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Highlights of a Parasha & Halacha Shiur by Rav Yehoshua Grunwald
וַתֵּלֶד רָחֵל וַתְּקַשׁ בְּלִדְתָּהּ.
And Rachel gave birth, and she had difficulty in her delivery. (Bereshit 35:16)
If there is a need on Shabbat for lifesaving medical care that entails Hillul Shabbat, should one seek a non-Jew or a minor to perform the Melacha?
The Shulhan Aruch (O.H. 328:12) rules that one should do it himself. The Rama argues and says that if it will cause no delay, one must use a non-Jew or do the Melacha with a Shinui (in an usual manner, thus turning it into a rabbinic prohibition).
The Taz (ibid.) objects to the Rama’s approach, because onlookers will mistakenly conclude that saving a life doesn’t override Shabbos, and next time they will search for a non-Jew while the patient dies.
Many Poskim follow the Taz, however, Rav Shlomo Zalman Auerbach in Minhat Shelomo says (and so it is reported in the name of Rav Moshe Feinstein) that this is limited to actual medical treatment, but ancillary processes (e.g., turning on lights) should optimally be done in a way that lessens the violation.
Strangely, although a woman in labor is considered a Hole Sh’Yesh Bo Sakana, a sick person with a life-threatening condition, even Maran agrees (ibid. 330:1) that a Shinui should be employed where possible. Why the difference?
The Mishna Berura (ibid.) answers that childbirth is less of a worry because it is a natural process and very rarely dangerous. Nevertheless, where using a Shinui or finding a non-Jew would cause a delay, a Jew must act himself.