Q: Muhtaram Mufti Saheb

Assalaamu Alaykum Wa Rahmatullaahi Wa Barakaatuhu

The choice of Terminating the Pregnancy Act was proposed in September 1997. As a Muslim health professional I am faced with various demands of terminating pregnancy. Kindly advise on the following:

1. Rape or incest.

2. Proven chromosomal abnormality by ultrasound or amniocentesis e.g. Downs syndrome, Trisomy 18, etc. where accuracy of diagnosis is greater than 90%.

3. Speculated abnormalities.

4. Pregnancy in which there is a danger to the mother’s mental well-being e.g. severe depression

5. Termination as a means of spacing, financial constraints, young and/or unwed.

B. Role of Muslim health professional with regard to the following:

1. Referral of a patient who is determined to have the procedure.

2. Medical personnel including working in public health service.

a) Clerking of patients i.e. making out file, determining reason for consult, doing initial examination, taking bloods for investigation and putting up drips;

b) Writing out a prescription as well as physically handing the abortifacient drug;

c) Evacuation of uterus once one has partially aborted and management of complications following a termination e.g. sepsis shock, etc.

3. Role of anaesthetists:

a) Where he or she is aware that the person is undergoing a termination of pregnancy.

b) Where he or she is called for a so called miscarriage and then only discovers that it is due to a premeditated termination.

(Abridged version of questions from IMA-Gauteng)

Almighty Allah Ta’ala says in the Quran: Life is from a decree of my Lord. (Sura 12 Verse 85). The above verse is self explanatory on the sanctity and significance of life. Generally every decree is from Allah Ta’ala but the honour of attribution increases its sanctity and demands its highest level of reverence. This command is mentioned in many verses of the Noble Quran: Allah Ta’ala says: "Whosoever has spared the life of a soul, it is as though he has spared the life of all people. Whosoever has killed a soul, it is as though he has murdered all of mankind." (Sura 5 Verse 32)

The above should suffice to express the sanctity of the Rooh (life). The Noble Qur’aan describes the various stages of man’s primordial development but it does not specify the exact duration of each state. In one verse of the Noble Qur’aan, Almighty Allah Ta’ala says, ‘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 (foetus) lump; then We made out that lump bones, and clothed the bones with flesh; then We developed out of it another creature: So blessed be Allah, the best to create.’ (Surah 23 Verses 12 and 14)

In a Hadith related by Bukhari and Muslim, our beloved Rasulullah (Sallallaahu Alayhi Wasallam) 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 an angel is sent to him who blows the breath of life into him…’

Based on the above references, Muslim jurists have deduced that the first four months (120 days) of gestation is the crucial time period. After this the foetus is regarded as being ‘alive’ and an abortion is not permissible for any reason whatsoever; and, should an abortion be done then it would constitute murder. Thus an abortion may be performed within the 120 days period only if there is a valid Sharee reason. (Family Planning and Abortion; Qaadhi Mujahidul Islam, published by the IMA of South Africa)

Upon and after 120 days, it will not be permissible to abort the child. Almighty Allah Ta’ala, the All-Knowing the All Merciful, has endowed the foetus with life. The heights of His Infinite Wisdom cannot be reached or comprehended. The importance of the biggest problem in the circumstances cannot be equivalent to the importance of the Rooh (life). In general, abortion is not permissible but within 120 days as stated above; however, it is permissible to abort the child in the following instances:

1) Rape and incest

2) Proven abnormalities, e.g. Anencephacy (no brain), Downs Syndrome, Trisomy, HIV positive, congenital rubella health.

3) If the foetal abnormalities are not proven but speculated, then, if there is a high risk that a woman may suffer from any of the above factors, then in the opinion of an honest, reliable and an experienced Muslim doctor, abortion may be permissible prior to the four months’ gestation. It must be stressed that these are exceptional circumstances in which an abortion is allowed. Once again, it must be emphasised that the permission granted rests on medical grounds. (Ibid)

4) If there is a high risk of the mother’s permanent mental well being and if the doctor is certain (Zanne Ghaalib) that the depression, schizophrenia will be permanent and incurable.

5) Abortion before 120 days is not permissible due to spacing of children, financial constraints, young age and unwed mothers.

Before answering the questions on the role of Muslim health professionals regarding abortion, as an introduction, we wish to briefly explain the fundamental principles that attribute to your queries. Almighty Allah Ta’ala says, "And do not assist in sin". (Surah 5 Aayat 2).

The Fuqaha have explained the extent of the prohibition in assisting in sin. If the assistance is the motivating factor and the only reason for committing the sin, then such assistance is prohibited. For example, a person provokes a non- Muslim by speaking evil about his idols; he in turn speaks evil of Allah (Allah forbid). The provocation was the motivating factor of speaking evil of Allah. Similarly, if a person deals in such things that are used only for committing sin, for example, the sale of musical items, then that assistance is sinful and forbidden.

If the assistance is not the motivating factor for committing the sin but the sin is committed by an independent perpetrator, for example, a hawker sells grapes to a person who makes wine. The hawker does not know the intention of the consumer; neither does he make the wine himself. The selling of grapes by the hawker will not be assisting in sin.

A Muslim health professional is duty bound to obey the laws of Shariah in his profession. The role of the doctor in abortion is analogous to a person who deals in things used only to commit sin. Therefore he cannot perform an abortion prohibited in the Shariah, for example, after 120 days or even motivate such an abortion.

1. If the patient is determined to have an abortion prohibited in the Shariah, then it is not permissible for the doctor to make any referrals. By doing so, she will be assisting in sin.

2. a) If the medical personnel are not aware that the patient requires abortion (which is prohibited in the Shariah), then these services will not be regarded as assisting in sin. If they are aware of the patient’s intention of having a prohibited abortion in the Shariah, then it is not permissible for them to offer their services in clerking such patients.

b) Writing out a prescription for an abortifacient patient drug as well as physically handing the drug for abortion is prohibited in the Shariah as that will be assisting in sin, have not permissible.

c) To evacuate the uterus after partial abortion and treating a patient from sepsis shock, etc. after abortion is permissible. The services of the doctor is after the patient has committed the sin.

3. a) If the anaesthetist is aware that the patient is undergoing an abortion, he or she cannot provide his or her services.

b) A Muslim anaesthetist may offer his or her service in a miscarriage even though he or she discovers that the miscarriage is due to a premeditated termination. According to our understanding the anesthetist will not induce the miscarriage.

4. It is not permissible for a Muslim pharmacist to dispense medication prescribed to induce an abortion prohibited in the Shariah since it will be assisting in a sinful act.

5. It is permissible for Muslim nursing staff to nurse patients during the pain and bleeding following the abortion.

Mufti Ebrahim Desai

Last modified: July 19, 2007