[The Muslim Medical Practitioner|Birth Control-Introduction|Islamic Viewpoint]
[Contraception|Sterilisation|Family Planning|Abortion|Control of Menstruation]

About the Author

Moulana Qâdî Muhajidul Islam Qâsimî is the Chief Qâdî [Muslim Judge] of the Imârate Sharî'yah (Muslim Personal Law Body) of the states of Bibar and Orissa, India. This body was established in 1921 and presides over cases involving disputes between Muslim parties and passesjudgement in accordance with Islamic law. Formerly, he was a lecturer in the Tafsir of the Holy Qur’ân, Hadith, Islâmic jurisprudence and Philosophy at the famous Jamia Rahmânia in Monghyr, Bihar.

Moulana is also an executive member of the All India Muslim Personal Law Board established in December 1972 to safeguard Muslim Personal Law in India and to implement its own Islamic decision in matters involving the Sharî'ah.

Moulana has visited South Africa on several occasions and the scholars and the masses have benefited tremendously from his vast repertoire of knowledge. May Allâh accept all his efforts.

Âmîn.

The Muslim Medical Practitioner

Medical practice serves the whole of humanity and it should not be considered merely as a new and exclusive scientific knowledge. If a medical practitioner sincerely, honestly and conscientiously uses it to serve mankind, then it becomes an act of worship. Medical practice then is elevated to the position of worship [ibâdah].

Our Prophet Muhammad Sallallâhu alaihi wasallam said: "Knowledge has two aspects - one aspect is concerned with knowledge of the religion, the other is knowledge of the body." Allâh has given the medical practitioner knowledge of the body and through it he can bring relief and comfort to suffering humanity. This in itself is one of the many favours of Allâh upon him.

Muslim doctors are destined to render sterling service to humanity in this world. According to Islâm, all mankind is the family of Allâh [Al khalqu 'iyalullah]. A person who deals in tile best possible way with any member of this family becomes nearer and dearer to Allâh. Doctors can render the best service to humanity and thus achieve a noble position in becoming the worthiest servants of Allâh.

In society, doctors generally command great respect and authority. There are different kinds of professions but no professional enjoys as much love and respect of the people he serves as much as a doctor. The doctor-patient relationship is unique in that the patient considers the doctor as a healer and a kind person - someone with whom he can share his suffering, who can relieve him of his misery and in whom he or she can confide.

The great tragedy of present day Muslims is that we have receded farthest from the field of knowledge and, in fact, have even begun to dislike the pursuit of it. Imân has left our hearts and knowledge our minds. The new generation of Muslims is under the misconception that all new branches of knowledge originated and flourished in Europe. Muslims should realise that medicine had its foundation from Greek medicine. It was the Muslims who preserved this knowledge and saved it from perishing. It was this heritage that was transferred from one Muslim generation to the next at a time when Europe was languishing in darkness. Not only did Muslims preserve this knowledge, but they also improved upon it, made research in many branches of knowledge, proposed new theories and developed them to the best of their abilities. All Europe did was to take this improved base of scientific knowledge and to develop it further. Therefore, knowledge and research in fact, are the heritage of Muslims, not of Europe. To shy away form the acquisition of knowledge and to dislike it does not befit a Muslim.

I dearly wish that every Muslim student of medicine, engineering or any branch of science should not only study his field as a professional but should also be actively involved in research and thereby serve mankind in alleviating its misery. When new experiments are conducted and new principles derived therefrom, then this will also serve to produce a profound beneficial effect on the general condition of the Muslims. I hope all Muslims pay serious attention to this matter and try to regain the lost position of being leaders in the field of research and knowledge.

The Muslim medical practitioner should remain a true and ideal Muslim by his character, moral rectitude and deep knowledge.

Birth Control: Introduction

Birth control has two aspects:

1. Family Planning i.e. limiting the number of children to a specific number.

2. Population control i.e. the regulation of the growth of population in such a way that it does not exceed a certain limit.

The concept of birth control is based on the Malthusian Theory which states that while the harvest reaped from available land is limited, the rate of growth of human population is not. Consequently it will continue to increase and will eventually reach an explosive proportion whereby the available land will not be able to support the vastly expanded population. Malthus stated that to control the growth of population, the husband and wife should exercise self-restraint for curbing population growth. Owing to mass propaganda. the phobia of "population explosion" reached such proportions that any and all methods, including abortion to control population growth were advocated and accepted. However, at present the situation is such that abortion even of well-formed foetuses is considered justified and has been legalised in many countries. 'This is despite the fact that Malthusian and Neo-Malthusian theories over the past two centuries have been disproved, and the myth of "population explosion" laid bare.

The Islamic Viewpoint

In order to understand whether Islâm prohibits birth control, certain basic and essential concepts need to be enunciated and clearly understood. These are based on the Holy Qur’ân and the Sunnah of the Prophet Sallallâhu alaihi wasallam. Their validity cannot be questioned by our limited knowledge of Islâm, preconceived notions, selfish motives and apologetic attitudes.

Consider the answers to the following questions:

1. As Muslims, what is our belief?
2. What is our concept of Allâh?
3. What is our position on this earth?
4. What is the basic economic principle in Islâm?

As Muslims it is our belief that Allâh, the Almighty is Rabb-ul-Âlamîn, i.e. Lord of the Universe. The quality of Rububiyat belongs to Allâh i.e. He is the Creator, Nourisher, Sustainer, Protector, Preserver and Master of all that is in the Universe.

We believe that Allâh has created us and the universe and made all the necessary and complete arrangements for our sustenance before our creation. It is Allâh who has taken upon Himself the responsibility to sustain all the creatures on earth. Allâh states in the Qur’ân:

"There is no creature on earth but whose sustenance is provided by Allâh." (Surah 9:6)

Allâh Ta'âla has also undertaken to maintain a balance in the production of crops and the supply of all our essential needs in proportion to our requirements. Nothing has been created in an unbalanced and disproportionate manner. The source of all potential forces and energies being with Allâh, it is inexhaustible and unlimited. Allâh states in the Qur’ân:

"And there is not a thing but its treasures are with Us, but We only send down thereof in due and ascertainable measure." (Surah 15:21)

"All things have We created in proportion and measure." (Surah 54:49)

At another place it is stated that if man were given all things beforehand, then man would destroy it or be extravagant in its use. Thus everything has been created in a balanced way. Such a situation will never arise on a universal scale, when there will be people but no food to eat. Shortage of food in the world is not real but apparent and based on artificial premises. Scarcity of food is a man-made situation created by manipulation of the laws of supply and demand by business interests for the sake of excess profiteering. In order to increase the price of grain, shiploads thereof are sunk.

It is an accepted and recognised fact that the potential of a piece of ground to bear fruit, crops and vegetation is not limited by Allâh to a specific amount. Modern methods of irrigation and cultivation have been responsible for a tremendous increase in the output of the same piece of ground which used to bear a limited percentage of crop or was altogether barren, desert land.

To think that Allâh has forsaken the world and that population explosion would occur so that man would starve to death, is the view of a person who does not believe in Allâh. Allâh is an Ingenious Power, the best of Planners and can accomplish anything. As Muslims we firmly believe in this concept and therefore cannot accept the economic reason for family planning.

That the increase in population should be curbed for economic reasons is not a new proposition. This concept was not exclusive to the Malthusian theory. The same concept was prevalent during the Jâhiliyyah (pre-Islâmic) period.

The Qur’ân should be read and understood in the proper perspective. In Surah Bani Israel from verses 23 - 3 1, the Qur’ân teaches us the following:

1. To worship none but Allâh.
2. To be kind and fulfil one's duties to one's parents.
3. To help the poor, weak and needy.
4. Not to be extravagant nor practice niggardliness.
5. Allâh provides sustenance for whom He pleases.
6. Not to kill children for fear of want.

Allâh has ordered man to maintain a balance between his income and expenditure. The word Iqtisâd used in Arabic conveys the meaning that the Islâmic law of economics is based upon following a middle and balanced course in expenditure. Islâm demands that one should neither be miserly (to the extent of not even spending on essential requirements), nor should one be a spendthrift indulging in extravagance. Not to spend on a necessary requirement is niggardliness and to spend lavishly is extravagance. Both are extreme courses. Therefore a balanced way in expenditure should be adopted. Allâh knows best the true needs of every person and cares for them. To some He gives in abundance and others receive less, but in all cases, He gives in just measure.

"Verily your Lord provides sustenance in abundance for whom He pleases.' and He provides in a just measure. For He does know and regard all His servants." (Surah 17:30)

In the next verse Allâh warns:

"Kill not your children for fear of want. We shall provide sustenance for them as well as for you Verily the killing of them is a great sin." (Surah 17:31)

The purpose of this sequential teaching is to show that this is not simply a question of killing. If it were so, then there would be no need for such a verse, since murder, whether of a child or an adult remains a crime which has been prohibited by the Qur’ân. Therefore, there was no need to mention it in the above verse if the intention was only limited to proscribing a crime. But by mentioning it in the above verse, Allâh analyses the mentality of the person who kills his children and the reason for his doing so.

Some of the Arab tribes practised female infanticide. Even now infanticide is practised in many countries for economic reasons. The key words are "for fear of want." To kill children out of fear of poverty and thereby try to curb the population is an abhorrent idea which the Qur’ân cannot tolerate and does not propagate.

The protagonists of birth control have exploited the similar mentality of present-day man to the maximum. They declared that if no attempts were made to curb the rate of population growth, then there would soon be insufficient food for people to eat. Millions who accepted the assertion without questioning its validity, were mislead, and eventually started practising birth control without paying attention to what the consequences might be.

Such thinking is totally repugnant to the spirit of Islâm. It is diametrically opposed to the teachings of the Qur’ân. The Qur’ân makes it clear, in no uncertain terms, that it is Allâh and Allâh alone who provides mankind with sustenance. A person can only give to another person what he himself has received from Allâh.

Allâh created both man and woman and assigned different roles, responsibilities and functions to them. Procreation and reproduction of mankind is a basic object of marriage in Islâm and therefore any action which has an effect of curtailing or stopping altogether this process cannot be acceptable from the Islâmic point of view.

In man’s quest for bodily comforts and luxuries, many expenses have to be borne to maintain a high standard of living and in this process life becomes intolerable. In his selfishness and greed, he wants numerous items on his dining table at any one meal time. He is not content with one food item only. There is no need for one to have so many courses at a particular meal with the resultant leftovers being thrown away. At lunch and dinner parties, thousands of rands are squandered, and instead of making provision for the future generation, one would rather see them killed (through birth control). Such thinking is unacceptable in Islâm. The desire to have a small family is not validated by the notion that one has to undergo many difficulties, this is the result of non-Islâmic thinking. There is no justification to encourage this kind of thinking.

Islâm has taken into consideration the real needs of man at all times and the changing circumstances and problems. It has a solution to all problems but it cannot change its laid down rules to suit the condition of a society, which is materialistically inclined and devotes itself to the attainment of evil desire.

Birth control should be viewed in the light of the above facts. Nevertheless, Islâm being a perfect code of life, permits certain methods of contraception for particular cases and for specific reasons. This is explained in the next section.

Contraception

• vasectomy in the man
• tubal ligation in the woman

As far as the reversible methods are concerned, Islâm allows the physical methods viz. coitus interruptus and the rhythm method. The husband must however, seek the consent of his wife when practising coitus interruptus. During the period in which the Qur’ân was revealed, azal [coitus interruptus] was practised by the Arabs, but it was not prohibited by any verse. However, it seems that the Prophet Sallallâhu alaihi wasallam did not approve of it entirely. Once a Sahabi told the Prophet Sallallâhu alaihi wasallam that he practised coitus interruptus. The Prophet Sallallâhu alaihi wasallam thrice commented: ""O! So you practise azal?" in such a manner that it was evident that he did not approve of it entirely. Moreover, that which is destined to happen will take place. In this case it so happened that the Sahabi concerned did have a child despite his practising azal.

The mechanical and chemical methods are permissible only under special circumstances (mentioned later) provided they do not transgress any fundamental Islâmic laws eg. they should not be harmful to the user. Therefore, it would seem that the use of condoms and spermicidal jellies is permissible. As far as the intra-uterine device and the oral contraceptive pill in concerned, the physician must ensure that there is a proper indication for their use and that they would be safe for the user. Only then would their use be permissible.

Sterilisation

The ruling of the Sharî’ah on sterilisation operations is as follows:

Vasectomy in the man

This is totally prohibited in Islâm. It cannot be sanctioned by the Sharî’ah under any circumstances. Islâmic law also prohibits castration. A common factor between vasectomy and castration is that both destroy the power of reproduction in man, although the ability to cohabit is still present. It is a cause of the murder of the future generation.

This cannot be declared permissible as a general rule, because it renders a woman incapable of conceiving. There is a possibility that the factor on account of which she is being counselled for, tubal ligation might change thereafter. However, there would then be little hope of her becoming pregnant again. However, if an honest and experienced doctor fears that the life or permanent mental health of a woman would be seriously affected by a pregnancy and there is no other cure for her sickness, in such a case only would tubal ligation be permissible.

Conclusion: It must be made clear that while certain methods of contraception are permissible in Islâm, they can only be used under the circumstances sanctioned by the Sharî’ah. These specific circumstances are dealt with 'In the following lines.

Family Planning

Most people implement family planning measures for social reasons eg. it is fashionable to have small families, having a large family may curtail the social activities of the wife, having many children may spoil her "figure" etc.

Islâm does not sanction family planning to meet with the demands of present day fashion or social reasons. Although Islâm encourages a woman to look well and to beautify herself for the sake of her husband, it does not sanction the same for the sake of public approbation, which is the present trend. The Holy Qur’ân says:

"And tell the believing women to lower their gaze and guard their modesty, that they should not display their beauty and ornaments except what (must ordinarily) appear thereof, that they should draw their veils over their bosoms and not display their beauty except to their husbands..." (Surah 24:31)

Professional Reasons

Family planning for professional reasons eg. the wife wants to pursue a career, is not permitted in Islâm.

Islâm places no burden on the shoulders of a woman or any responsibility on her to earn a living. Her maintenance before marriage is the responsibility of her father, after marriage her husband, and in old age her children. Islâm does not want that a woman should work like a labourer in the markets or be exploited economically. The general rule, therefore, is that it is not permissible to control the birth of children on account of professional reasons.

Nevertheless, it cannot be denied that there are cases where a woman is forced to seek employment to maintain her children or family on account of desperate circumstances. Under such circumstances it would be permissible for the couple to adopt reversible methods of birth control. This relaxation, however, does not apply to those women who merely try to maintain a very high standard of living, or who try to earn and accumulate as much wealth as possible in order to keep in step with the current fashionable trends. This would defeat the object of the creation of women and destroy the family unit which is the foundation of any society.

The concept of spacing children means the practise of contraception in order to allow a reasonable time period between the birth of any two children, the purpose being that each child receives adequate attention of the mother in its upbringing. In the difficult task of nourishing, training and educating a child, the full attention of a mother is required. If a baby is born every year, then it is extremely difficult to provide the necessary care and attention for each child. From this discussion in Raddul Mukhtar and other books of Islâmic jurisprudence (on the question of abortion), it can be deduced, that if another pregnancy would seriously affect the care and upbringing of the existing child, then reversible methods of birth control may be practised.

Thus family planning towards the spacing of children, so that each child receives adequate attention, would be permissible in Islâm. However, it must be emphasised that even this concession should be treated with respect. It must be made clear that spacing of children should not be used as a pretext for continuing family planning for an indefinite period, for this will be contrary to the injunction of our Holy Prophet Sallallâhu alaihi wasallam who said:

"Marry and procreate."

Family Planning for Medical Reasons

If an experienced doctor, in all honesty and sincerity, is of the opinion that having children would endanger a mother's physical health eg. if she is suffering from cardiac disease, renal disease or her life would be threatened, then it is permissible for the couple concerned to practise reversible methods of contraception. The same ruling applies if a mother is physically crippled and therefore unable to care for a child, or if she is suffering from a psychiatric illness. It must be stressed that the decision to practise family planning under such circumstances does not rest upon the couple concerned. The decision must be taken by a physician and must be based on medical grounds.

Genetic Disuses

If it is the opinion of a responsible and an experienced physician that there is a high risk - not just a vague suspicion - of a baby being born with a serious genetic disease eg. mongolism, haemophilia etc. then it is permissible to adopt reversible methods of birth control.

From this it is apparent that there is a role for the Muslim doctor in genetic counselling. The risk of a baby inheriting a serious genetic disease should be carefully determined, and any advice given should not be based on mere suspicion. Reversible methods of contraception should be advocated in those cases where the risk of a baby being born with a serious genetic disease is high.

Non-Muslim Patients

The attitude of a Muslim doctor at all times must be in consonance with the teachings of Islâm for all his patients. Therefore, a different standard with regard to contraception and sterilisation for non-Muslim patients cannot be adopted.

In Islâm, abortion is primarily a prohibited sphere. The general rule is that abortion is harâm. Under certain circumstances, however, an abortion may be permissible. According to the Sharî’ah, the sin of abortion, once the limbs have formed, is the same as murder. An abortion prior to the limbs being formed would not carry the sin of murder, but still is a major sin.

Period of Gestation

In a Hadith related by Imâm Bukhâri and Imâm Muslim, our beloved Prophet Muhammad Sallallâhu alaihi wasallam has said:

"Verily the creation of each one of you is brought together in his mother's belly for forty days in the form of a seed, then he is a clot of blood for a like period, then there is sent to him the angel who blows the breath of life into him..."

Thus it would seem that the breath of life [rûh] is instilled into the foetus after 120 days.

The Qur’ân describes the various stages of man's primordial development but it does not specify the exact duration of each stage. In Surah Mu'minun, the Qur’ân states:

"Man We did create from a quintessence (of clay), then We placed him as (a drop of) sperm in a place of rest, firmly fixed, then We made the sperm into a clot of congealed blood, then of that clot We made a lump (foetus), then We made out of that lump bones, and clothed the bones with flesh, then We developed out of it another creature, so blessed be Allâh, the best to create." (Surah 23-12-14)

Based on this, Muslim jurists have deduced that the first four months of gestation is the critical time period. After this the foetus is regarded as being 'alive' and all abortion is not permissible for any reason whatsoever, and if performed would constitute murder. ]'bus an abortion may be performed when a very valid and legitimate reason exists and certain stringent criteria are fulfilled, only prior to the first four months of gestation period.

However, if the pregnancy, constitutes a serious threat to the life of the mother, then an abortion is permissible irrespective of the period of gestation.

Permissible Factors

If there is a high risk that a woman may suffer from any of the following factors, then in tile opinion of an honest, reliable and an experienced Muslim doctor, abortion may be permissible prior to four months gestation:

It must however be stressed that these are exceptional circumstances in which all abortion is allowed. Once again it must be emphasised that the permission granted rests on medical grounds.

Cripple

If a pregnant woman is severely crippled or suffers from a serious mental illness and is in no position to care for herself, and If it Is possible to give the child for caring or adoption after it is born. then abortion is out of the question. However, if no such arrangement can be made, then an abortion will be permissible before the end of the first four months of gestation.

Control of Menstruation

Some women control their menstruation periods with the aid of drugs to suit certain occasions e.g. honeymoon, Haj, etc.

Allâh says in the Qur’ân:

"They ask you concerning women's menstrual periods. Say: "They are filth, so keep away from women in their periods and do not approach them until they are clean. But when they have purified themselves, you may approach them in any manner, time and place ordained for you by Allâh, for Allâh loves those who turn to Him constantly and He loves those who keep themselves pure and clean." (Surah 2:222)

From this verse it is apparent that menstruation is an impurity harmful to the body and should therefore be released and is undesirable to retain within the body.

Therefore, undue prolongation of the inter-menstrual period is undesirable. According to the Sharî’ah, there is no valid reason to take drugs to control menstruation for occasions such as honeymoon and haj. Nevertheless, there is nothing in Islâmic law to declare it as prohibited, provided that the woman does not suffer any serious side effects of such drugs or any harmful effects on account of retaining the menstrual flow.