Why Does the Torah Describe Babies Born Hands First?

An Impossible Birth Story

The story of Judah and Tamar in Genesis 38 ends with Tamar giving birth to twins:^[1]

^{בראשית לח:כז} וַיְהִי בְּעֵת לִדְתָּהּ וְהִנֵּה תְאוֹמִים בְּבִטְנָהּ. ^לח:כח וַיְהִי בְלִדְתָּהּ וַיִּתֶּן יָד וַתִּקַּח הַמְיַלֶּדֶת וַתִּקְשֹׁר עַל יָדוֹ שָׁנִי לֵאמֹר זֶה יָצָא רִאשֹׁנָה. ^לח:כט וַיְהִי כְּמֵשִׁיב יָדוֹ וְהִנֵּה יָצָא אָחִיו וַתֹּאמֶר מַה פָּרַצְתָּ עָלֶיךָ פָּרֶץ וַיִּקְרָא שְׁמוֹ פָּרֶץ. ^לח:ל וְאַחַר יָצָא אָחִיו אֲשֶׁר עַל יָדוֹ הַשָּׁנִי וַיִּקְרָא שְׁמוֹ זָרַח.

^{Gen 38:27} When the time came for her to give birth, there were twins in her womb! ^38:28 While she was in labor, one of them put out his hand, and the midwife tied a crimson thread on that hand, to signify: This one came out first. ^38:29 But just then he drew back his hand, and out came his brother; and she said, “What a breach you have made for yourself!” So he was named Perez. ^38:30 Afterward his brother came out, on whose hand was the crimson thread; he was named Zerah.

The story has two features that contradict the reality of childbirth.^[2]

One at a time – Twins cannot switch places mid birth. They do not come out of the uterus together nor are they both in the birth canal at the same time.

Hands first – Babies are generally born head first (cephalic presentation), with the baby’s hands positioned alongside its body, pressed in by the birth canal, toward the direction of its legs. Less common are the breech presentations (3-4%).^[3] In rare cases (0.1% incidence), an arm or both arms can present together with the head or buttocks (compound presentation). But, to the best of my knowledge, babies never emerge with their arms extended forwards.^[4]

The Meaning of the Story

The story is meant as an allegory or a foundational myth, explaining the relationship between two Judahite clans, that of Zerah and that of Peretz. Since biblical tradition associates King David with the Peretz clan, it is clear that this clan wins out, although the story implies that Zerah had some claim to seniority as well.^[5]

Some scholars have suggested that the withdrawal of Zerah’s hand back into Tamar’s womb indicates that Zerah is voluntarily relinquishing his birthright.^[6] In other words, Zerah is the active child, first putting out his hand, then withdrawing it in favor of his brother.

And yet, this does not fit well with the comment of the midwife, who describes Peretz as the active one: “What a breach you have made for yourself?!” (מַה פָּרַצְתָּ עָלֶיךָ פָּרֶץ). Thus, I suggest that the author is implying that Zerah’s brother Perez grabbed his twin by the feet and pulled him back, and then hurried to be the first out of the womb. In other words, the twins grappled with each other in the womb, Zerah took the lead first, but ultimately, Peretz emerged first.

Jacob and Esau: Another Grappling Twins

This reading is supported by the parallels to the birth of the pair of twins narrated earlier in the Torah, Jacob and Esau:

^{בראשית כה:כד} וַיִּמְלְאוּ יָמֶיהָ לָלֶדֶת וְהִנֵּה תוֹמִם בְּבִטְנָהּ. ^כה:כה וַיֵּצֵא הָרִאשׁוֹן אַדְמוֹנִי כֻּלּוֹ כְּאַדֶּרֶת שֵׂעָר וַיִּקְרְאוּ שְׁמוֹ עֵשָׂו. ^כה:כו וְאַחֲרֵי כֵן יָצָא אָחִיו וְיָדוֹ אֹחֶזֶת בַּעֲקֵב עֵשָׂו וַיִּקְרָא (נ”ש‎: ויקראו) שְׁמוֹ יַעֲקֹב…

^{Gen 25:24} When her time to give birth was at hand, there were twins in her womb. ^25:25 The first one emerged red, like a hairy mantle all over; so they named him Esau. ^25:26 Then his brother emerged, and his hand had hold on Esau’s heel; so he (SP: they) named him Jacob….

Scholars have long emphasized the commonalities between these stories in both language and content.^[7] Both,

• Begin with the words וְהִנֵּה תְאוֹמִים/תוֹמִם בְּבִטְנָהּ “behold, there were twins in her womb”;
• Describe competition in the womb between twin brothers;
• Have the first child associated with red (hair or string)
• Assume that the one that comes out second (Jacob) or is supposed to come out second (Peretz) will be dominant.

These literary connections highlight the motif shared between both stories—how two groups of similar origins are described as twins, and the ultimate ascendency of one over the other is foreshadowed in their birth.

Both stories also assume that babies emerge from the maternal womb with their hands extended forward. Jacob’s grasping of Esau’s heel pre-supposes that the first part of Jacob’s body to come into the world was his hand. This positioning is stated explicitly in the case of Zerah, and may be implied with respect to Perez as well, who fought his way past his brother, pulling him back. Yet, both texts present physiological impossibilities.

The Door of the Womb

Perhaps this image is related to the idea that the womb is depicted metaphorically as a door, and doors are opened with hands. The use of a door as a metaphor for the womb is found most clearly in Job 3, where Job curses the day he was born:

^{איוב ג:י} כִּי לֹא סָגַר דַּלְתֵי בִטְנִי…

^{Job 3:10} Because it did not block the door of my [mother’s] womb…

This accords with other biblical descriptions of doors whose locks are placed on the inside and so they are opened or closed from within rather than from the outside.^[8] But again, it is important to remember that this entailment of the door metaphor, that the door is opened by a hand from the inside, is not accurate from a physiological perspective.

Men Did Not Attend Childbirth

So how did these two stories about birth hands-first arise? Biblical narratives were written by men or mostly by men, and in ancient Israel, as was the case in most places until recently, men were not present at childbirth.^[9] The view that childbirth generated impurity, as evident in the requirements for post-partum purification (Leviticus 12), would have reinforced cultural gender divisions so that only women would have attended to a woman giving birth.

Biblical birth scenes feature a “midwife” (Gen 35:17; 38:28) or “midwives” (Exod 1:15–21), and similarly “the women attending her” (1 Sam 4:20). In contrast, the father is not present at the birth, but rather awaits word from a messenger, as reflected in Jeremiah 20:15:

אָרוּר הָאִישׁ אֲשֶׁר בִּשַּׂר אֶת אָבִי לֵאמֹר יֻלַּד לְךָ בֵּן זָכָר…

Cursed is the man who brought my father the news, saying: A boy is born to you.

Childbirth, then, was a female event that took place within a closed circle of women, and it is possible that men would have had only scant information about the experience. This is also reflected in the Bible’s stereotypical and one-dimensional descriptions of birthing mothers. Women in childbirth are described as helpless, suffering great pain, and screaming bitterly.^[10] We may presume that the cries of woman were heard even by those outside the birthing room, causing this trope to develop.

Another text that points to a stereotyped perception, devoid of awareness of actual childbirth, is the mocking description:

^{ירמיה ל:ו} …רָאִיתִי כָל גֶּבֶר יָדָיו עַל חֲלָצָיו כַּיּוֹלֵדָה…

^{Jer 30:6} …I see every man with his hands on his loins like a woman in labor…^[11]

The men in this verse are grabbing their loins out of fear, and the verse describes this inaccurately as a posture as typical of women in childbirth. The author is incorrectly positing that the woman’s loins were the locus of pain, and were grabbed by the woman, during childbirth, since men tend to grab their organ when it is hurt or injured. Had the biblical descriptions of childbirth been written by women, they would have been entirely different.^[12]

The Realia Behind the Misconception: Animal Births

The male authors of these passages assumed that human children were born in the same way as farm animals—births that they would have seen. In standard births of cows, sheep, and goats, as well as horses, camels, and donkeys, the hooves (the tips of the forelegs) are the first parts of the body to emerge from the womb. The hooves precede the tip of the newborn animal’s nose and its mouth, which are thrust forward by the pressure of the birth canal.^[13]

In difficult births, when the animal refuses to come out of the womb, a farmer will tie a rope around the forelegs, which are sticking out, and pull the animal out. The pulling action brings the forelegs out first, while the head retreats somewhat, emerging from the birth canal only after the legs have fully emerged. Ancient farmers and shepherds likely employed similar methods to assist an animal with a difficult birth, and this would have further reinforced their conceptions about the sequence in which limbs emerged during birth.

From Farm Animals to Humans

Most likely, ancient Israelite men’s equation between animal and human birth would have been intuitive. This erroneous assumption was held by the narrators and authors of the stories about childbirth in the Bible, and it functions as a significant basis for the story of the births of Jacob and Esau and of Zerah and Perez.