Written by Abdussalam Adepoju A. (MB; BS Ib)
Preamble
Contraception refers to any of the processes or methods used for the prevention of pregnancy in human females. It is a practice that has existed probably as old as humanity itself. In its advanced forms, the practice certainly appears to have gained widespread acceptance in the modern world, having secured a firm footing in the United Nation’s (UN) Millennium Development Goals (MDGs) [specifically MDG 5] and the sequent Sustainable Development Goals (SDGs), specifically SDGs 3.7 and 5.6. (1) The term is close to and often used interchangeably with the term ‘family planning’ even though they’re not synonyms. The latter refers to carefully controlling the timing, number, and interval of childbearing in order to achieve and maintain a high standard of living for the general population and good health for mothers. Contraception is promoted by the UN because of perceived benefits associated with family planning as has been demonstrated by science till date. However, amid a few confirmed and many merely alleged side-effects and Islam’s seemingly tepid position toward the practice, many are averse to contraception, shielding themselves with one of the many excuses afforded them by the earlier mentioned cons. But what exactly does Islam say about contraception? Is it totally forbidden (Haraam), or is it discouraged or encouraged? Is contraception really harmful or not? This article aims at presenting to you the facts and debunking the myths about contraception from both the scientific and Islamic perspectives.
Merits of Contraception
First, I’ll simply state the benefits associated with contraception regardless of whether it agrees with the tenets of Islam or not. In another section below, I will discuss Islam’s viewpoints. Note that the benefits stated below cover the concepts of both family planning and contraception.
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Improved infant survival (2): research has shown that when pregnancies are not adequately spaced, most babies born from it end up dying in infancy and their mothers also are left with much poorer health. The same happens if a woman gets pregnant at a time when she suffers from an illness that makes her unfit for the stress of pregnancy. Preventing pregnancy for such purposes is highly beneficial.
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Reducing teenage pregnancies (2): medical knowledge shows that most teenage girls are not physically ready for pregnancy. Indeed, many such pregnancies end up in devastating complications for the girls and many such babies are either born prematurely, underweight or simply die in the process of childbirth. Secular views hold that providing contraception to such girls allows them – if they’re unable to abstain — to have sex without running the risk of health problems due to pregnancy.
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Avoiding unsafe abortion (2): Despite strict laws and penalties against abortion, it is a known fact that many still resort to it even in counties where it is a crime. In addition, most of those who provide the services under these circumstances are either not qualified or poorly equipped, resulting in incorrect and substandard procedures that cause severe complications for the women who patronize them, sometimes resulting in loss of lives or complete loss of reproductive potential. It is believed that if contraception is made readily available, these pregnancies wouldn’t even occur in the first place.
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Securing youth’s potentials (2): One other benefit which is related to the second point stated above is the assertion that contraception allows youth female and male alike to delay childbearing without necessarily delaying sexual intercourse in order to prevent it or, I presume, the responsibilities that come with it from limiting them from actualizing their full potentials in life.
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Controlling population growth (2): Secular views once again hold that if population growth is not controlled, then the resources of each nation required to maintain an adequate standard of living will not be able to expand at a rate high enough to keep up with the growth rate of her people. The most common approach to effecting this is to educate people that parents are responsible for the welfare of their children and that tailoring the number of children one bears with one’s resources is advisable, and hence the need for contraception as a regulating mechanism for a demographic Another approach which has been in use in China from 1970 to date is to limit family size to a certain number backed by law. (3)
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Protection from disease (4): control of Dysmenorrhoea, excessive bleeding, protection from pelvic inflammatory disease and some cancers are some of the health-related benefits of contraceptives.
Downsides of contraception
Truly, nearly everything on earth that has benefits can also have a few negative effects even if only in certain circumstances, and that includes clean water. A few unfavourable effects are known to be associated with the use of contraceptives, but these few effects are often exaggerated in magnitude in discussions among women. More specifically, many women have begun to express opinions such as this: “anything Islam forbids is certainly not good for our body or soul, and these many horrendous side effects of contraceptives are proof that it truly is forbidden”. However, such opinions are wrong, and I will show you why. First, I’ll start by mentioning some of the important side effects of contraceptives (4,5):
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Implants:g. Norplant: This type is inserted into a woman’s arm and left in place for some time during which it is effective. The major side effect known with this is irregular bleeding, but this is usually mild. More so, there are standard and inexpensive medical approaches to control the bleeding. You should visit a Specialist to learn more about the procedure
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Depo-progestin injections:g. Depo-Provera: This type indeed has a significant number of side effects. Irregular bleeding or completely absent bleeding, weight gain, and delayed return of fertility after termination are the important ones. First, it has been documented that this bleeding tends to decrease with continued use. Second, this bleeding is usually really mild so much so that it has no direct health consequences. Also, as mentioned earlier, temporary measures exist to control the bleeding. As for weight gain, if one takes the regular precautions against growing fat (controlled calorie intake and regular exercise), there wouldn’t be any significant gain in weight. It is true that it may take up to 18 months after termination of use before the woman’s fertility returns.
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The pills: Progestin-only pills have very few side effects; little more than mild unexpected bleeding, nausea et cetera. By far, the more important one to mention here is the combined oral contraceptive pill, commonly known as ‘the pill’. These are associated with quite a number of side effects including risk of venous thrombosis, slightly increased the risk of heart disease and association with some cancers. Generally, most of these associations are weak and only become important when the woman has some other factors (e.g. smoking and sedentary lifestyle) which have stronger associations with those conditions.
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Intrauterine Contraceptive Devices (IUCDs): These are about the best contraceptives available so long as you’re alright with the long-lasting Nevertheless, it can be removed once it is no longer needed and fertility resumes shortly after. The exact duration of return to fertility varies with several factors including whether, or not, the woman had an infection or got infected later after IUCD insertion. Research has also shown that fertility is not impaired after contraception with IUCD. (6) IUCDs have little or no systemic side effects and claims that it kills an already formed baby is false. The only exception to this is when Copper-T is used for emergency contraception. Otherwise, its mechanisms of action do not involve any ‘babycide’.
Islam’s Perspective and Verdict on Contraception
The position of Islam on contraception cannot be expressed in one simple sentence. Although there are verses and one tradition that are related, there are no statements of direct prohibition or endorsement of contraception in the Qur’an, or the sayings or actions of the Holy Prophet (sa). Due to this dearth of direct scriptural evidence, there are many different views or attitudes toward the practice by Muslim scholars. While many endorse it to varying extents, several others prohibit it completely. In fact, a number of Islamic countries have adopted family planning programs with support from their religious scholars, with Iran leading at a contraceptive prevalence rate (CPR) of 74% and Turkey, Morocco, Egypt, and Indonesia closely following behind them at CPRs of at least 60%. (7)
Nevertheless, here, I will present the relevant portions of the Qur’an and Hadith, and then interpret them in the light of the sayings of the Promised Messiah (as) and his Khulafaa’. Furthermore, I will present an evidence-based position on the use of contraceptive in Islam, after correlating the aforementioned scriptural sources and religious authorities with current medical knowledge.
The Qur’an says:
“Your wives are a tilth for you, and approach your tilth when and how you like and send ahead some good for yourselves…” 2: 224
“And mothers shall give suck to their children for two whole years; for those who desire to complete the suckling…” 2: 234
“And kill not your children for fear of poverty. It is we who provide for them and for you. Surely, the killing of them is a great sin” 17: 32
The Hadith of the Holy Prophet (sa) that relates to contraception is given below:
Narrated by Abu Dawood: A man said, “O Messenger of Allah, I have a slave woman and I engage in ‘azl (withdrawal before ejaculation) with her, because I do not want her to get pregnant, but I want what men want. But the Jews say that ‘azl is a lesser form of infanticide”. He (sa) said: “The Jews are lying. If Allah wants to create, you cannot prevent that.”
–Abu Dawood; Kitaab Al-Nikaah, 1856
Before I interpret the above, it would be best to quote the saying of the Promised Messiah (as) on the topic first.
“Your wives are a tilth for the purpose of procreation, so approach your tilth as you may desire but keep in mind the requirements of tilth, that is, do not have union in any manner that may obstruct the birth of children…
Of course, if the wife is ill and it is certain that pregnancy will put her life in danger, or there is a sincere belief that some other valid reason exists, then such circumstances are exceptions. Otherwise, it is not permissible in the laws of Islam to obstruct the birth of children……”
–Chashma-i-Ma’rifat, Ruhāni Khazā’in, Vol. 23, pp. 292-293
Analysis of Scriptural Evidence on the Position of Islam on the use of Contraceptives
Khalifat-ul Masih the second, Mirza Bashirudeen Mahmood Ahmad (ra), in his commentary of Qur’an 17:32 stated:
“…The killing of children may also take the form of birth-control which, however, is permissible if, for instance, by conception the life of a pregnant woman is considered, by competent medical authority to be in danger in the event of her giving birth to a child…”
This interpretation is clearly in agreement with the Promised Messiah’s statement quoted above. Also, the fourth Khalifat-ul Masih, Mirza Tahir Ahmad (rha) stated in one of his question and answer sessions that population control, which is one of the major reasons behind the West’s propagation of contraception is a false concept. Further, he stated that if the powerful people of the world employed the proper approach (that is, as provided by Islam) in the allocation of the world’s resources, such a concept would not exist at all and that God has made adequate provision on earth that will be sufficient for all mankind no matter the extent to which our reproductive potential is explored. This agrees with the Qur’anic verse that states: “And there is no creature that moves in the earth, but it is for Allah to provide it with sustenance…” Qur’an 11: 6. The statement of the Promised Messiah quoted above is deemed enough as a comment on Qur’an 2: 224. Qur’an 2: 234 can be said to be a provision by Allah Himself in agreement with the view that contraception is permitted when it is for the sake of ensuring good health for the mother. This is because lactational amenorrhoea which is one of the methods of natural contraception arises if one obeys the injunction to breastfeed the child for “two whole years”, although current medical research proves that this method is only very effective in the first 6 months of breastfeeding.
Having explained the above, what is left to comment on is the tradition of the Holy Prophet (sa). If we carefully examine it, we will find that even though we can infer that the reaction of the Prophet meant that there was no sin in his action (i.e. he would have unequivocally stated it if it was otherwise), it would be wrong to infer that doing such in order to limit financial expenditure was also permissible or simply ‘not wrong’. I would rather maintain a position based on all evidence put forward so far that ‘azl would fall under actions classified as mustahabb in Islamic jurisprudence i.e. such actions as are not sinful but are also not the best.
When is Contraception permissible?
Synchronizing all the above with current medical knowledge, I hereby outline a practical approach of the principles of Islam on the use of contraception. Contraception is only permissible in Islam under special circumstances. Each of these circumstances is broken down into the simplest terms in the following bullets:
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That the woman’s health is threatened: based on current medical knowledge, there are many circumstances that can threaten a woman’s health with respect to pregnancy, even when she looks apparently healthy. Some of these threats are potential and they become actualized if the woman proceeds to get pregnant in these circumstances
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A teenage girl: even though her body is physiologically fit to permit conception. It is often not physically mature to see the process through especially the process of childbirth. This verdict may be applied only in the context of the Islamic provision that sexual relations can only occur within a marriage.
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The number of childbirths per woman: generally, it is agreed that when a woman bears another pregnancy after having borne 4 pregnancies up to at least 7 months, the chances of several negative health outcomes occurring both to her and the babies rise significantly. Hence, after the 4th childbirth, contraception is halaal for her. If the husband desires more children, then he should consider taking another wife.
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The grown-up woman: Several risks are associated with pregnancy and child bearing for any woman older than 35, ranging from congenital anomalies such as Down syndrome in the child to many other diseases which the woman, thus, becomes at greater risk of such as hypertension, pre-eclampsia and other complications of pregnancy (8). Based on this evidence, if a woman by age 35 has already borne a few children desirable to her and her husband, it is not just permissible in Islam but is also advisable to use contraception.
“That there is a sincere belief that some other valid reason exists”: this is a blanket The Promised Messiah (as) has left it open and I would also keep it so. One tip I would give on its application, however, is that it is possible that only those who have true faith would be able to –by virtue of the spirit of holiness (Ruuhu-l-Qudus) which accompanies them safely apply this in their lives.
Conclusion
I have been to show having examined all relevant Qur’anic verses, traditions of the Holy Prophet (sa) and opinions of some of the scholars of Islam that contraception is not forbidden in Islam, rather, it is permitted but only in certain situations. However, neither the scriptures, the traditions nor the scholars that commented on them have explained in clear terms what these situations are. This I have attempted to do by synchronizing current medical knowledge with the position of Islam.
It is my sincere hope that with the help of this article, Muslim families can make an informed and proper decision concerning the use of contraception in the modern world.
“…And peace shall be on him who follows the guidance” Qur’an 20: 48
References
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Sustainable Development Goals. United Nations. Available at http://sustainabledevelopment.un.org/sdgs. (Accessed 29th October 2018)
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Benefits of Contraception use. New Zealand Family Planning. July 2013. Available at familyplanning.org.nz/news/2013/benefits-of-contraception-use. (Accessed 16th October 2018)
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One Child Policy. Available at: https://en.wikipedia.org/wiki/One-child_policy. (Accessed 22nd October 2018)
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Casey F.E, Richard S L (ed). Contraception. WebMD LLC. August 2018. Available at: https:/emedicine.medscape.com/article/258507 (Accessed 29th October 2018)
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Sech
L, Segall-Gutierrez P, Silverstein E, Mishell DR. Overview of Contraception. Merck Manuals Professional. 2018. Merck Sharp & Dohme Corp.
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Rancid L, Vlasic S, Matrljan I, Waszak CS. Return to fertility after IUD removal for planned Contraception. 1985 Sep; 32(3): 253-9
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Shaikh BT, Azmat SK, Mazhar A. Family planning and Contraception in Islamic Countries: A Critical Review of the Literature. J Pak Med Ass. 2013 Apr. 63 (4) pp 5-67 – 72
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Pregnancy warning for Older women. NHS UK. 17th June 2009. Available at: https://www.nos.uk/news/pregnancy-and-child/pregnancy-warning-for-older-women. (Accessed 29th October 2018)