Jonathan Goldstein and Jennifer Schiller were nervous, but they handed their 8-day-old son to Sara Imershein anyway.
Imershein, a kippah affixed to her brown hair with a pearl-studded bobby pin, pulled on white surgical gloves and - as family and friends watched in the couple's District of Columbia apartment - circumcised Noah Goldstein in less than 60 seconds with a steel scalpel.
Imershein, 65, noted the parents' pale faces. "He's doing so well," she said.
Two days later, she doled out a very different kind of comfort.
Approaching a patient in a Falls Church, Virginia, abortion clinic, Imershein saw a tear slipping down the woman's cheek. As a nurse administered anesthetic, Imershein rested her hand - now purple-gloved - on the patient's knee. She left it there until the woman's eyes closed.
In less than five minutes, with movements equally confident, Imershein performed an abortion on the woman, who was seven weeks pregnant. (The Washington Post is not naming the patient at her request.)
Since retiring from her District-based obstetrics-gynecology practice in 2015, Imershein has spent her time this way: performing first-trimester abortions and ritual circumcisions, known in Hebrew as brit milahs. She believes both practices achieve the same goal: allowing women to create the families they want. Given that, she said, her Jewish faith compels her to offer the two services to Washington-area residents.
She cited the Jewish concept of "mitzvot," which means "commandments." For her, she said: "It means I am commanded, if I have the skills as a physician, to use them to alleviate suffering. Not to use my skills would be wrong."
She is "hyper-aware," she added, that the two procedures are "under attack" in the United States. Imershein pointed to the Trump administration's ongoing rollback of abortion rights and a rising anti-infant-circumcision movement that says the procedure should be outlawed because babies cannot consent.
Imershein sees the opposition as another reason she must do what she does - and speak out about it, especially abortion. She has advocated for access to abortion in speeches at churches and synagogues, on her website and in op-eds, including one in this newspaper.
Dennis Ross, a New York rabbi who directs Concerned Clergy for Choice for the state's branch of Planned Parenthood, said it is important that Imershein is speaking up, especially as a Jew.
"People forget that there are religious groups that support access to the spectrum of reproductive health-care services, but, hey! There's another religious perspective," Ross said. "We've just got to be louder."
The vast majority of American Jews (83 percent) believe abortion should be legal in "all" or "most" cases as of 2014, according to the most recent Pew Research Center data, making them the most liberal faith group on that topic. What Jewish law, known as "halakhah," says is more complicated, failing to conform to either the perspectives of those who fight to end abortion access or those who promote it.
Halakhah mandates that abortion is necessary if the woman's life is in danger. For Jews to be able to "fulfill our religious tradition, actually, abortion must be legal," said Rabbi Marla Feldman, the executive director of Women of Reform Judaism, a group within the Reform segment of Judaism, the faith's largest and more liberal denomination.
But Jews vary on what constitutes a sufficient threat. By performing abortions for all women who meet the clinic's standards, Imershein, who is Reform, is taking a "very permissive" position that some more conservative Jews may see as immoral, said Elli Fischer, an Orthodox rabbi and halakhah historian.
Orthodox Jews also dislike the idea of a female "mohel," or circumcision performer, because a traditional interpretation of the law dictates that only men should fill that role.
Imershein said she is undeterred by backlash, whether from fellow Jews or non-Jewish Americans.
"My mother says I enjoy working in areas that are controversial," she said. "I laugh and come back with my line: 'I like areas that empower women.' "
* * *
Imershein began pondering a career in medicine when she was "a very little girl."
But the inclination became a vocation when she read James D. Watson's "Molecular Biology of the Gene" in eighth grade.
"I thought, 'Oh, wow, this is so interesting; reproduction is so interesting,' " Imershein said.
Later as a student at the University of Pennsylvania, she joined the Sexuality Center to counsel peers about contraception and sexual dysfunction, which sparked serious interest in the field of obstetrics and gynecology.
In medical school, Imershein learned that abortion, done properly by medical professionals, is "simple and easy and low-risk." A few years after that, she worked at an abortion clinic during her residency and was struck by patients' "unbelievable relief."
"That's the number one reaction of most patients," Imershein said. "They're just so grateful."
Post-residency, Imershein moved to Washington, D.C., to join her fiance and began work as a gynecologist. She opened her own practice in 1991 and from the start offered abortions alongside all the typical services.
Imershein's interest in women's reproductive health had never wavered. Nor had her Judaism.
Raised in what she called a "traditional Reform family" by parents "whose social lives revolved around synagogue," Imershein attended Shabbat dinners every Friday.
Today, though she does not go to synagogue "all that much" or keep kosher, she still sees Judaism as central to her identity.
Imershein did not explicitly link religious principles to her practice of medicine until late in her career. And, though she performed abortions before retiring, she kept quiet about it. Imershein worried that she and her family might be targeted for her work — fears that came true once in the early 1990s when antiabortion activists papered her home in fliers alleging she was a murderer.
Imershein's thinking started to shift after she signed up for mohel trainings in 1995, partly as a way to meet other Jews in the area. That's when she learned about mitzvot as a commandment - and, prodded by class conversations, began studying what the Torah and the Talmud, a book of Jewish oral law, said about abortion.
As she pored over the texts, sometimes helped by local rabbis, Imershein became convinced: She had to devote her retirement to circumcision, abortion and advocacy. In 2015, her two children now adults, she did it.
Nowadays Imershein spends about two days a week performing abortions at the Falls Church clinic. When she can, she conducts brit milahs for local families - at most "a few a month," she said.
She does not advertise, operating by word of mouth, and she does not "make much," she said. Of course, Imershein's advocacy - appearing at Planned Parenthood rallies in a white doctor's coat, for example - is free.
MiMi Levine, Imershein's 32-year-old daughter, sees her mother's work the same way it was explained to her at age 5, when Imershein told her that "it gives women freedom."
"I have always been super proud of her," Levine said. "I think she's a hero."
* * *
When she performs an abortion, Imershein believes she is not ending a human life. Jewish law — as laid out in the Torah, the Talmud and the "responsa," rabbinic wisdom gathered across centuries — teaches that human life starts at birth rather than conception, according to Fischer. The fetus "attains the status of a fully human life" when its head emerges, Fischer said.
The theory stems from a Torah passage about two men who got into a fight, said Daniel Eisenberg, a doctor and Orthodox Jew who lectures and writes on Jewish medical ethics. One man hits a passing pregnant woman by accident, causing her to miscarry — but the crime was treated as a "financial offense, not a capital one," Eisenberg said.
Eisenberg said some rabbis have understood this to mean the fetus is more akin to a kind of property than a person. Because of that, they say abortion is not murder, defined as the ending of a human life. Some faith leaders believe it still counts as killing, given that it ends a form of life, Fischer said, but halakhah insists there can be extenuating circumstances in which killing is permissible.
And that's where things get really murky.
One rule is clear: "The woman always takes precedence," Fischer said. "All else being equal, if there's a question of the mother's life versus the fetus's life, Jewish law privileges the former."
Fischer said Jews who take the most extreme, conservative view believe abortion is justified only when the woman is in mortal danger. Others might green-light abortions if the woman's physical or mental health will be impaired by giving birth.
If the woman has been raped, or the pregnancy is a result of incest, the abortion's validity may hinge on the "psychiatric effect on the mother," Eisenberg said.
Ross and Feldman, by contrast, said their vein of Judaism - the two are Reform - places a premium on the woman's ability to decide for herself, which reflects the notion that the woman's life should be valued above all else, Ross said.
"We believe that women are capable of making moral decisions based on their own religious views, their personal beliefs, their conversations and deliberations with medical professionals and family," Feldman said.
Said Ross: "Like her life does, her moral standing takes precedence over her pregnancy, too."
That's how Imershein sees it.
When a woman comes to the Falls Church clinic asking for an abortion, Imershein does not second-guess her reasoning. Same goes for when a mother asks her to officiate a brit milah - a less controversial procedure, though a small but growing number of Jews are questioning the tradition's merits.
"I ultimately give all rights to the mother," Imershein said. "With brit milahs, they're having the family they want, and if I'm doing the abortions, I'm just fulfilling the wish of women to have the lives they want."