Background reading material for medicine & fiqh panel discussion at the Kulliyah
of Medicine, International Islamic University, Kuantan on 25th March 2000 by Professor Omar Hasan Kasule Sr.
PURPOSES OF HUMAN REPRODUCTION
The purposes of the human reproductive
function can be considered at the individual, family, community, and human levels. Reproduction at an individual level fulfils
a deeply-felt human desire for self-perpetuation and a form of immortality. Parents are proud of their children, al tafakhur bi al awlaad (, 9:85) and naturally desire to have many, al takathur
bi al awlaad (9:69, , 19:77, 34:35, 57:20). Children help cement and strengthen
the marital bond. As regards the community level, the prophet encouraged Muslims to have as many offspring as possible to
give glory to the ummat so that it may be the largest of communities. When righteous people have many children and bring them
up to be righteous they will be spreading light and truth in the next generation in a very effective demographic strategy.
Reproduction is necessary to ensure survival of the human race
Contraception in all its forms runs
contrary to the objective of human reproduction mentioned above especially the human survival instinct. Contraception is against
basic human nature. There must exist very strong reasons and motivators to make humans limit their reproductive capacity.
LOW HUMAN FERTILITY
Human fertility is very low. Conception
can occur only in a narrow window of 3-4 days in the menstrual cycle when the ovum is released. Both the ovum and the sperm
have a limited life-span. Human conception is of low efficiency. Many ova and sperms are shed but are not utilized. It is
possible for one man to be the father of all humans on earth because he produces enough sperms over his life-time. Humans,
unlike some animals, do not time their copulation to coincide with the release of the ova. Despite the low fertility humans
down the centuries have for various reasons wanted to control conception and birth.
Offspring resembles both parents
because they both contribute to the genetic material (KS 574). Quantitatively both parents have equal contributions of genetic
material to the offspring. The final appearance of the offspring is not an ‘average’ of the two parents because
recessive genes from one parent are overshadowed by dominant ones from the other parent in determining particular traits.
LEGAL RULINGS ABOUT REPRODUCTION
Marrying and getting offspring is
obligatory, wajib,for the community
otherwise it will weaken and disappear. It is permissible, jubbah, for the individual
who can choose to have children or not to have children. It is highly recommended that individuals have children.
POPULATION and BIRTH CONTROL
Greed not to share wealth. Malthusian
Fear of inability to look after additional
Freedom to indulge in sexual intercourse
Contraception: Contracpetion was practised by all societies past and present: ancient Egypt,
ancient Greece. Modern period: many countries have instituted
punitive measures for couples who have more than the set number of children.
Abortion: Abortion was used and continues to be used by those who do not want to bear children and find themselves
Infanticide, wa'ad: The pre-Islamic custom of killing girls, qatl
al banaat fi al jaahiliyyat,for fear of poverty was condemned by the Qur'an
(6:137, 6:140, 6:151, , 60:13). Those innocent children will enter jannat
(, KS 575). Pharaonic Egypt
instituted a population control policy when the number of Banu Israil increased. Selective infanticide of boys was carried
out, qatl al awlaad 'inda al fara'inat (2:49, 7:127, 7:141, 14:6, 28:4, 28:9, 40:23-25).
Genocide: Ethnic cleaning
GENERAL LEGAL RULINGS ON CONTRACEPTION
We must distinguish between birth
control at the societal level as a public policy and birth control as a family decision. There is no evidence of permissibility
of the former. There are grounds for permitting the latter is specific circumstances. The specific rulings are discussed under
each method of contraception.
MALE CONTRACEPTIVE METHODS
MALE REVERSIBLE METHODS
The reversible methods for males
are the condom, coitus saxanicus, coitus reservatus, and coitus interruptus. Coitus interruptus is allowed, tarkhiss al 'azal (KS 154 KS 154-155: Bukhari K67 B96; Bukhari K82 B4; Bukhari K77 B18; Muslim K77 H15-H28; Abu
Daud K12 B46; Tirmidhi K9 B39; Nisai K26 B55; Ibn Majah K9 B30; Darimi K71 B36; Muwatta K29 H95-H97, H99, H100; Ahmad 3:22,
26, 33, 47, 49, 51, 53, 57, 59, 63, 68, 71, 72, 82, 88, 92, 93, 140, 309, 312, 313, 377, 380, 386, 388, 450; Ahmad 6:361;
Tayalisi H 1244, 1697, 2175, 2177, 2193, 2207). Although permitted,coitus interruptus
is considered offensive, karahiyat al 'azal (KS 155: Muslim K1 H31,;TirmidhiK9 B40; Ibn Majah K9 B61; Muwatta K29 H98;Hakim?Ahmad
1:380, 397, 439; Hakim?Ahmad 6:361, 434; Tayalisi H 396. It is forbidden if the wife does not give permission, al nahyu 'an al 'azal illa bi idhniha (KS 155 Hakim?Ahmad 31).
MALE IRREVERSIBLE METHODS
Vasectomy is the only available irreversible
contraceptive method for males. It has some side effects.
FEMALE CONTRACEPTIVE METHODS
FEMALE REVERSIBLE METHODS
Reversible methods for females are
either mechanical or chemical. The mechanical barriers are: the diaphragm, the cervical cap, the vaginal sponge, and the IUD.
Often neglected and not mentioned are the traditional non-invasive methods of sexual abstinence and using the natural rhythm
of menstruation to avoid coitus during the fertile days of the menstrual cycle. Each of these methods has advantages and side
effects that are either physical or psycho-social.
Spermicides: Spermicides kill sperms. Each has its own specific method operating either before or after conception.
Intra-uterine device: The IUD prevents implantation of a fertilized ovum. The safest and perhaps the least effective
is the rhythm method.
The oral contraceptive pill suppresses ovulation. The OC has revolutionised contraceptive practice since its
development in the 1960s. It is largely responsible for the excesses of the sex revolution in which people saved from fear
of pregnancy engaged in sex on an unprecedented scale. The sequential progesterone-estrogen pill's mechanism of action involves:
inhibition of ovulation by suppressing FSH and LH, alteration of cervical mucosa and inhibiting sperm transport, interference
with ovum transport, inhibition of implantation by suppressing normal endometrial development. Besides its contraceptive actions,
the pill is useful in menstrual regulation. Among its adverse effects are: circulatory disorders such as MI, venous thrombosis,
CVA, and HT; abnormal uterine bleeding, carbohydrate intolerance, neoplasia, and gall bladder disease.
FEMALE IRREVERSIBLE METHODS
There are two main irreversible methods
for females: tubal ligation and hysterectomy. Tubal ligation is a simple surgical procedure that is reversible with much difficulty.
Hysterectomy is not done deliberately for purposes of contraception. It is carried out for some other purpose and it serves
the additional purpose of contraception.
SOCIAL IMPLICATIONS OF CONTRACEPTION
Availability of safe contraception
removes the fear of pregnancy and encourages more people to engage in illegal extra-marital sexual activity
Population imbalances resulting from
severe birth control
PRELUDE TO GENOCIDE
Wide-spread practice of birth control
makes it easier to accept and practice genocide.
The traditional diagnosis of pregnancy
was based on amenorrhoea, signs and symptoms of pregnancy, and abdominal enlargement in the late stages. Earlier diagnosis
of pregnancy based on hormonal and radiological procedures is now available. This earlier diagnosis can not lead us to shortening
the post-divorce period of waiting, iddat al talaaq. We know that the material reason, illat, for waiting three months is
to ensure that the wife is not pregnant. We however do not know the wisdom, hikmat, behind the ordaining of iddat.
Legal situations may arise in which
the diagnosis of pregnancy is disputed. Pregnancy is not possible below a certain minimum age. It is however possible to get
pregnant even before menarche.
B. PERIOD OF GESTATION
Legal situations arise in which the
court must reach a decision based on knowledge of the minimum and maximum periods of gestation. Bleeding or spotting in early
pregnancy (KS 207: Darimi K1 B97, Muwatta K2 H101) that is thought to be an abortion or a menstruation can be the cause of
the confusion in computing the period of gestation. The early jurists using medical knowledge available in their times had
reached conclusions about the minimum and maximum durations of gestation. These need to be revised in view of modern medical
knowledge and the availability of sophisticated diagnostic procedures.
C. ACTIVITIES IN PREGNANCY
PHYSICAL ACTS OF IBADAT
Salat: Standing up, qiyaam; bowing, rukuu; prostration, sujuud, and sitting down in salat may be difficult for a woman in advanced pregnancy. It may also be difficult
for her to put her hands on her abdomen.
Siyaam: A pregnant woman may be excused
from fasting. If the excuse is based on fear of nutritional deficiency in the mother or in both the mother and the fetus,
the missed fasting must be made up. If the exemption is based on fear of harm to the fetus alone, expiation is by feeding
Hajj: the hustles of movement in
hajj may be too strenuous for a pregnant woman
Sexual intercourse is physically
cumbersome in advanced pregnancy. It may also introduce infections in the birth canal. In the rare instance of placenta previa
it may provoke potentially fatal bleeding.
Legal punishments, huduud, can not
be carried out in pregnancy until after delivery and suckling of the baby
There is no ruling against breast
feeding in pregnancy. It is a medical necessity since breast milk is the best food for a baby.
STRENOUS PHYSICAL WORK IN PREGNANCY
A woman in advanced pregnancy has
limited ability to do physical work, at home or outside the home, and has to be excused
A pregnant woman can be divorced
but can not be forced out of her house until after delivery
D. POST-PARTUM BLEEDING, nifaas
MINIMUM and MAXIMUM PERIODS
Qur'an: touching the Qur;an is forbidden
Sexual intercourse is forbidden
Divorce of a woman in the post-partum
period is prohibited
Studies in sheep have shown that
the mature fetus provides the initial stimulus for parturition by secreting cortisol which acts on the placenta to decrease
progesterone secretion, increase estrogen and prostaglandin secretion. This causes cervical ripening and results into parturition.
These findings have not been confirmed in humans.
CRYING OF THE NEWBORN
The books of sunnat have given reasons
for the crying of the baby at birth (KS 575: Bukhari K65 S3 B2; Muslim K43 H148; Ahmad 2:233, 368). Every new born is touched
by the shaitan, mass al shaitan 'inda al wilaadat (KS 575: Bukhari K60 B44; Bukhari
K65 S3 B2; MuslimK43 H146-147; Hakim?Ahmad 2:233, 274, 288, 292, 319, 368, 523).
RIGHTS OF THE FETUS
Right to life
Right of inheritance
RIGHTS OF THE NEW BORN
RIGHTS OF THE MOTHER
WHAT IS DONE FOR THE NEWBORN
Adhan and iqamat at birth
Naming, tasmiyat: choice of a good
Shaving the hair, halq al sha’r
5.0 BREAST-FEEDING, ridha’a
A. CONTROL OF LACTATION
Onset, continuation, and end of lactation
are under endocrine & neural control, neuro-humoral. It can be affected by the psychological state of the mother. Drugs
can also affect lactation so care must be taken in any prescriptions for the mother. Some drugs suppress lactation as a side
effect. Some drugs may be taken with the deliberate purpose of suppressing lactation. Drugs given to the mother can be excreted
in breast milk and can affect the baby.
B. PERIOD OF BREAST-FEEDING
The Qur'an set the statutory period
of breast-feeding as 2 full years, muddat al ridha'a (2:233, 31:14, 46:15). No maximum period was set.
C. PAYMENT FOR BREAST FEEDING
The father has to give financial
compensation to a divorced wife who is breast-feeding his child (65:6)
FOSTER BREAST FEEDING
Breast feeding of a child not issued
from the mother automatically creates a legal relation that in the regard of the Law is no different from that that of a son
or a daughter. The relation encompasses the wet nurse, the children of the wet nurse,and the husband of the wet nurse. The conditions set by the Law for this relation to hold are: the wet nurse must be
a female at least 9 years of age, the baby suckled must be less than 2 years old, and at least 5 separate breast feeding sessions
must be held. The legal relationship thus established leads to marital restrictions between foster brothers and foster sisters
E. ACITIVITIES DURING BREAST FEEDING
PHYSICAL ACTS OF IBADAT
Salat: a nursing mother is allowed
to combine 2 prayers
Suckling while pregnant:
Intercourse with suckling woman:(al ghayla)
Milk banks:purpose - how used - advantages - disadvantages - fiqh issues - how to resolve fiqh issues
Work and maternity leave for lactating
Marriage before menarche
Medical complications of coitus in menstruation
Hysterectomy before menarche
Ovariectomy before menarche
Teaching Qur’an while in menstruation
Physiological distress of menstruation
Psychological distress of menstruation
Reason for making up salat and not saum if missed during menstruation
Hormonal menstrual regulation
Criteria for decision that menstruation has stopped in order to bathe
Physiological explanation of the manifestations of the pre-menstrual syndrome
Pre-menstrual syndrome and marital disputes
Pre-menstrual syndrome as legal defence in criminal acts
Salat with pre-menstrual syndrome
Saum with pre-menstrual syndrome
Menopausal mood and mental changes causing marital discord
Menopausal or post menopausal syndrome as legal defence in criminal cases
Artificial menopause, surgical or medical
Pros and cons of using estrogen replacement therapy
Legal rulings on menorrhaghia
Legal rulings on metrorrhaghia
Legal rulings on dysmenorrhoea
Legal rulings on trans-sexuality
Legal rulings on sexual abstinence, rahbaniyyat
Sexual attraction: visual, chemical, aural
Use of cosmetics to hide natural defects
Use of defects to enhance appearance
Rulings on the use of perfumes
Rulings on cosmetic surgery
Rulings on male circumcision
Rulings on female circumcision
Problems due to discord between biological and mental maturity
Teenage sexual abstinence
Penalty for non-coital adultery
Definition of female shyness in relation to sexual hygiene
Definition and rulings on awrat
Rulings on khalwat in the car, the office, by telephone, by internet
Rulings on mixing, ikhtilaat, at the work-place, public transportation, hospital, class-room
Rulings on what constitutes tabarruj
Rulings on spouse withholding sexual priviledges
Rulings on maharim
Population control as national policy
Rulings on male methods of contraception
Rulings on female methods of contraception
Disagreement between husband and wife on contraception
Legal rulings on the minimum and maximum durations of pregnancy
Determination of date of conception in disputes about parenthood
Determination of the date of conception in disputes about zina accusations
Salat and saum in first trimester pregnancy complications