Islamic Teachings on Reproductive Health and Fertility Transition

8/2/2019 Islamic Teachings on Reproductive Health and Fertility Transition

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ISLAMIC TEACHINGS ONREPRODUCTIVE HEALTH AND

FERTILITY TRANSITIONIN MUSLIM-MAJORITY COUNTRIES

Mehtab S. Karim, Ph.D.

Head, Reproductive Health Program

Professor of DemographyDepartment of Community Health Sciences

Aga Khan University

[email protected]


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As societies transform from apredominantly traditional to apredominantly modem system they tendto experience considerable demographicchanges. Ansley Coale (1984) notes thatthis "transformation is the substitutionof slow growth achieved with low

fertility and mortality for slow growthmaintained with relatively high fertilityand mortality rates."


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During the 1960s and 70s while trying toexplain persistently high fertility in the

developing during, most WesternDemographers had taken the view thathigh fertility was generally embedded in

cultural and religious factors, whichencouraged high fertility in most countriesof Latin America, Africa and Asia.

In this respect, much more has been writtenabout high fertility among Muslims than

about the followers of any other religion.


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For example even when no considerablefertility decline was noted in anydeveloping country, Dudley Kirk (1966)in his review of Muslim fertility,

observed that:

Muslim populations tended to have highfertility, that there was no evidence ofdecline, and that in a given country,Muslims tended to have higher fertilitythan adherents of other religions.


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Caldwell took a similar view about sub-Saharan Africa, arguing that high fertility

rates in the region , "have much to do witha religious belief system, that operatesdirectly to sustain high fertility.

He further contended that in his study ofseveral developing countries, thecommonest factor in explaining highinfant mortality was the predominance of

Muslim countries. He argued that highinfant mortality in these countries was dueto lower status assigned to women intheses predominantly Muslim countries,

which also leads to higher fertility .


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However, taking a broader view,Bongaarts, in his theory of proximate

determinants of fertility postulates, thatdue to socio-biological factors, fertility islikely to be lower than its maximumvalue as a result of:

delayed female age at marriage, higher use of contraception, high prevalence of induced abortion and, prolonged practice of breastfeeding


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In Islamic scriptures, as recorded in the

revealed book the Quran andHadith(sayings of the Prophet),views on eachof the four proximate determinants of

fertility are available.

These issues have also been widely

debated in the writings of the earlyMuslim jurists and scholars.


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ISLAMIC TEAHINGS ONFAMILY PLANNING


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In Islamic scriptures, as recorded inthe revealed book the Quran andHadith(sayings of the Prophet,

PBUH), views on each of the fourproximate determinants of fertilityare available in the writings of the

early Muslim jurists and scholars.


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On MarriageAmong His signs is this, that He created foryou mates from among yourselves, that youmay dwell in tranquillity with them

The Quran, Surah 30:21

The Prophet (PBUH) discouraged celibacyand encouraged all Muslim males andfemales to get married.


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One finds general references in the QuranandHadith regarding marriageable ageand the age of sound judgment, withoutspecifying a fixed age.

However, some scholars have argued that,if a girl is married at too young age, anelement mentioned in the Quranofdwelling in tranquillity could be missing.


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Thus, Imam Abu Hanifa suggested an ageof marriage of 18 years for boys and 17 for

girls.

Subsequently, these were adopted in theOttoman Family Law before the First

World War.


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On Lactation

Mothers shall suckle their children for twowhole years


Imam Al-Ghazali was of the opinion thatsince mother must breastfeed the children fortwo years, therefore, while the mother islactating, to avoid another pregnancy,couples should practice birth control.


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On Contraception

In Hadith, azl (coitus interruptus) ismentioned either as a saying of the Prophetor as his tacit approval. The Prophets(PBUH) companion Jabir relates:

We used to have recourse to azl during

the days of the Prophet while the Quranwas being revealed. He came to know of itbut he did not prevent us from doing so.


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Throughout the Middle Ages, Muslim

physicians instructed people oncontraceptive methods.

Thus the most well known Muslimphysician al-Razi gave illustrations of thedifferent methods of contraception in hisbook Al-Hawi. He suggested three waysfor preventing conception:

withdrawalprevention of ejaculation orapply to the uterus a tampon or a certain

spermicide.


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In sum, there was a general consensus amongearly Muslim scholars that contraception ispermitted in Islam.

However, most scholars accept thatcontraception is not acceptable in twosituations:

if it is used to avoid having female childrenor

if it is used to avoid parentalresponsibilities


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On Abortion

Those who support abortion quote the followingverse:

We created man from a product of wet earth.Then placed him as a drop (of seed) in a safelodging. Then fashioned We the drop a clot,then fashioned We the clot a little lump, then

fashioned We the little lump with bones, thenclothed the bones with flesh, and then producedit as another creation....



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Imam Bokhari quotes aHadithof the Prophet:

All of us have been kept as a drop of seedwhich remains in the shape of a drop in

the mothers womb for 40 days. Then foranother 40 days, it remains in the form of aclot of blood. Then another 40 days itremains in the form of a lump of flesh.Then an angel is sent to the fetus whoblows spirit (life) in to it.


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The most recent formulation on abortion,given by the grand Mufti of Egypt andRector of Al-Azhar reads as follows:

During the first four months, fetal life isnot believed to be human. Thus, juristicconsensus exists only to the point that

abortion after four months amounts totaking a life, but this limit may be setaside, if the mothers life is at risk.


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Opposing ViewsMaulana Maududi, a highly respected

scholar from the Indian sub-continentmakes the following arguments in his bookBirth control, first published in 1943:

The birth control movement is a plotagainst Islam.

To import birth control methods into

developing countries would be tantamountto ushering in moral malaise and,Women would feel free to join the labor

force and abandon their traditional roles.


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Maulana Maududi, however,allowed the practice of birth

control if a couple so desires forpersonal reason but not as aconcern for population growth


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Do Muslim countries have a typicaldemographic pattern?

In The Demography of Islamic Nations,Weeks (1988) found noticeable regional

and temporal diversity in fertility amongMuslim countries. He argued that,

The single most remarkable demographicaspect of Islamic societies is the nearlyuniversal high level of fertility.


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Samuel P. Huntington in his well publicizedbook, The Clash of Civilizations states:

The Resurgence of Islam has been fueled byequally spectacular rates of populationgrowth Population growth in Muslimcountries, provides recruits forfundamentalism, terrorism, insurgency, andmigration. [thus] demographic growththreatens Muslim governments and non-

Muslim societies alike [and] Each of thesechallenges is having and will continue to haveinto the 21st century a highly destabilizing

impact on global politics


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In a monograph on Reproductive Behaviour inMuslim Countries (1997), which I prepared for

UNFPA in 1997, based on the analyses of DHSdata from 12 Muslim countries, I had hadtaken the view that:

while poor socioeconomic conditions mighthave played an important role in maintaininghigh fertility in Muslim countries, more

recently effective family planning programscoupled with high female literacy seem tohave become major factors in achievingfertility transition in these countries.


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Post 9/11 there has been considerableinterest in Muslim population livingaround the World.

For example, the Economist ofLondon came out with a special issueon 13th September, 2003, with an

estimated population of 1.5 billionand the following regionaldistribution:


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Distribution of Muslim Population by RegionSouth Asia

Middle East and

North AfricaSubsaharan

Africa

South East Asia

Central Asia

Europe and

North America

East Asia


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I am of the view that:Demographic transition begun in most ofthe Muslim-majority countries at some timeover the past two decades, and in some, it

has moved very rapidly. Elsewhere, there isonly little evidence of the onset of fertilitydecline.

I support my view with the following dataand illustrations:


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# of countries with CDR

of 1970 200025+ 10 0

20-24 6 4

15-19 12 7

10-15 10 6

5-9 5 18


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Trends in Fertility Decline: 1960-2000

Till the early 1960s, fertility rates in almostall Muslim countries were fairly high.During the past 40 years many countries

have experienced substantial declines. Themost dramatic regional declines occurred inNorth Africa, where Egypt began with thegreatest early decline, quickly joined by

Tunisia, Morocco, and Algeria. All threeSouth-East Asian countries experiencedsimilar declines.


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Thus, in a majority of countries in theMuslim world, there is considerableevidence of demographic transition,

particularly in fertility, during the past 25years.

Muslim countries in East and West Africasaw only modest declines in fertility, whilein Asia, Pakistan, Afghanistan, Yemen andOman were the exceptions. The mostremarkable recent declines on the otherhand, were experienced by Bangladesh andIran.

Regional trends in fertility declines are

F tilit D li i N th d N th


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Fertility Decline in North and North-East African Countries

0

1

2

3

4

5

6

7

8

Algeria

Egypt

Libya

Moroc

co

Sudan

Tunisia

C

omoros

Djibo

uti

Somalia

TFR

Year 1960-65 Year 1970-75 Year 2000-05

F ili D li i W Af i


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Fertility Decline in West AfricanCountries

TFR

0

1

2

3

4

5

6

7

89

B

urkin

aFaso

Chad

Gambia

Guine

aMa

li

Maurita

niaNi

ger

Sene

gal

SierraLe

one

Year 1960-65 Year 1975-80 Year 2000-05

Fertility Decline in West Asian


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Fertility Decline inWest Asian

Countries

Fertility Decline in South-Central Asian


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Fertility Decline in South-Central AsianCountries

0

2

4

6

8

Afgha

nistan

Banglad

esh

Iran

KirgyzIstan

Maldi

ves

Pakis

tan

Tajiki

stan

Turkme

nista

n

Uzbakis

tan

TFR

Year 1960-65 Year 1975-80 Year 2000-05

Fertility Decline in South East Asian Countries


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Fertility Decline in South-East Asian Countries6.7 6.7

5.44.4 4.2

2.5 2.9 2.4

4.7

0

1

2

3

4

5

6

7

8

Brunie

Da

ressalam

Malaysia

Indonesia

T

FR

1960-651975-802000-05


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83

7472

6460

41

57 5449 48

28

64

56 56

14 1410 9 8

5

0

10

20

30

40

50

60

70

80

90

Percen

t

Chima

Iran

UK

Turkey

Italy

Bulgaria

Indonesia

Bangladesh

Phillipines

India

Pakistan

Algeria

Egyp

t

SouthAfrica

Coted'lvoire

Niger

Sudan

Senega

l

Ethiopia

Mozambique

Country

Similarly, currently married women using

contraception show no significant

differences between Muslim and non-Muslim Countries- 2003

IN CONCLUSION


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IN CONCLUSIONThere appears to be no typical pattern ofreproductive behavior which could be

described as Islamic. Islam as such seems tobe neither a hindrance nor a stimulating factorin fertility decline.

It seems that governments in most Muslimcountries, due to a pragmatic thinking haveadopted a positive approach to birth control.

However, with a few exceptions, contraceptiveuse rate is low and consequently fertility ishigh in some Muslim countries, similar to

other countries in the same region.


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Recently Prof. Mehtab Karim co-edited a book with Prof. Gavin Jones

on Islam, the State and Population.Hearst & Co. London. 2005

Islamic Teachings on Reproductive Health and Fertility Transition

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