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Obligatory Effort [Hishtadlut] as an Explanatory Model: A Critique of Reproductive Choice and Control


Studies on reproductive technologies often examine women’s reproductive lives in terms of choice and control. Drawing on 48 accounts of procreative experiences of religiously devout Jewish women in Israel and the US, we examine their attitudes, understandings and experiences of pregnancy, reproductive technologies and prenatal testing. We suggest that the concept of hishtadlut—”obligatory effort”—works as an explanatory model that organizes Haredi women’s reproductive careers and their negotiations of reproductive technologies. As an elastic category with negotiable and dynamic boundaries, hishtadlut gives ultra-orthodox Jewish women room for effort without the assumption of control; it allows them to exercise discretion in relation to medical issues without framing their efforts in terms of individual choice. Haredi women hold themselves responsible for making their obligatory effort and not for pregnancy outcomes. We suggest that an alternative paradigm to autonomous choice and control emerges from cosmological orders where reproductive duties constitute “obligatory choices.”

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The authors would like to thank Don Seeman, Zsuzsa Berend and two anonymous reviewers for their inspiring, supportive and helpful comments on this manuscript.


The US research sample was funded by a postdoctoral research grant to Elly Teman from the Penn Center for Integration of Genetic Healthcare Technologies at the University of Pennsylvania and by a grant to Elly Teman from the Robert Wood Johnson Health and Society Program at the University of Pennsylvania. The Israeli research sample was partially funded by a research grant to Tsipy Ivry from the Dept. of Sociology and Anthropology at the University of Haifa and partially from a research grant to Elly Teman from the Behavioral Sciences Dept. at Ruppin Academic Center, Israel.

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Correspondence to Elly Teman.

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Compliance with Ethical Standards

This article is based upon two separate research projects. The Israeli sample was reviewed and approved by the Ethics committee of the Faculty of Social Sciences at the University of Haifa, Israel. The US sample was approved by the Institutional Review Board of the University of Pennsylvania.

Conflict of Interest

Elly Teman, Tsipy Ivry, and Heela Goren declare that they have no conflict of interest and that no conflict of interest exists for this research.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all interviewees and all names have been changed to pseudonyms and identifying information has been omitted.

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This article is our original work and has not been published before or submitted simultaneously to another journal.

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Teman, E., Ivry, T. & Goren, H. Obligatory Effort [Hishtadlut] as an Explanatory Model: A Critique of Reproductive Choice and Control. Cult Med Psychiatry 40, 268–288 (2016).

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  • Ultra orthodox Jewish women
  • Reproductive choice
  • Religion
  • Reproductive technologies
  • Explanatory models
  • Moral dilemmas