ISLAMIC TEACHINGS ON REPRODUCTIVE HEALTH AND FERTILITY TRANSITION IN MUSLIMMAJORITY COUNTRIES

1
ISLAMIC TEACHINGS ON REPRODUCTIVE HEALTH AND
FERTILITY TRANSITION IN MUSLIM-MAJORITY COUNTRIES

• Mehtab S. Karim, Ph.D.
• Head, Reproductive Health Program
• Professor of Demography
• Department of Community Health Sciences
• Aga Khan University
• mehtab.karim_at_aku.edu

2

• As societies transform from a predominantly
  traditional to a predominantly modem system they
  tend to experience considerable demographic
  changes. Ansley Coale (1984) notes that this
  "transformation is the substitution of slow
  growth achieved with low fertility and mortality
  for slow growth maintained with relatively high
  fertility and mortality rates."

3

• During the 1960s and 70s while trying to
  explain persistently high fertility in the
  developing during, most Western Demographers had
  taken the view that high fertility was generally
  embedded in cultural and religious factors,
  which encouraged high fertility in most countries
  of Latin America, Africa and Asia.
• In this respect, much more has been written
  about high fertility among Muslims than about the
  followers of any other religion.

4

• For example even when no considerable
  fertility decline was noted in any developing
  country, Dudley Kirk (1966) in his review of
  Muslim fertility, observed that
• Muslim populations tended to have high
  fertility, that there was no evidence of decline,
  and that in a given country, Muslims tended to
  have higher fertility than adherents of other
  religions.

5

• Caldwell took a similar view about sub-Saharan
  Africa, arguing that high fertility rates in the
  region , "have much to do with a religious
  belief system, that operates directly to sustain
  high fertility.
• He further contended that in his study of several
  developing countries, the commonest factor in
  explaining high infant mortality was the
  predominance of Muslim countries. He argued that
  high infant mortality in these countries was due
  to lower status assigned to women in theses
  predominantly Muslim countries, which also leads
  to higher fertility .

6

• However, taking a broader view, Bongaarts, in his
  theory of proximate determinants of fertility
  postulates, that due to socio-biological factors,
  fertility is likely to be lower than its
  maximum value 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 and Hadith (sayings of
  the Prophet), views on each of the four
  proximate determinants of fertility are
  available.
• These issues have also been widely debated in the
  writings of the early Muslim jurists and
  scholars.

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• ISLAMIC TEAHINGS ON FAMILY PLANNING

9

• In Islamic scriptures, as recorded in the
  revealed book the Quran and Hadith (sayings of
  the Prophet, PBUH), views on each of the four
  proximate determinants of fertility are available
  in the writings of the early Muslim jurists and
  scholars.

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On Marriage

• Among His signs is this, that He created for
  you mates from among yourselves, that you may
  dwell in tranquillity with them The
  Quran, Surah 3021
• The Prophet (PBUH) discouraged celibacy and
  encouraged all Muslim males and females to get
  married.

11

• One finds general references in the Quran and
  Hadith regarding marriageable age and the age of
  sound judgment, without specifying a fixed age.
• However, some scholars have argued that, if a
  girl is married at too young age, an element
  mentioned in the Quran of dwelling in
  tranquillity could be missing.

12

• Thus, Imam Abu Hanifa suggested an age of
  marriage of 18 years for boys and 17 for girls.
• Subsequently, these were adopted in the Ottoman
  Family Law before the First World War.

13
On Lactation

• Mothers shall suckle their children for two
  whole years The Quran,
  Surah 2233
• Imam Al-Ghazali was of the opinion that since
  mother must breastfeed the children for two
  years, therefore, while the mother is lactating,
  to avoid another pregnancy, couples should
  practice birth control.

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On Contraception

• In Hadith, azl (coitus interruptus) is mentioned
  either as a saying of the Prophet or 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 Quran was being
  revealed. He came to know of it but he did not
  prevent us from doing so.

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• Throughout the Middle Ages, Muslim physicians
  instructed people on contraceptive methods.
• Thus the most well known Muslim physician al-Razi
  gave illustrations of the different methods of
  contraception in his book Al-Hawi. He suggested
  three ways for preventing conception
• ? withdrawal
• ? prevention of ejaculation or
• ? apply to the uterus a tampon or a certain
• spermicide.

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In sum, there was a general consensus among
early Muslim scholars that contraception is
permitted in Islam. However, most scholars
accept that contraception is not acceptable in
two situations ?if it is used to avoid having
female children or ? if it is used to avoid
parental responsibilities
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On Abortion

• Those who support abortion quote the following
  verse
• We created man from a product of wet earth.
  Then placed him as a drop (of seed) in a safe
  lodging. Then fashioned We the drop a clot,
  then fashioned We the clot a little lump, then
  fashioned We the little lump with bones, then
  clothed the bones with flesh, and then produced
  it as another creation.... The Quran,
  Surah 2314

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Imam Bokhari quotes a Hadith of the Prophet

• All of us have been kept as a drop of seed which
  remains in the shape of a drop in the mothers
  womb for 40 days. Then for another 40 days, it
  remains in the form of a clot of blood. Then
  another 40 days it remains in the form of a lump
  of flesh. Then an angel is sent to the fetus who
  blows spirit (life) in to it.

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• The most recent formulation on abortion,
  given by the grand Mufti of Egypt and Rector of
  Al-Azhar reads as follows
• During the first four months, fetal life is
  not believed to be human. Thus, juristic
  consensus exists only to the point that abortion
  after four months amounts to taking a life, but
  this limit may be set aside, if the mothers life
  is at risk.

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Opposing Views

• Maulana Maududi, a highly respected scholar
  from the Indian sub-continent makes the
  following arguments in his book Birth control,
  first published in 1943
• The birth control movement is a plot against
  Islam.
• To import birth control methods into developing
  countries would be tantamount to 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 for
  personal reason but not as a concern for
  population growth

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Do Muslim countries have a typical demographic
pattern?

• In The Demography of Islamic Nations, Weeks
  (1988) found noticeable regional and temporal
  diversity in fertility among Muslim countries.
  He argued that,
• The single most remarkable demographic aspect of
  Islamic societies is the nearly universal high
  level of fertility.

23
Samuel P. Huntington in his well publicized
book, The Clash of Civilizations states The
Resurgence of Islam has been fueled by equally
spectacular rates of population growth
Population growth in Muslim countries, provides
recruits for fundamentalism, terrorism,
insurgency, and migration. thus demographic
growth threatens Muslim governments and
non-Muslim societies alike and Each of these
challenges is having and will continue to have
into the 21st century a highly destabilizing
impact on global politics
24

• In a monograph on Reproductive Behaviour in
  Muslim Countries (1997), which I prepared for
  UNFPA in 1997, based on the analyses of DHS data
  from 12 Muslim countries, I had had taken the
  view that
• while poor socioeconomic conditions might have
  played an important role in maintaining high
  fertility in Muslim countries, more recently
  effective family planning programs coupled with
  high female literacy seem to have become major
  factors in achieving fertility transition in
  these countries.

25

• Post 9/11 there has been considerable
  interest in Muslim population living around the
  World.
• For example, the Economist of London came out
  with a special issue on 13th September, 2003,
  with an estimated population of 1.5 billion and
  the following regional distribution

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Distribution of Muslim Population by Region
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I am of the view that

• Demographic transition begun in most of the
  Muslim-majority countries at some time over the
  past two decades, and in some, it has moved very
  rapidly. Elsewhere, there is only little evidence
  of the onset of fertility decline.
• I support my view with the following data and
  illustrations

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AN OVERVIEW OF DEMOGRAPHIC TRANSITION IN MUSLIM
MAJORITY COUNTRIES 1970-2000

• of countries with CDR
• of 1970 2000
• 25 10 0
• 20-24 6 4
• 15-19 12 7
• 10-15 10 6
• 5-9 5 18
• lt5 0 8
• Total 43 43

• of countries with CBR
• of 1970 2000
• 45 28 6
• 40-44 4 8
• 35-39 8 4
• 30-34 2 3
• 25-29 1 7
• 20-24 0 8
• lt20 0 7
• Total 43 43

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Trends in Fertility Decline 1960-2000

• Till the early 1960s, fertility rates in
  almost all Muslim countries were fairly high.
  During the past 40 years many countries have
  experienced substantial declines. The most
  dramatic regional declines occurred in North
  Africa, where Egypt began with the greatest early
  decline, quickly joined by Tunisia, Morocco, and
  Algeria. All three South-East Asian countries
  experienced similar declines.

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• Thus, in a majority of countries in the
  Muslim world, there is considerable evidence of
  demographic transition, particularly in
  fertility, during the past 25 years.
• Muslim countries in East and West Africa saw
  only modest declines in fertility, while in Asia,
  Pakistan, Afghanistan, Yemen and Oman were the
  exceptions. The most remarkable recent declines
  on the other hand, were experienced by Bangladesh
  and Iran.
• Regional trends in fertility declines are
  demonstrated in the following illustrations.

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Fertility Decline in North and North-East African
Countries
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Fertility Decline in West African Countries
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Fertility Decline in West Asian Countries
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Fertility Decline in South-Central Asian
Countries
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Fertility Decline in South-East Asian Countries
8
6.7
6.7
7
6
5.4
4.7
5
4.4
4.2
4
TFR
2.9
2.5
3
2.4
2
1
0
1960-65
Malaysia
Indonesia
1975-80
Brunie
Daressalam
2000-05
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IN CONCLUSION
There appears to be no typical pattern of
reproductive behavior which could be described as
Islamic. Islam as such seems to be neither a
hindrance nor a stimulating factor in fertility
decline. It seems that governments in most
Muslim countries, due to a pragmatic thinking
have adopted a positive approach to birth
control. However, with a few exceptions,
contraceptive use rate is low and consequently
fertility is high 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