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Pregnancy

By:
Serena Tolino
Source:
Oxford Islamic Studies Online What is This? Online-only content developed by noted scholars is continuously added to the site, part of our ongoing efforts to expand our coverage of the Islamic world.

Pregnancy

Introduction

Pregnancy (or gestation) is the term which is used to refer to the time during which one or more offspring develop inside a woman’s uterus. It usually has a length of forty weeks from the last menstrual period, or thirty-eight weeks from the moment of conception. Pregnancy can occur by sexual intercourse or by assisted reproductive technology. The term which is used to refer to the developing offspring is “embryo” during the first nine weeks after conception, and fetus from that moment until birth. However, these temporal limits are not universally accepted.

Pregnancy in the Qurʾān and Sunnah

The two most relevant Qurʾānic passages in relation to pregnancy are 22:5 (“O People, if you should be in doubt about the Resurrection, then [consider that] indeed, We created you from dust, then from a sperm-drop, then from a clinging clot, and then from a lump of flesh, formed and unformed—that We may show you. And We settle in the wombs whom We will for a specified term, then We bring you out as a child, and then [We develop you] that you may reach your [time of] maturity. And among you is he who is taken in [early] death, and among you is he who is returned to the most decrepit [old] age so that he knows, after [once having] knowledge, nothing. And you see the earth barren, but when We send down upon it rain, it quivers and swells and grows [something] of every beautiful kind”) and 23:12–14 (“And certainly did We create man from an extract of clay. Then We placed him as a sperm-drop in a firm lodging. Then We made the sperm-drop into a clinging clot, and We made the clot into a lump [of flesh], and We made [from] the lump, bones, and We covered the bones with flesh; then We developed him into another creation. So blessed is Allah, the best of creators”).

In these passages three stages of development of the embryo are described, which in Arabic are indicated with the terms nuṭfa (sperm-drop), ʿalaqa (clinging clot of blood), and muḍgha (lump of flesh).

These verses are somehow specified by two prophetic traditions: the first one is attributed to Ibn Masʿūd, and is reported by Bukhārī and Muslim. Accordingly, the Prophet said that “each one of you is assembled in his mother’s belly in forty days, then he becomes a ʿalaqa for the same period, and then a muḍgha for the same period.” After this period God sends an angel which breathes the souls into him (Bukhārī, 3: p. 1212; Muslim, 4: p. 2036). According to the second tradition, which is attributed to Ḥudhayfa and reported by Muslim, the angel creates the hearing, sight, skin, flesh, and bones when forty, forty-two, or forty-five nights (according to the different versions of the ḥadīth) have passed from the nuṭfa (Muslim, 4: pp. 2037-2037).

These two aḥādīth became particularly relevant in the legal discourse, especially between the tenth and twelfth centuries, when the concept of an eternal soul as a separate entity from the human body became widespread in the Islamic world due in part to the impact of Neoplatonism. In this period the debate about abortion was shaped by the issue of ensoulment which, in the Islamic tradition, is said to occur around 120 days after conception. This concept granted personhood and rights to the embryo during pregnancy—rather than merely after delivery—and at the same time took a clear stance against the Christian idea of ensoulment at the moment of conception (Eich, 2009, pp. 326–332).

The Debate in the Premodern Period

In the premodern Islamic world, the most prominent and robust medical discussions revolved around the prescribed roles of the male and the female during the process of conception. Clearly the debate was rooted in the contemporary scientific debate, mostly shaped by the opinions of the two leading authorities in premodern medicine, Hippocrates (460–370 B.C.E.) and Galen (129–201), as well as the leading figure in natural philosophy, Aristotle (384–322 B.C.E.). While Hippocrates and Galen maintained that there existed a male and a female semen, and that both contributed to the formation of the embryo, Aristotle supported the view that males produced semen, while females offered the passive material, which the male semen would transform into an embryo. Aristotle assumed that the semen was the residual of fully digested blood. The process of digestion could be completed only by males, due to their vital heat, while women could only produce menstrual blood, because the lack of internal heat did not allow them to complete this digestive process. With the discovery of ovaries (that Galen called “female testicles”), Hippocrates’ theory regained importance. Ibn Sīnā (980–1037), one of the leading Muslim scientists, accepted the idea that females produced semen, but also tried to reconcile it with Aristotle’s theory, for example, stating that the female semen was thin in comparison to the male semen, due to the incompleteness of the digestive process (Weisser, 1983, pp. 122–124).

There are a number of Prophetic aḥādīth that reflect this debate and seem to confirm the prevalence of the theory of the two semen in the premodern Islamic world. According to one of them, Umm Salama asked whether women have nocturnal emissions, and the Prophet answered: “How could then her son resemble her?” (Muslim, 1:p. 251). According to another version of the ḥadīth, Umm Salama asked the Prophet whether a woman should wash if she had a nocturnal emission (in Arabic iḥtalamat). The Prophet answered that “she should do so if she sees the fluid” (in Arabic māʾ) (e.g., al-Bukhārī, 1: p. 60). According to yet another version, the Prophet added that the male semen is white, while the female semen is yellowish, and that the child will resemble the one who has the stronger semen, or whichever reaches the uterus first (Muslim, 1: p. 250). According to another ḥadīth, the Prophet attributed to the stronger semen not only the resemblance, but also the sex of the child (al-Ṭabarānī, 12: pp. 246–247).

In premodern Islamic law, one of the most contentious issues was the length of pregnancy. Jurists fixed the minimum length of pregnancy at six months. The “six months” agreement was the result of a subtraction from the thirty months mentioned in Qurʾān 46:15 (“His mother carried him with hardship and gave birth to him with hardship, and his gestation and weaning [period] is thirty month”), of the twenty-four months mentioned in Qurʾān 2:233 (“Mothers may breastfeed their children two complete years for whoever wishes to complete the nursing [period]”). The minimum duration of pregnancy was particularly relevant for the discussions on the attribution of paternity: the paternity of a child who was born less than six months after marriage was clearly contested.

Jurists did not agree instead on the maximum length of pregnancy: most jurists fixed it at two years, but some Mālikīs extended it up to twelve years (Eich, 2009, p. 307). This was explained with the theory of the sleeping embryo. According to this idea, if a woman is divorced, separated, or widowed from her husband, then remarries and gives birth to a child before the canonical six months, she may be legally considered pregnant from the former husband, as the embryo slept and was revitalized when she started to have sexual intercourse with the new husband (Eich, 2009, pp. 310–313).

Other aspects that were discussed revolved around the question of when the embryo acquires the status (and consequently the rights) of a human being. For example, the amount of blood money to be paid in case a woman is hurt and as a consequence miscarries depends on the status of fetal development. The majority of jurists considered that the full diyah should be paid after ensoulment, that a formed fetus inherited (and passed inheritance to his relatives), and that religious burial was permitted in this case. Other topics that were discussed were the legal waiting period of a pregnant divorcée and her maintenance, and the legal status of a female slave when she delivers an aborted embryo or fetus (Ghaly, 2014, p. 163).

Pregnancy and Contemporary Bioethics

In the field of contemporary bioethics and, specifically, of Islamic bioethics, pregnancy is related to a number of issues. One of the most debated issues (in both premodern and modern discussions) is the status of a child who is born out of wedlock. According to Islamic law, only legitimately married men and women can have sexual intercourse. Sexual intercourse between two unmarried persons constitutes a case of zinah, which, according to classical Islamic law, is considered a ḥadd crime and should be punished with fustigation for a non-muḥṣan (a person who never consumed a valid marriage) and death by stoning for a muḥṣan. Historically speaking, the punishment for zinah according to Islamic law has rarely been applied, due on the one hand to the Qurʾānic necessity that four witnesses saw and described the illegal intercourse, and on the other to the punishment for qadhf (slander) in case of false testimony. Moreover, the well-known legal maxim al-walad li-l-firāsh (the offspring belongs to the matrimonial bed) acted as a deterrent against the declaration of illegitimate children.

Nevertheless, there is still today a certain stigma attached to a child who is not born from a legally valid marriage, the so called walad al-zinah. In many Muslim-majority countries single mothers encounter difficulties when registering a child born out of wedlock. Consequently, they cannot obtain the necessary documents, which makes it difficult to obtain access to health insurance, education, and other basic services.

Another relevant issue is in vitro fertilization (IVF), the process by which an egg is fertilized by sperm in vitro and then implanted into a woman’s uterus. While Muslim jurists typically consider IVF to be acceptable—as long as the entire process involves only the two married parties—IVF is equated to a case of zinah if there is a third-party donor who provides sperm, eggs, or embryos. There is also the case of surrogate pregnancy, where a woman agrees to carry on a pregnancy for another person or persons, who will then become the newborn’s legal parent(s), is highly debated, as there is the involvement of a third party’s uterus.

Another debated issue is that of abortion. While virtually all jurists agree that abortion is forbidden after ensoulment, there is the question of when ensoulment occurs. Based on when their particular school of thought believes the ensoulment takes place, jurists have allowed abortion if it is practiced within 40, 80, or 120 days. This debate is strictly connected to the question of when human life begins, which has been discussed, for example, in a 1985 meeting of the Islamic Organization for Medical Sciences in Kuwait. In this meeting a variety of positions on the beginnings of human life emerged, with some scholars considering that human life starts immediately with conception, and others arguing that it starts after ensoulment (Ghaly, 2012). The Islamic Organization for Medical Sciences also discussed these topics in its meetings in 1987; 1988 and 1989, while the International Islamic Fiqh Academy in Jeddah discussed the issues of frozen embryos in 1990 and cloning in 1997.

In the twenty-first century, access to abortion varies greatly in different Muslim-majority countries, with cases like Tunisia, where abortion is legal, or cases like Egypt, where it is legal only in case of serious threats to the mother’s life.

Bibliography

Primary Sources

  • Bukhārī, Muḥammad al-. Ṣaḥīḥ al-Bukhārī, edited by Muṣṭafā Dīb al-Bughā. 7 vols. Damascus and Beirut: Dār ibn Kathīr, 1993.
  • Ibn al-Ḥajjāj, Muslim. Ṣaḥīḥ Muslim, edited by Muḥammad Fuʾād ʿAbd al-Bāqī. 5 vols. Cairo: Dār Iḥyā’ al-Kutub al-‘Arabiyya, 1991.
  • Ṭabarānī, Abū al-Qāsim Sulaymān ibn Aḥmad. Al-Muʿjam al-kabīr, edited by Ḥamdī ʿAbd al-Majīd. 25 vols. Cairo: Maktabat ibn Taymiyya, 1983.

Secondary Sources

  • Eich, Thomas. “Induced Miscarriage in Early Mālikī and Ḥanafī Fiqh.” Islamic Law and Society 6, nos. 3–4 (2009): 302–336. This discusses the development of embryology in Mālikī and Ḥanafī fiqh in the first six centuries of the Islamic era, and demonstrates how this is relevant to understanding the position on induced miscarriage in the two madhhabs.
  • Gadelrab, Sherry Sayed. “Discourses on Sex Differences in Medieval Scholarly Islamic Thought.” Journal of the History of Medicine and Allied Sciences 66, no. 1 (2011): 40–81. This article contextualizes Islamic theories of sex differences.
  • Ghaly, Mohammed. “Human Embryology in the Islamic Tradition. The jurists of the Post-formative Era in Focus.” Islamic Law and Society 21 (2014): 157–208. A comprehensive investigation of the impact of Greek medicine on the theories of human embryology in the Islamic tradition.
  • Ghaly, Mohammed. “The Beginning of Human Life: Islamic Bioethical Perspectives.” Zygon 47, no. 2 (2012): 175–213. A discussion of the proceedings of the symposium of the Islamic Organization for Medical Sciences on “Human Life: Its Beginning and Its End from and Islamic Perspective” that took place in 1985 in Kuwait.
  • Musallam, Basim F. Sex and Society in Islam: Birth Control before the Nineteenth Century. Cambridge, U.K.: Cambridge University Press, 1983. A good introduction to theories of conception, contraception, and birth control in premodern Arab medicine.
  • Sulaymān al-Nūr, Muḥammad. “Muddat al-ḥaml bayna al-fiqh wa’l-ṭibb wa baʿḍ qawānīn al-aḥwāl al-shakhṣiyya al-muʿāṣira”, Majallat al-Sharīʿa wa’l-Dirāsāt al-Islāmiyya 70 (2007): 288–315.
  • Weisser, Ursula. Zeugung, Vererbung und Pränatale Entwicklung in der Medizin des arabisch-islamischen Mittelalters. Erlangen: Verlagsbuchhandlung Hannelore Lüling, 1983. An analysis of theories of procreation and prenatal development in medieval Islamic medicine.
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