו להורגו דהוה ליה כילוד ואין דוחין נפש מפני נפש
Its head has emerged: With a women that is experiencing difficulty giving birth and is in danger. And it is taught in the first section [of this teaching], "the midwife extends her hand and cuts it up and extracts [the pieces];" as the entire time that that it has not gone out into the air of the world, it is not [considered] a soul, and [so] it is possible to kill it and to save its mother. But when its head came out, we cannot touch it to kill it, as it is like a born [baby]; and we do not push off one soul for the sake of another.
(ט) אַף זוֹ מִצְוַת לֹא תַּעֲשֶׂה שֶׁלֹּא לָחוּס עַל נֶפֶשׁ הָרוֹדֵף. לְפִיכָךְ הוֹרוּ חֲכָמִים שֶׁהָעֻבָּרָה שֶׁהִיא מַקְשָׁה לֵילֵד מֻתָּר לַחְתֹּךְ הָעֵבָּר בְּמֵעֶיהָ בֵּין בְּסַם בֵּין בְּיָד מִפְּנֵי שֶׁהוּא כְּרוֹדֵף אַחֲרֶיהָ לְהָרְגָהּ. וְאִם מִשֶּׁהוֹצִיא רֹאשׁוֹ אֵין נוֹגְעִין בּוֹ שֶׁאֵין דּוֹחִין נֶפֶשׁ מִפְּנֵי נֶפֶשׁ וְזֶהוּ טִבְעוֹ שֶׁל עוֹלָם:
Behold it is a negative prohibition to have mercy on the pursuer. Therefore, the Sages have ruled if there is a pregnant woman who is in travail in childbirth, that it is permissible to dismember the fetus in her womb, whether by medicinal means or whether surgically, because it is as if he is pursuing her life. However, once the fetus’ head has emerged, one may not lay a hand on it (to abort it), because one cannot override one life to save another, and this is the way of the world.
27. שו”ת ציץ אליעזר י”ג:ק”א
יא סיון תשל”ה
השאלה היא, אודות הפסקת הריון בגלל המחלה הנקראת תיי – סקס.. הטכניקה בה ניתן כיום לבצע בדיקות מעבדה אלה, אינה נותנת תוצאות לפני תום שלשה חדשי הריון. לזאת נפשו בשאלתו, אם: האם לראות במחלה זו אשר תוצאותה כה חמורות וכה וודאיות, מספיק חמור בכדי לאפשר הפסקת הריון גם אחרי שלשה חדשים, או האם התקופה הזו של שלשה חדשים היא אבסולוטית ואין שום סיבה פרט לסיבה של פקוח נפש ישיר באם, אשר מאפשר הפסקת הריון אחר ג’ חדשי עיבור, ע”כ.
והנה אחרי העיון בדבר בכובד ראש בכל צדדי הנתונים שבבעיה האמורה, נלפענ”ד על יסוד הבירורים הנרחבים שכתבתי בדבר הפסקת הריון בספרי שו”ת צ”א חלק ט’ סי’ נ”א שער ג’… כי שבמקרה המיוחד הזה אשר תוצאות כה חמורות בכנפיו עם המשכת ההריון והלידה, אפשר להתיר הפסקת הריון עד שבעה חדשים, ובאופן שבביצוע הפסקת ההריון לא יהא כרוך בשום סכנה לאם. משבעה חדשים והלאה הדבר כבר יותר חמור, (והחומרא בזה אז כבר הוא יותר מדעת נוטה ומסברת הכרס כביטויו של החו”י להלן באות ד’). מכיון שבמלאות ז’ חדשים בא כבר הולדבהרבה מקרים לידי גמרו.
ברור ופשוט הדבר בהלכה, דישראל אינו נהרג על העוברין, ומלבד דעה יחידית סוברים הפוסקים שאיסור מיהא ישנו, אבל דעת הרבה מהפוסקים שהאיסור אינו אלא מדרבנן, או הוא רק משום גדר בנינו של עולם, אבל מחמת איבוד נפשות אין נדנוד כלל, ומשום כך מתיר בשו”ת מהרי”ט ח”ט סי’ צ”ז – צ”ט לסדר בישראלית הפלת ולד בכל היכא שהדבר נחוץ משום רפואת אמו, אפילו באין סיבה של פקו”נ לאם…
ובכזאת, ויותר מזאת, צידד להתיר בהדיא בשו”ת שאילת יעב”ץ ח”א סי’ מ”ג… וא”כ הגע בעצמך האם יש צורך, צער וכאב, יותר גדול מזה של נידוננו, אשר יגרם לאם בהולד לה יצור כזה, שכולו אומר יסורים ומכאובים ומיתתו בטוח במשך מספר שנים, ועיני ההורים רואות וכלות באין לאל ידם להושיע?… נראה שזהו המקרה הקלאסי ביותר שיש להתיר. ולא משנה באיזה צורה מתבטאים הכאבים והיסורים, גופיים, או נפשיים. ויסורים וכאבים נפשיים המה במדה מרובה הרבה יותר גדולים ויותר מכאיבים מיסורים גופיים…
(ב) וזאת לדעת, כי בדבריהם של המהרי”ט והיעב”ץ לא נזכר כלל שישנו כאלו הפרש בזה בין תוך ג’ חדשים לבין לאחר ג’ חדשים, וההגבלה הסתמית בזה היא רק שיש חילוק בין עקר לצאת לבין לא עקר לצאת, ואדרבה היעב”ץ כותב בהדיא בלשון: כל כמה דלא עקר, ומינה דהא כל כמה דלא עקר אין חילוק באיזה חודש שהיא נמצאת…
(ד) גם בשו”ת חוות יאיר סי’ ל”א שהעלה והזכיר בתשובתו שם מדבר זה שניתן לחלק בין קודם מ’ יום לבין אחר מ’ יום, או בין קודם ג’ חדשים לבין אחר ג’ חדשים, הביע כלאחר יד את הסתייגותו מחילוקים כאלה, וכותב בלשון: – מכל מקום אין מבוקשנו לדון מדעת נוטה וסברת הכרס יעו”ש.
(ו) באשר על כן כאשר גיליתי דעתי מראש, נלפענ”ד דיש להתיר לכגון נידוננו לסדר הפסקת הריון מיד עם הוודע המבחן הברור והוודאי שאכן יולד ילוד כזה, אפילו עד שבעה חדשים להריונה. ובאופן שסידור הפסקת ההריון תתבצע בצורה כזאת שלא יהא כרוך בה כל סכנה לאם…
(ז) אוסיף לומר לרווחא דמילתא, שמה טוב יהא אם אפשר הדבר לסדר שאשה רופאה תבצע את הפסקת ההריון, דבאופן כזה יתווסף עוד דבר המקיל בזה, וזאת לפי דעתם של החו”י והיעב”ץ בתשובותיהם שם. ועוד, שס”ל שהאיסור בישראל בהריגת עובר הוא משום השחתת זרע יעו”ש, ונשים הא אינן מצוות על כך לדעת רוב הפוסקים
27. Tzitz Eliezer, 13:102 (R. Eliezer Waldenberg)
1975
The question is regarding terminating a pregnancy because of the Tay-Sachs disease… The technology today which allows testing for this disease cannot giver reliable results prior to three months into the pregnancy. Thus his question is if one can view such a disease with such severe and certain consequences, sufficient severity to allow for a termination of the pregnancy even after three months, or if the period of three months is absolute, and there is no justification, short of direct risk to the life to the mother, that would allow for a termination of pregnancy after three months.
Behold after investigation into the matter with great seriousness, and with consideration of all the relevant circumstances, it seems in my humble opinion, on the basis of the analysis that I wrote in my responsa, 9:51.3… that in a case such as this, in which the consequences are so grave if the pregnancy and childbirth are allowed to continue, it is permissible to terminate the pregnancy until 7 months have elapsed, and in a way in which no danger will befall the mother. Beyond 7 months the issue is more serious (and the stringency here is more based on how the matter seems and the “knowledge of the gut”, to use the phrase of the Havot Yair) since at the end of 7 months the fetus is often fully developed.
It is clear that capital punishment is not prescribed for abortion, and with the exception of a single opinion, the decisors conclude that there is nevertheless some form of a prohibition. But the opinion of most rabbis is that the prohibition is only of Rabbinic origin, or that it is in the category of the well-being of the world, but that there is not even the slightest element of destroying a life. Therefore, Maharit, in his responsum, permitted abortion for a Jewish woman whenever the matter was necessary for her health even when her life was not at stake… And therefore ask yourself where is there a great need regarding pain and suffering greater than the woman in our case which will be inflicted upon her if she gives birth to such a creature whose very being is one of pain and suffering and his death is certain within a few years… and added to that is the pain and suffering of the infant. This would seem to be the classic case in which abortion may be permitted, and it doesn’t matter what type of pain and suffering is endured, physical or emotional, as emotional pain and suffering is to a large extent much greater than physical pain and suffering…
(6) Thus, as I have indicated at the outset, it would seem in my humble opinion that one can allow in a case such as ours to arrange for a termination of the pregnancy immediately once the test results are definitive that the child has this disease, even up to 7 months of pregnancy, provided that there is no risk to the mother…
(7) I will add that, to do it in the best possible way, it would be ideal if the operation could be performed by a woman doctor, for in such a case there would be another aspect of leniency, according to Havot Yair and Yavetz in their responsa. For they are of the opinion that the prohibition for a Jew to kill a fetus is because of wasting of seed, see there, and women are not prohibited in doing such according to most decisors.
34. שו”ת ציץ אליעזר, כ:ב
ח”י טבת תשנ”ג.
עובדא הוה באשה אחת שהרתה רביעיה, אחרי בדיקות רפואיות החליטו הרופאים שמן ההכרח להמית עובר אחד דאזי יוולדו שלשת הנותרים חיים, אחרת יוולדו כולם מתים, ונשאלתי מבעלה שהוא ת”ח אם מותר זאת על פי דין להמית אחד מהם כדי שהאחים ישארו בחיים ואם זה לא דומה לההלכה הנפסקה ברמב”ם בפ”ה מה’ יסודי התורה הלכה ה’ דאם אמרו להם עכו”ם תנו לנו אחד מכם ונהרגהו ואם לאו נהרוג כולכם יהרגו כולם ואל ימסרו להם נפש אחת מישראל…
ועל האמור שההורג את העובר אין שם רוצח אליו ושלא נכלל בהג’ עבירות שנאמר בהם יהרג ואל יעבור שאחד מהם שפ”ד, אין מי שחולק, ונחלקו רק איזה עבירת לאו יש בזה, אי משום לאו דחבלה, או משום השחתת זרע, וכיוצא בזה, אבל אין זה אפילו בגדר של אביזרייהו דשפ”ד, ואמבוהא דספרי סוברים שאינו אלא מדרבנן, ומהם מכנים זאת רק בשם קצת איסור…
לאור כל האמור נלפענ”ד להלכה בנידון שאלתנו שמותר להמית עובר אחד כדי להציל עי”כ חיי יתר שלשת העוברין אשר כל אחד מהם הוא בבחיה על רודף את משנהו
Tzitz Eliezer, 20:2 1993.
The case is of a certain woman who is pregnant with quadruplets, and after a medical exam the doctors have determined that it is necessary to kill one fetus, and then the other three will definitely live, but without this, all of them will die. I was asked by her husband, who is a talmid chakham, if it is permissible by law to kill one of them so that his siblings live, or if this is similar to the law that is ruled in Rambam, Foundations of Torah 5:5, that if non-Jews tell you to give us one person to be killed, or else we will kill all of you, that you must let everyone die rather than giving over one Jewish soul…
Now, we have shown, that one who kills a fetus is not considered a murdered, and that this is not included in the three cardinal sins for which it is said that one must die rather than transgressing, one of which is murder, and on this point no one argues. The only debate is which negative prohibition applies to this case, whether the prohibition of wounding or that of wasting seed, or something similar, but that this is not even in the category of appurtenances to murder. And the majority of the decisors are of the opinion that it is only a Rabbinic violation, and some frame it merely as “a minor violation”…
Based on all the above, it appears to me, in my humble opinion, that the ruling regarding our question is, that it is permissible to kill one fetus so that more than three fetuses (each one of whom is in the category of a pursuer of the other) will survive…
שו”ת אגרות משה חושן משפט ב:סט
אסרו”ח סוכות תשל”ז….
הנה בדבר הריגת עובר במעי אמו בישראל….
וברמב”ם פ”א מהלכות רוצח ה”ט מפורש עוד יותר דהריגת עובר הוא רציחה ממש…
ולכן לדינא… איכא איסור רציחה מלא תרצח גם על עובר ורק שפטור ההורגו ממיתה, … ומטעם זה הוריתי שאף שהרופאים אומרים שיש חשש שמא תמות האם כשלא יהרגו את העובר, אף שלענין חלול שבת וכל האיסורין היו מחללין והיו עוברין במדת חשש שאמרו דהא גם בשביל ספק קטן וס”ס מחללין, מ”מ להרוג את העובר יהיה אסור עד שתהיה האומדנא להרופאים גדולה קרוב לודאי שתמות האם….
וגם לענין אונס אם רשאי הרופא לעבור ולא ליהרג… שא”כ יש לו להיות בדין יהרג ואל יעבור…ולכן צ”ע לדינא אם איכא בזה דיהרג ולא יעבור או לא…
כתבתי כל זה לענין הפרצה הגדולה בעולם שהמלכיות דהרבה מדינות התירו להרוג עוברים ובתוכם גם ראשי המדינה במדינת ישראל וכבר נהרגו עוברים לאין מספר שבזה”ז הא עוד יש צורך לעשות סיג לתורה, וכ”ש שלא לעשות קולות באיסור רציחה החמור ביותר, שלכן נשתוממתי בראותי תשובה מחכם אחד בא”י הנכתב למנהל ביה”ח שערי צדק ונדפס בחוברת אסיא י”ג המתיר הולדות שע”י בחינות הרופאים כשהוא עובר יותר מג”ח שהעובר הוא במחלת תיי – סקס להפילו, ומצד זה הקדים שעצם הריגת העוברים הוא להרבה פוסקים רק מדרבנן… וברור ופשוט כדכתבתי הלכה הברורה ע”פ רבותינו הראשונים המפרשים והפוסקים ממש שאסור בדין רציחה ממש כל עובר בין כשר בין ממזר בין סתם עוברים ובין הידועים לחולי תיי – סקס שכולן אסורין מדינא ממש, ואין לטעות ולסמוך על תשובת חכם זה ושרי ליה מריה בזה הכו”ח לכבוד התורה ודין האמת.
Iggrot Moshe, Choshen Mishpat, 2:69
Day after Sukkot. 1976.
Regarding Killing a fetus…
And in Maimonides it is even more explicit that killing a fetus is actual murder…
Therefore, regarding the law, it is prohibited under the prohibition of “Thou shalt not murder” to abort a fetus, with the single exception that one who kills it is exempt from the death penalty… And because of this I ruled that even if the doctors are saying that there is a possibility that the mother may die if the fetus is not killed – although for desecrating Shabbat and violating other commandments one would do so in such a case, even for a small concern of life – nevertheless, to kill a fetus it would be forbidden until the doctors assess that the likelihood of her death is almost definite…
And even if the doctor is being forced by threat of death to perform an abortion, it would appear that he must give up his life rather than do so [although an argument could be made to the contrary]… Therefore, this ruling requires greater thought, whether one must give up his life rather than perform an abortion…
I have written all this because of the great calamity in the world that many governments have allowed the killing of fetuses, among them political leaders in the State of Israel, and countless of fetuses have already been killed, and in these days the greatest need is to make a fence around the Torah, how much more so not to make leniencies regarding the prohibition of murder that is so severe. Thus, I was appalled by the responsa of a learned man in Israel written to the director of Shaarei Tzedek Hospital who permits the abortion of a Tay-Sachs fetus even beyond 3 months. And he ruled such by prefacing that the prohibition was, according to many decisors, only rabbinic… It is clear and simple as I wrote, the law which is made clear by the early rabbis and the decisors of Jew law, that abortion is prohibited as it is considered actual murder, whether the fetus is legitimate or illegitimate, regular fetuses or those which are suffering from Tay-Sachs. It is strictly prohibited, and do not err and rely on the responsum of that learned man…
There is clear precedent in the tradition, as it has developed to our day, to permit abortion of a fetus to save a mother's life, to safeguard her health, or even for "a very thin reason," such as to spare her physical pain or mental anguish. Some recent authorities also consider the well-being of other children, and the future of the fetus itself as reasons to permit abortion. All agree that there must be a reason to justify the destruction of the potential person the fetus will become after birth. Where there is reason to believe that the fetus may be defective, it is advisable for the mother to go to her obstetrician and undergo amniocentesis and/or other prenatal tests. If the tests indicate that the child will be born with major defects which would preclude a normal life, and which make the mother and the family anxious about the future, it is permitted to abort the fetus. The rabbi should meet with the mother (and father) and explain the approach of Jewish law to abortion. He should indicate the gravity of the act of aborting the fetus, as well as the extenuating circumstances which Jewish law considers as justification for an abortion. The rabbi should recommend a full discussion with the father and other members of the family in consultation with a physician and a psychiatrist, to help the mother understand the impact the abortion will have on her and other members of the family. The final decision should be made by the mother in consultation with the family.
A Teshuvah on Abortion RABBI ISAAC KLEIN - This paper, originally published in Conservative Judaism (Fall1959), was adopted as aM ajority Opinion on August 23, 1983, by a vote of 11-1- 5.
Our conclusion, therefore, must be that abortion is morally wrong. It should be permitted only for therapeutic reasons.
Since every Reform Jew possesses an ultimate moral right to autonomy, each possesses the authority to determine for her/himself what she/he believes true and valid. This includes the right to decide for her/himself the standard to use in determining if an entity is human. Even so, an objective standard for humanness that is accepted by the generality of humankind would be difficult for a Reformer to deny although he/she would have the right to do so…
From the testimony of the religious, philosophic, and scientific communities of the world viewed as a whole, it is evident that there is no generally accepted objective standard for determining whether a fetus is a human being or part of the mother in which it exists. There exist only a mélange of subjective standards varying from one religionist to another, from one philosopher to another, and from one scientist to another. Consequently, since there is no objective standard for determining humanness, no impediment exists to deter the Reform Jew from deciding for her/himself whether a fetus is a human being or part of the female in which it exists…
According to Reform principles, as stated above, every person owns his/her own body, with the ultimate right, consequently, to determine what that body shall do and experience. This being the case, it is a Reform presumption that whatever exists within the confines of a person’s body and is physically connected to it is part of that body, and therefore entirely under the authority of the person whose body it is. If some entity, a person or organization of persons, therefore, whishes to exercise authority over a fetus in a woman’s body, the entity must prove convincingly either that the fetus is a person and not part of that body or that is possesses a moral right to authority over the woman’s body superior to that of the woman whose body it is. No entity – state, religious institution or individual – has taken even beginning steps to demonstrate objectively that a fetus is a person or that the entity possesses a moral right to override a woman’s authority over her own body.
וא"ל אנטונינוס לרבי נשמה מאימתי ניתנה באדם משעת פקידה או משעת יצירה א"ל משעת יצירה א"ל אפשר חתיכה של בשר עומדת שלשה ימים בלא מלח ואינה מסרחת אלא משעת פקידה אמר רבי דבר זה למדני אנטונינוס ומקרא מסייעו שנאמר (איוב י, יב) ופקודתך שמרה רוחי
And [Roman Emperor] Antoninos said to Rabbi Yehuda HaNasi: From when is the soul placed in a person? Is it from the moment of conception or from the moment of the formation of the embryo, forty days after conception? Rabbi Yehuda HaNasi said to him: It is from the moment of the formation of the embryo. Antoninos said to him: That is inconceivable. Is it possible that a piece of meat could stand for even three days without salt as a preservative and would not rot? The embryo could not exist for forty days without a soul. Rather, the soul is placed in man from the moment of conception. Rabbi Yehuda HaNasi said: Antoninos taught me this matter, and there is a verse that supports him, as it is stated: “And Your Providence [pekudatekha] has preserved my spirit” (Job 10:12) indicating that it is from the moment of conception [pekida] that the soul is preserved within a person.
(ה) תָּא חֲזֵי, בַּר נָשׁ דְּאִתְיְילִיד לָא אִתְמָנָא עָלֵיהּ חֵילָא דִּלְעֵילָּא, עַד דְּאִתְגְּזַר. כֵּיוָן דְּאִתְגְּזַר, אִתְּעַר עָלֵיהּ (רוחא) אִתְּעָרוּתָא דְּרוּחָא דִּלְעֵילָּא. זָכֵי לְאִתְעַסְּקָא בְּאוֹרַיְיתָא, אִתְּעַר עָלֵיהּ אִתְּעָרוּתָא יַתִּיר. זָכֵי וְעָבִיד פִּקּוּדֵי אוֹרַיְיתָא, אִתְּעַר עָלֵיהּ אִתְּעָרוּתָא יַתִּיר. זָכֵי וְאִתְנְסִיב, זָכֵי וְאוֹלִיד בְּנִין, וְאוֹלִיף לוֹן אוֹרְחוֹי דְּמַלְכָּא קַדִּישָׁא, הָא כְּדֵין הוּא אָדָם שְׁלִים. שְׁלִים בְּכֹלָּא.
Come and See, when a person is born, their soul does not enter them [as a baby] until they enter the covenant (the bris or maybe a simchat bat). If that person succeeds in delving into Torah, a further soul is roused within them. If they succeed in performing mitzvot, another soul is roused in them. If they succeed in sanctifying another [getting married], having children, and teaching them the ways of the Holy One, then they [the parent] becomes a complete person, totally complete.