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Dam Makah- Blood from a wound

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Dam Makkah is blood that comes from a wound or trauma and therefore does not cause a woman to become Niddah. Blood that originates from the uterus is the kind of bleeding that causes one to become Niddah. (A wound in the uterus is a complex situation which will not be addressed here.) At times, Dam Makah may interfere with a successful Hefsek Taharah and achieving clean Bedikot. It may even be noticed on underwear, or tissues used in the bathroom.

Wounds can be found on the cervix, the vaginal canal, or on the labia. The wound may not necessarily be considered a “medical wound”, or pathological finding, or be of any health concern at all. In fact, many wounds are only considered wounds halachically and would not be considered to be a wound, medically. Many of these wounds do not cause any pain at all.

 Some common sources of wounds are an ectropion (should be have an asterisk with definition?I didn’t explain the other conditions), polyps, the stitch site after delivery of a baby and a prolapsed uterus. Urinary infections are sometimes accompanied by bleeding from the bladder which would not be ruled as Dam Niddah. Other causes of a Makah-wound are excessive Bedikot, Bedikot done in a rough manner, washing of the vaginal canal, and waxing.

During the different stages of a woman’s reproductive cycle, she may be more prone to wounds. Nursing mothers, as well as post-menopausal women, tend to have a drier (,) than usual, vaginal canal which can lead to bleeding when touched. During pregnancy, the vaginal canal and surrounding area may be engorged with blood making these areas more prone to bleeding on contact. During the post-partum stage, the labia, vaginal canal and/or cervix may also bleed when touched until complete healing takes place. Usually the bleeding caused by these situations would be paskened - halachically ruled -as Dam Makkah by the Rav.

Various birth control methods ( consult a Rav for permissibility) can affect the integrity of the vaginal canal and cervix, causing these areas to bleed when touched. This too could be considered as Dam Makah, by the Rav.

Many gynecological procedures and tests can cause bleeding of the cervix, or vaginal canal, due to trauma caused by medical instruments. This bleeding would usually be classified as Dam Makah and would not cause a Niddah status. A Rav should be consulted.

These are some examples of Dam Makah that may occur that could be classified as non Niddah bleeding/staining. However, it is important to note that any sighting of blood, which one suspects is not uterine bleeding, must be presented, along with all relevant information, to a Rav for halachic ruling. The Rav will use the concept of “Teliyah” (can we explain: attributing to something other than the uterus OK to explain) to attribute the bleeding to a wound if such is the case.  Many times the Rav will require additional information provided by a physical exam. A trained and certified Bodeket can perform this exam to verify the source of any bleeding. She will then provide a report to the Rav who will pasken whether or not the blood is Dam Makah.

One may prevent, or at least minimize, the issue of Dam Makah altogether by not actively looking for stains. Other than the time of Shiva Nekiim- the seven clean days, it is advisable to wear dark, or colored underwear, to refrain from looking at tissues, or into the toilet water and to avoid performing  Bedikot which are not required by halachah. In this way, one will save a lot of aggravation and not become Niddah unnecessarily.

Spotting or staining does not “automatically” render a woman niddah; it depends on where the blood is coming from. While this distinction may be irrelevant to medical doctors, who are focused onpathology and disease, a Bodeket can determine the source of bleeding and provide a report for your Rav, so a proper and informed halachic decision can be made.
Now you can be examined confidentially and discreetly by Channie Akerman, who was trained by the original Bodeket in Israel. Endorsed by prominent Rabbonim and numerous authors of sefarim on Taharat Hamishpacha, the exam can sometimes prevent unnecessary separation time and trips to the mikvah.
Special attention and guidance is also given to newlyweds, who are often unsure at this special time in their lives. Practical, hands-on instruction provided in how to make bedikot and similar issues.