Your faith or mine: a pregnancy spacing intervention in an ultra-orthodox Jewish community in Israel

Ultra-orthodox (haredi) Jews in Israel have an exceptionally high fertility rate of 7.7. As most fathers spend their days studying the Bible, the women struggle to support their large families under severe economic pressures. Some women experience maternal exhaustion coping with this life situation. Contraception for pregnancy spacing raises myriad dilemmas in the haredi community, however, many of which apply to promoting family planning in religious settings more generally. In a health promotion course for 23 haredi registered nurses at the University of Haifa in 2006-2007, pregnancy spacing was selected as the subject of the class project, the main aim of which was to convey an influential health message in a culturally acceptable manner. As the issue was debated, it was agreed the project should also address a range of women's health problems as well as pregnancy spacing. Thus, maternal nutrition, pelvic floor tone, dental health, maternal exhaustion and competition over number of children were added. A brochure was prepared and widely distributed in the haredi community, where it was well received. This paper describes the classroom dynamics during the planning and application of the project. It illustrates the importance of cultural awareness when addressing sensitive issues and communities with particular cultural dispositions.