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Lecture for 3rd year medical students on 18th November 2000 by Professor Omar Hasan Kasule Sr.
OUTLINE
1.0 MENSTRUATION, haidh
A. Physiology
B. Normal Menstruation
C. Pre-Menstrual Syndrome
D. Menopause, Ya’isu Mina Al Haidh
E. Menstrual Disorders
2.0 HUMAN SEXUALITY, shahwat al jimaa
A. Gender Identity
B. Expression Of Human Sexuality
C. Regulation Of Human Sexuality
D. Human Sexuality And Marriage
E. Coitus
3.0 PREGNANCY, haml/habl
A. Diagnosis Of Pregnancy
B. Period Of Gestation, muddat al haml
C. Physical Activities In Pregnancy
D. Breast-feeding in Pregnancy
E. Legal Proceedings in Pregnancy
4.0 DELIVERY, wadhau al haml
A. Birthing Process
B. Taharat in Labor and Delivery
C. Ibadat in Labor and Delivery
D. Post-Partum Bleeding, nifaas
E. The New-Born
5.0 BREAST-FEEDING, ridhaa’at
A. Neuro-Humoral Control
B. Period Of Breast-Feeding, muddat al ridhaa’at
C. Payment for breast-feeding, ajr al ridhaa’at
D. Foster breast-feeding
E. Activities during breast-feeding
1.0 MENSTRUATION
A. PHYSIOLOGY
MENARCHE:
The start of menstruation in adolescence, menarche, is a sign of adulthood. The age at menarche increases with improvement of nutritional status. The minimum legal age at menarche is 9 years; there is no maximum set by the Law. Menarche may be early or delayed within the normal expected age ranges.
NEURO-HUMORAL CONTROL:
The physiological events of the menstrual cycle are tightly controlled and coordinated by the hypothalamus-pituitary-ovary axis. The menstrual cycle is not under the woman's conscious control (KS 208). Use of hormones to regulate normal menstruation for the convenience of the woman should be discouraged unless there is a legal necessity, dharuurat, such as hajj. Such regulation may interfere with the husband's sexual rights and lead to marital disputes.
LENGTH OF THE MENSTRUAL CYCLE:
The menstrual cycle is one lunar month on the average (KS 209). It is one of the signs of Allah that a physiological process like menstruation can have the same duration as the astronomical processes involving rotations and revolutions of the sun and the moon.
DURATION OF THE MENSTRUAL FLOW
The Law sets 1 day as the minimum duration of the menstrual flow. If the menstrual flow is less than 24 hours, prayers missed in that time have to be repeated because that flow is not recognized as menstruation.
DURATION OF THE INTERMENSTRUAL PERIOD
The minimal interval of purity, inter-menstrual period, recognized by the Law is 15 days.
B. NORMAL MENSTRUATION
SOCIAL INTERACTION IN MENSTRUATION
Menstruation is natural and is not a disease (MB#203). Unlike Jews, Muslim men do not treat a menstruating woman as someone to be shunned (KS 208, MB#204, 205, 206, 208, 209). She carries on her normal life like any other member of the community with minimal restrictions. A menstruating woman can enter the kaaba (KS 207). She can walk through the mosque. Clothes worn during menstruation can be used for prayer without the necessity of washing them (KS 154). Spots of menstrual blood however have to be washed away if wet and scraped away if dry.
MARITAL RELATIONS IN MENSTRUATION
A menstruating woman can do anything with her husband except vaginal sexual intercourse (KS 208). The normal marital relations, mubasharat, continue (KS 208). A menstruating woman can touch her husband as usual such as washing his head (KS 207) even if he is in iitikaaf (KS 207). The husband can pray beside her (KS 207, MB 222) and can read Qur'an beside her (KS 207). A menstruating woman can share the bed with her husband but cannot have sexual relations (KS 207, MB#217). The Qur'an ordained sexual abstinence during menstruation, iitizaal al nisa fi al mahiidh (p 383 2:222) Coitus during menstruation is considered is a sin (KS 208) and a heavy penalty, kaffarat, has to be paid to expiate the sin (KS 208). If there is a dispute between a husband and wife about the start or end of menstruation, the man's right to sex is upheld.
IBADAT IN MENSTRUATION
Menstruation is a distress, al haidh adha (p 383 2:222). A menstruating woman is exempted from obligatory prayers (KS 208, MB#210). She is allowed to enter the mosque (KS 208) but not to pray there She does not have to make up prayers missed during menstruation (K209, MB# 216); She can attend eid salat (MB#218) but does not pray. She is not allowed to touch the Qur 'an, mass al Qur'an (KS 209) or read the Qur'an, tilawat al Qur'an (KS 209) but she can listen to it with no obligation to make sujuud al tilawat (KS 209). She is allowed to read or recite dua and other writings that contain Qur’anic verses as long as the intention is not reciting the Qur’an itself. She is excused from fasting Ramadhan but has to pay back missed days, qadha al saum (KS 208, KS 209). The use of hormones to regulate the menstrual period in order to be able to complete the rituals of pilgrimage is widely used. A menstruating woman cannot perform circumbulation, tawaaf, or the trotting, sa’ay, between safa and marwa. PURIFICATION AT
THE END OF MENSTRUATION
A bath, ghusl, is required at the end of the menstrual flow (MB#213). This bath has both hygienic and ritual aspects and tayammum can be sufficient when no water is available (KS 210). Hair must be undone (MB # 215) and must be combed (MB # 214). This bath must be undertaken before any sexual relations (KS 207, KS 210)
THE WAITING PERIOD, iddat
The menstrual cycle is used to determine the length of the post-divorce waiting period, iddat al talaaq (KS 210), as well as the waiting period after death of a husband, iddat al maut. There are disputes among the jurists whether the period is 3 months, three menstruations, or three inter-menstrual periods, quruu/tahuuraat.
C. PRE-MENSTRUAL SYNDROME (PMS)
SYMPTOMS and SIGNS
About 80-90% of women experience some form of PMS. The symptoms of PMS are: labile emotions, anger/irritability, anxiety/tension, decreased interest in usual activities, easy fatigability, lack of energy, difficulty in concentration, change in appetite, sleep disorders, and physical symptoms such as breast tenderness.
LEGAL RULINGS
PMS has a social impact and has been implicated by research as a factor in mental disorders, irritability, child abuse, alcohol abuse, and depression. Salat may not be possible in severe forms of PMS but must be made up later. PMS also has legal implications since it can be used as a court defense in mitigation of crimes committed while in an irritable and tense mental state. PMS may also be raised as an argument for diminished legal competence, ahliyyat, in civil transactions by women. A woman suffering from PMS could for example refuse to testify in court. Loss of interest in sex may create stress in marital relations. This is one additional justification for prohibition of divorce during menstruation.
D. MENOPAUSE, ya’isu mina al haidh
PHYSIOLOGY
Climacteric: Climacteric is a period when the woman undergoes endocrine, somatic, and physiological changes as she comes to the end of her reproductive career and prepares to enter middle age. Climacteric changes are related to ageing and estrogen depletion. The processes leading to the climacteric start even before birth. At 20 weeks of intra-uterine life there are 700 million oogonia. As the ovary ages, these decrease to 700,000 at birth. The decrease increases throughout the rest of life. The climacteric like early childhood and adolescence is a period of transition and is associated with problems and complications.
Menopause: Menopause is permanent cessation of menses and is considered part of the climacteric. The age at menopause has been rising in countries and societies where nutrition and health have been improving. Many women do not enter menopause until they are in their late 40s or early fifties. Khadijah, the first wife of the prophet, gave birth at an advanced age above 40 years. Among the manifestations of menopause are: vasomotor flushes, osteoporosis, genito-urinary atrophy (vagina, urethra, and bladder), and cardiovascular disorders (MI, CVA).
Post-menopause: The postmenopausal syndrome is due to deficiency of estrogen. It is a cause of distress, anxiety, behavioral, and physical disorders.
PROBLEMS OF THE MENOPAUSE
Bleeding disorders
Mood changes
RULINGS ABOUT MENOPAUSE
Artificial early menopause: A woman can choose to go into early menopause because of the inconvenience of menstruation and childbirth. Early menopause can be induced medically or surgically. Artificial menopause is necessary, dharuurat, if there is serious disease like cancer. Other indications that do not reach the level of dharuurat are prevention of genital tract cancer by surgical removal of the organs that normally become cancerous and shortcutting the problems of the labile transitional period of the menopause. The harms, dharar, must be considered against the benefit, maslahat, with the understanding that under the Law prevention of harm, dariu al mafsadat, has precedence over accruing a benefit, jalb al maslahat. In cases of early surgically induced menopause lifetime estrogen replacement therapy, which has complications and side effects, may be necessary.
Delay of menopause: It is conceivable that with suitable hormonal manipulation, a woman could delay the onset of menopause. This is praiseworthy if the intention is to prolong reproductive life or strengthen marriage. It is offensive if done for purposes of appearing young to the general society. The Law in general is against any deceptions regarding a person's age.
Estrogen replacement therapy: Estrogen replacement therapy (ERT) can alleviate virtually all menopausal symptoms. ERT has serious side effects that have to be considered under the two principles of benefit and harm.
E. MENSTRUAL DISORDERS
Menorrhaghia: menorrhaghia is excessive menstrual flow. There are no special rulings on this. Extra care must be taken with hygiene especially if mosque entry is contemplated.
Metrorrhaghia:
Prolonged menstruation: the menstrual flow may be prolonged in association with
menorrhaghia and without it. The Law considers 15 days the maximum duration of the menstrual flow. Salat and fasting are suspended during this time. Salat and other acts of ibadat are resumed if the flow continues beyond 15 days.
Dysfunctional uterine bleeding, DUB: Prolonged bleeding, istihaadhat, is not considered menstruation (MB#171). Intermittent vaginal discharge is also not a problem (MB#219). DUB does not stop the woman from salat or fasting. It is treated as urinary incontinence. The woman washes her vagina and perineum, pads herself, makes wudhu and prays immediately to try to avoid being caught by more bleeding. Sexual relations are allowed in DUB unless there is a medical contra-indication (K 154 Abu Daud K1 B118, Darimi K1 B85, Muwatta K2 H108).
DYSMENORRHOEA
The severe pain of dysmenorrhoea may interfere with ibadat and civil obligations.
2.0 HUMAN SEXUALITY
A. GENDER IDENTITY
TWO GENDERS:
Allah created 2 different and distinct genders as a pair (75:39, 53:45, 92:3). The male is different from the female (3:36) although ultimately both are from the same source (4:1, 7:189, 16:72, 30:12, 39:6). Each gender is encouraged to maintain its biological, psychological, emotional, and social identity. This is for the purpose of facilitating and regulating relations between the two genders for the good of the whole society. Parity, zawjiyat, is a basic phenomenon of creation that requires that men and women complement one another each bringing to the relationship unique features of the respective gender identity. This complementation would be meaningless if the two genders lost their separate identities. On the demographic level, there should exist equal numbers of men and women. This is maintained in a normal social setting. In abnormal situations the balance may be lost leading to social problems. One of the signs of the impending last day, yawm al qiyamat, will be gender imbalance with too many women for few men (KS p. 106). This will be followed by a lot of adultery, zina (KS p. 264).
GENDER AWARENESS:
Gender awareness develops very early in children. Sexual awareness develops towards puberty. Innate knowledge or awareness of gender is reinforced by the child's observation of anatomical and behavioural differences between men and women. Socialization also plays a role in strengthening gender awareness.
GENDER DISCRIMINATION:
Pre-Islamic Arabia: Gender separation has been used in a wrong way to discriminate against women on the basis of their gender. In pre-Islamic Arabia, jahiliyyat, there was despise for females, idhlaal al nisa. There was preference for male births and hatred for females (6:137, 6:140, 6:151, 17:31, 60:12, 81:8-9, 16:58-59). Parents were sad on birth of a daughter (16:58-59, 43:17). Infant daughters were considered a blemish, aar (16:58-59, 43:17) and were buried alive, wa'ad al banaat (6:137, 6:140, 6:151, 16:58-59, 17:31, 60:12, 81:8-9). Women were inherited as goods (4:19) and were denied the good things of life (6:139).
Judaism: Jewish law is very discriminatory against women
Christianity: In Christendom, women were blamed for the original sin of Adam and Hawa and suffered discrimination as a result.
Modern Europe: The contemporary European secular society has gone to the other extreme in rejection of the discrimination of women practised in earlier centuries. However in the process of the so-called liberation of the woman new and perhaps more degrading forms of enslavement have evolved. In contemporary western society the woman's body is sometimes treated as a sexual object to be exploited in the commercial advertisement and entertainment industries. The European concept of equal rights for men and women is different from the Islamic one. It requires a woman to behave, act, and be treated like a man. This will in the end remove the social legal protections for the women that are necessary because of her different biology and her functions as a mother and a wife. Islam calls for equity and not equality.
ISLAM and the WOMAN
Islam has emphasized gender identity while rejecting all forms of discrimination against the woman on the basis of her gender. The Qur'an makes it clear that both Adam and Hawa were misled (2:36, 7:22, 20:121). They both sought forgiveness from Allah and were forgiven (7:23). In 2 verses it is Adam and not Hawa who is mentioned as seeking forgiveness (2:37, 20:122). Human sexuality could be a cause of corruption. Women because of their sexual attractiveness can be a source of fitnat (MB #1837; Qur'an 64:14). This has been misunderstood as derogatory to the moral standards of women. In practice it is men who are more often the active or aggressive party in sexual corruption and should take the blame. Any situation of corruption involves both a man and a woman and both are morally guilty. The law equalises their guilt and their punishment (24:2). In the same way Islam equalizes their reward for good work (3:195, 4:124, 16:97, 40:40, 33:35). Men can also be a sexual attraction as the Qur'an tells us in the story of Yusuf (PBUH). His beauty was a temptation, fitnat, for women (12:26).
TRANS-SEXUALITY:
The Law considers any blurring of the gender distinction between males and females as highly undesirable. This applies to the way of dressing, talking, behaving and socializing. Effeminate men must not be allowed to enter homes (MB #948). Severe punishment is reserved for men who try to appear like women, mukhannath, and women who try to appear like men, mutarajjil, (KS p. 190, KS p. 540). The law specifies acceptable clothing and other bodily ornamentation for men and women (KS p. 266, KS p. 466). Only women can use silk (MB p. 947, KS p. 465) and gold (KS p. 213). It is recommended for men to grow a beard as a sign of their masculinity (KS p. 468).
B. EXPRESSION OF HUMAN SEXUALITY
HUMAN SEXUALITY IS NORMAL:
Allah created sexual desire, shahwat, in humans (3:14, 7:81, 27:55). It is as normal as is the desire for food or shelter. Like other desires that Allah created in humans it is powerful and can overwhelm a weak human (23:106). Sexual desire like the desire for food can be satisfied legally or illegally. It is illegal to satisfy the sexual desire outside marriage or with a partner of the same gender (7:81, 27:55), or with animals or inanimate things. Humans differ from animals in that their sexual desire is there all the time. Animals develop the desire only in the period just before copulation and in their reproductive season or phase. This period is called estrus in apes. It is clear that human sexual desire is not only for reproduction but also for pleasure. In animals sexual desire is strictly related to the reproductive function. Expression of human sexuality involves the male and female together. This has been the convention since the creation of Adam. The mutual needs of men and women for one another are illustrated in the case of Adam and Hawa (KS p.41). Allah told him to settle in heaven with his wife.
MONASTICISM IS FORBIDDEN:
Islam forbids complete rejection and suppression of the sexual instinct (MB #1828, 1829, 1830, KS p. 253). The prophet forbade his companions from castrating themselves so that they may be devoted to worship, ibadat, all the time. Monasticism as practised in some Christian sects and other religions is a human invention (57:27) that goes against basic human nature.
SEXUAL ATTRACTION:
Allah has created in each gender features that attract the other gender. These include the physical beauty of the body (shape, size, movements, texture, colour), the voice (pitch and depth), scalp, and body hair (length, distribution, texture). Studies in animals have shown the existence of pheromones. These are chemical sexual attractants emitted by females. Their existence in humans is being studied. Physical beauty is appreciated by Islam and is considered one of the 4 reasons for marrying a woman (MB #1835). The intending spouses must see one another before marriage (MB #1846). This is to ensure that there is enough sexual attraction between them and prevents the regrets that may occur after marriage ('umdat). Physical beauty deteriorates with age. Virginity enhances female sexual attraction and is considered desirable (56:36, 66:5). Marrying virgins is preferred (MB #1831) but there is no prejudice against the elderly widowed (2:234-235) or divorced (2:232) women. Aisha was the only wife of the Prophet who was a virgin. Shaitan exploits the sexual attraction between the genders to inflame passions that lead to sexual transgression. Each person always has shaitan with him or her (KS p. 48). The sexual attractiveness of the woman is generally more than that of the man. Thus in sexual relations it is the male who usually seeks out the female. The extra beauty and attractiveness of the woman can be a temptation for both her and for men (12:23-24 & 12:30-34). A woman conscious of her beauty may exploit it by being flirtous and thus exposing herself to men. Men will be attracted by her beauty and may lose control and commit sexual transgression.
ENHANCING SEXUAL ATTRACTIVENESS:
Human sexual attraction is enhanced in many ways; some are legal whereas others are not. Clothes enhance physical appearance besides the functions of covering nakedness and protecting the body against the elements of the weather. Perfumes and other good smells perhaps play the role of pheromones in humans. Women and men can dye their hair (KS p. 215). It is however forbidden to dye the hair black or to use artificial hair. Circumcision (khitaan) is exercised in many societies for both men and women. Female sexuality is a cause of much controversy. Some societies consider that it enhances sexuality whereas others consider it to decrease sexuality and use it to control sexual transgression. Islam did not forbid it but requires that it be moderate and considerate (KS p. 214). Circumcision of men is of hygienic importance.
C. REGULATION OF HUMAN SEXUALITY
SEXUAL HYGIENE:
The 2 hollow organs will lead most people to hell: the mouth, fam, and the genitals, farj (KS p. 178). Both are involved in sexual corruption one negotiates whereas the other commits the crime. The law has regulations for proper conduct of sexual relations. These either aim at decreasing sexual stimulation or removing antecedents of adultery. Normal functioning of society requires that marriageable men and women interact. Both genders, in their appearance and behavior, can stimulate sexual passions. This results into a higher likelihood of sexual transgression. The physical acts of sexual transgression are preceded by acts that may not innately be illegal. They are however forbidden or restricted because they could lead to or facilitate the commitment of sexual transgression. These restrictions come under the rubric of prevention of approaching adultery, qurb al zina (6:151, 17:32). The severe punishment for zina, hadd al zina, (24:2-3) is a social or public deterrent in cases of flagrant violation of the law. Under normal circumstances, it is the family and the community that regulate sexual behavior. The state intervenes when sexual promiscuity becomes public and deterrent measures become necessary to control it.
CONTROL OF THE SEXUAL DRIVE:
It is wrong to consider suppression of human sexuality. It must be allowed expression but in a regulated civilized way. The issue is the manner in which it is expressed. This may be right or wrong. For the youths who are not able to marry, fasting is recommended as a means of controlling the sexual urge for a short time (MB 440). For the married fasting should not be overused. The fasting person must remember that the family has rights (MB p 454). Thus conjugal rights of the husband or wife can not be abolished on the basis of non-obligatory, nafil, fasting. The individual can exercise control over the sexual urge even in the presence of extreme provocation. A husband and wife need not be separated in situations in which coitus if forbidden like pilgrimage, fasting, or menstruation. A fasting couple are not allowed to engage in behavior that may make them lose control and engage in coitus. Kissing of spouses in fasting is allowed provided there is no fear of transgression otherwise it is forbidden (KS p. 138).
PSYCHOLOGICAL BARRIERS:
The family and society must erect psychological barriers that make the commission of sexual transgression difficult. Severe punishment is reserved in the hereafter for a person who allows sexual misconduct in his or her family, duyuuth (KS p. 263). There should exist in society a psychological revulsion to sexual corruption. Sexual misbehaviour, fahishat, should not be broadcast openly (4:148, 24:19). Thus accusations of marital infidelity, al qadhaf, should not be made without proof and severe punishment is reserved for the accuser who cannot produce 4 witnesses (KS p. 435, 24:4, 24:11-19, 24:23). Talking about sexual infidelity openly and lightly will eventually make the crime look ordinary and common and thus easier to commit. Those who committed sexual transgression should be socially isolated by not allowing them to marry chaste people. They can only marry other adulterous persons.
NON-COITAL ADULTERY:
Adultery is a major sin. It has antecedents and if these are avoided the major ultimate sin may be avoided. The sexual urge is so strong that many people involved in an antecedent of zina may not be able to control themselves from going on to commit the illegal coitus. The concept of non-coital adultery refers to acts and behaviours that lead to zina. The various organs of the body can therefore be said to commit non-coital zina, zina al jawarih (MB #2061, KS p. 264). The eye, the ear, the mouth, and even the legs that walk from place to place can be accessories to the ultimate sin of illegal coitus. Thus there are regulations to prevent people from ever getting near adultery (17:32). The measures that protect the genitals from the ultimate crime are referred to as hifdh al farj (70:29-30) and ihswaan al furuj (21:91, 24:33, 66:12). Men who protect their genitals are called al muhswinin and women are called al muhswinat (4:24-25, 5:5, 24:4, 24:23).
SHYNESS, haya:
The Islamic term haya is not perfectly translated by the English term, shyness. Haya, the morality of Islam (KS p. 206), is an inner spiritual protective device that makes a person shun sin and what may lead to it. It is not bashfulness or being introvert as some may think of it. Haya is considered part of faith, iman (KS p. 206). Haya is always for the good and can never be negative (KS p. 206). It is a characteristic attribute of all messengers (KS p. 206). The Qur'an describes in detail the haya of the daughters of Shuaib in their meeting with Musa (PBUH) that should serve as a model for other women (28:23-28).
COVERING NAKEDNESS, satr al awrat:
Awrat are those parts of the body that could elicit sexual stimulation if seen. Covering awrat prevents sexual corruption. Nudity of varying degrees is found in societies according to their level of sexual immorality. Both men and women must cover the awrat. The awrat of men is different from that of women. The woman's awrat is all her body except the face and the hands. The man's awrat is confined to what is between the navel, surrat, and the knee, rukbat. The extent of covering awrat also depends on the person likely to see and the person being seen (24:31). More of the awrat could be exposed to close relatives within the confines of the home (24:31, 33:55). A close male relative is not allowed to see a woman's nakedness except what is between the navel and the knee. The regulations of hijab are relaxed for an elderly woman with no hope of marriage (24:60). The laws on exposing nakedness start applying to children from the age of 7. They should seek permission before entering rooms of adults in the home for fear of accidental exposure of awrat. Male and female children should not share beds after the age of 7. The law regulates the use of public baths. Where it is not possible to cover awrat, public baths are forbidden (KS p. 203). Naked persons are not allowed in such baths (KS p. 203). The laws of hijab contain special provisions for women as was described in the verses on hijab (KS p. 541). It is not enough for the woman to cover her nakedness. The law of hijab specifies in detail how that nakedness be covered. For example it must be covered in such a way that the shape of the body is not definable. Clothes through which the colour of the skin can be seen are not permitted. In general the woman should cover all of her body except the face and the hands. In cases of high temptation due to her beauty she may have to wear a full veil covering her face as well.
SECLUSION, khalwat:
Seclusion, defined as a man being with a marriageable woman who is not his wife in a place where others cannot see them, is forbidden (KS p. 540, MB # 1868). Whenever a man is with a woman in seclusion, shaitan comes between them. Shaitan is always trying to misguide as he did with Adam and Hawa (2:36, 7:22, 7:27).
FREE MIXING, ikhtilat:
The law prohibits men and women mixing without necessity. When men and women are together the natural sexual attractiveness could lead them into temptation. When mixing is unavoidable for societal necessity, the Law on male-female interaction has prescribed certain etiquettes. Awrat must be covered as prescribed by the law, satr al awrat (24:31). The regulations of hijab for women must be followed. Men and women who are strangers to one another have to lower their gaze, ghadh al basar (24:31), and not look at each other fixedly and for a prolonged time. Both genders must have haya (28: 23-25). If a man and woman talk to one another they must be serious, jidiyyat al takhatub (33:32) and not engage in frivolous talk that could lead to temptation. An atmosphere of solemnity, wiqaar, must be maintained during the whole period of interaction (24:31).
SEXUAL DISPLAY, tabarruj:
Women are supposed to conceal their ornamentation from public display (24:31). Women are discouraged from going out of their homes heavily adorned with attractive ornamentation (KS p 539). This includes wearing very heavy perfume in public. Such ornamentation should be reserved for the home. The ruling is more severe for a wife whose husband is absent (KS p. 540).
PRIVACY OF THE HOME, hurmat al bayt:
A stranger is not allowed to enter a home unless given permission. This is to preserve the privacy of the occupants. The stranger may enter unannounced and find them in various degrees of nakedness. Thus permission to enter ensures that the house occupants' nakedness will not be exposed accidentally (MB #2060). A wife cannot admit a stranger to her home without the permission of her husband (KS p. 542). Rooms within the home are also private territory that should not be entered before asking for permission.
D. HUMAN SEXUALITY AND MARRIAGE
MARRIAGE AND SATISFACTION OF SEXUALITY:
Marriage is a natural human institution. Adam and Hawa were the first couple (2:35). Marital relations have continued ever since. A spouse is a source of psychological tranquillity (30:21, 25:74, 7:189). Marriage is the only institution that allows full expression of human sexuality in a responsible way. It is, according to the Qur'an, a deep and serious relationship (4:21). The spouses give good company to one another, mu'asharat (4:19). Islam encourages marriage for all (KS p. 546). Marriage is protection against sexual immorality (KS p. 547, 60:10). If a man sees an attractive woman he should go to his wife immediately because that protects him from potential sin (KS p. 155). Marriage also serves the purpose of procreation to maintain the human race and rear children until adulthood (3:47, 4:1, 16:72, 19:20). Marriage is a public affair that must be announced and known in the community that a couple are husband and wife to avoid any suspicions that arise in secret marriages (KS p. 547, 2:235). The spouses must freely consent to enter into a marital relation (4:191). Desire for sexual satisfaction is a major reason for marriage. It is considered offensive by the law for a person who has no sexual desire at all to get married. A person who has desire for sexual satisfaction but has impediments like poverty or physical disability (disease, impotence) should control the desire by fasting.
The sexual relation in marriage is wider that coitus. It involves mutual enjoyment such as kissing and fondling. The marital relation is much wider than a sexual relation. It involves social and psychological bonding. The husband and wife have to be close physically, psychologically and emotionally. Mutual good treatment and sympathetic consideration sustain love after the initial period of passionate involvement (4:19). The husband and wife can bathe together and see each other's nakedness (MB p 123/p). The husband cannot keep away from contact with the wife because of menstruation. He can sleep with his menstruating wife provided both can control themselves to avoid copulation (MB p. 147). It is forbidden for a wife to withhold sexual favours from her husband without a valid reason (KS p. 542). The wife cannot fast nafilat without the permission of the husband (MB #1860) because that would deny him his conjugal rights.
PROHIBITION OF TEMPORARY SEXUAL RELATIONS:
Marriage is a permanent institution, abadiyyat al zawaaj, and cannot be a temporary sexual relationship. Four temporary sexual relations that are forbidden: (a) temporary marriage, mut'at (b) prostitution, bighaa (c) adultery between consenting adults, zina and (d) marriage with the hidden intention to divorce after a time, zawaaj bi niyyat al talaq. They are forbidden because they reduce the sexual relation to its physical form without regard to the emotional, psychological, and social dimensions. They undermine and destroy the fabric of society. Temporary marriage, mut'at, is forbidden by law (MB #1844, KS p. 549). This is a type of marriage contracted by both parties for a fixed period of time. It violates the need for children to be reared in a permanent family. Humans require at least 15 years to be reared to adulthood. Prostitution is the exchange of sexual favors for money. It is physical enjoyment without emotional or psychological involvement. The law prohibits forcing girls into prostitution (24:33) for the sake of money. Adultery, zina, may have some form of emotional and psychological involvement besides the physical enjoyment but these are temporary. Some scholars have quoted evidence on the permissibility of marriage with the intention of divorcing. In our view the practice involves dishonesty on the part of the husband by failing to disclose his full intentions to the partner. Disclosure would turn this type of marriage into a form of mut'at marriage that is forbidden.
PRIVACY OF THE SEXUAL RELATION:
The sexual attributes of a woman are private between and her husband. It is forbidden for one woman to describe the sexual details of another women to her husband (MB #1869, KS p. 539). It is forbidden for both spouses to disclose their sexual experiences to any outside parties (KS p. 540).
SEXUAL ATTRACTIVENESS IN MARRIAGE:
The sexual attractiveness is a continuous process that is necessary to bind the 2 spouses together. Some people misunderstand this to mean that a woman is attractive before marriage in order to attract the man and need not maintain her attractiveness after that. A married woman must always look attractive to her husband (KS 540). This prevents him from being tempted by other women. The prophet forbade the return of a husband from a trip at night because he may surprise his wife who will not be able to prepare herself and be in the most attractive form (MB #1871). The wife is entitled to articles of hygiene to maintain her beauty. This however does not include cosmetics.
PROTECTION OF CHASTITY, ghiirat
Ghiirat: The word ghiirat has been translated incorrectly into English as jealousy. It is more than simple sexual jealousy. It is a drive in the spouse and other members of the family to protect the chastity of both males and females. Ghiirat is commendable (MB p. 904 chapter #30) and is necessary for proper functioning of society. Too much of it could be destructive.
PROHIBITED MARRIAGES, maharim:
For proper functioning of the extended family, free and easy social intercourse must exist among its members. More intimate contacts will occur among the family members that are possible with outsiders. Sexual attraction and the sexual desire being human and natural could also exist within the extended family. The door to this was closed by the law by declaring degrees of relatives who are not marriageable (4:23) and with whom close social intercourse is allowed within the family.
E. COITUS
PURPOSES AND BENEFITS OF COITUS:
Coitus serves 2 purposes: reproduction and sexual enjoyment. It is the most intimate and intense physical expression of human sexuality. All other expressions of sexuality precede or prepare for it. Sexual enjoyment in marriage, al istimta'u fi al zawaj, is normal and is encouraged (4:24). Some scholars have argued that this enjoyment is confined to vaginal coitus. The majority argue that the enjoyment covers all parts of the body unless specifically prohibited by law. Coitus is necessary for childbearing. Children are a bounty from Allah, intimate al dhuriyyat (25:27, 42:49). It is difficult to describe the benefits of sexual satisfaction to physical and psychological health. It is however known that its deprivation for prolonged periods of time leads to psychological and emotional distress.
CONSUMMATION OF MARRIAGE:
Marriage is annulled when coitus is physically impossible and there is no hope for a medical or surgical solution. This may be due to anatomical or physiological anomalies in both the male and the female. With recent developments in surgery some of these may be correctable. Psychogenic factors may cause vaginismus or frigidity in female and impotence in males. Appropriate treatment may be undertaken to prevent marital annulment. In cases of male impotence a grace period of 1 year is allowed while treatment is being sought. After that the marriage has to be annulled because it can no longer fulfil the fundamental purpose of protecting chastity of both partners. The marriage is considered consummated when successful coitus is achieved at least once. Coital failure after that does not lead to automatic annulment of marriage. The marriage payment, mahr, is not due in marriages annulled before sexual consummation.
CONJUGAL RIGHTS:
Both husband and wife have rights to sexual satisfaction. The conjugal rights are enforceable by law. None of the spouses can refuse under reasonable conditions. The refusal of a wife is considered rebellion, nushuuz, and the law has prescribed remedial measures for it.
FREQUENCY:
Like all other human activities there should be a balance between too little and too much coitus. Too much indulgence could be harmful in both the physical and psychological dimensions. Too little could be similarly harmful. The law does not stipulate any particular frequency. Each couple should find out for themselves what frequency is sufficient to satisfy and protect, ihswaan, them from sexual corruption. Some jurists have argued that once every 4 days is the ideal based on the reasoning that a man with 4 wives can rotate among them in 4 days. Omar decreed that no soldier would be kept away from his wife for longer than 6 months, which perhaps sets the upper limit of sexual deprivation.
CONDITIONS IN WHICH COITUS IS FORBIDDEN:
There are a few conditions in which coitus is prohibited for health or religious reasons. Coitus with menstruating women is forbidden (2:222). The same applies to women in the period of post-natal or post-abortion bleeding, nifaas. Coitus is prohibited during the day for fasting persons but is allowed at night (2:187). It is prohibited at all times during the period of ihram in pilgrimage, hajj (2:197). Coitus is forbidden in the mosque (2:187). A divorced woman is required by law to stay in her former husband's home for 3 months. He is prohibited from having sexual relations with her during this time and if he does the divorce automatically lapses. There are disputes about the permissibility of coitus with a lactating woman, ghayla. The best opinion is that it is permissible. It is inconceivable that sexual relations could be stopped for the period of 2 years that the Qur'an recommends for breast-feeding.
ACTIONS PROHIBITED IN SEXUAL RITUAL IMPURITY, janabat:
After coitus and before ritual bath, ghusl, the following acts are forbidden: (a) reciting the Qur'an (KS p. 163), (b) prayer, salat, (c) circumbulating the kaaba, tawaaf.
ADAB OF SEXUAL CONDUCT:
Coitus is an act of love and not mere physical satisfaction. It should be approached with that end in mind. Foreplay is a sunnat and it allows both parties to be psychologically and physiologically prepared. It is preferable that there is desire in both parties. Preparation for coitus includes reciting the basmalat (KS p. 154) and a supplication, dua, (MB# 1854, KS p. 155). There is no control of the manner or postures of coitus provided it is vaginal (KS p. 154) and is natural. Coitus interruptus ('azl) is permitted (KS p. 154). It is considered offensive, makruh (KS p. 155). It cannot be done without the permission of the wife (KS p. 155). Anal intercourse is forbidden with both women ( ) and men (KS p. 155). Wudhu after copulation is recommended (Muslim #597, 598, 600, 601, 602, 603, 605). Wudhu is recommended between 2 copulations (Ibn al Qayim p.259). Bath (ghusl) after intercourse is obligatory (KS p. 411, Muslim #616, 618, 619, 622, 623). The mere contact of the male and female genitalia makes bathing obligatory (KS p. 411). Orgasm whether during coitus or in a dream, ihtilaam, necessitates bathing (). Bathing is necessary even if the sexual orgasm is experienced in a dream (KS 411; Muslim #607, 608, 609, 610, 613).
3.0 PREGNANCY, haml
A. DIAGNOSIS OF PREGNANCY
The Qur’an mentioned pregnancy, haml (p. 297 3:6, 3:35, 7:189, 13:8, 16:78, 19:22, 22:2, 22:5, 23:14, 31:14, 31:34, 39:6, 46:15, 53:32, 65:4, 65:6). The traditional diagnosis of pregnancy was based on amenorrhoea, signs and symptoms of pregnancy, and abdominal enlargement in the late stages. Earlier diagnosis of pregnancy based on hormonal and radiological procedures is now available. This earlier diagnosis cannot lead us to shortening the post-divorce period of waiting, iddat al talaaq. We know that the material reason, illat, for waiting three months is to ensure that the wife is not pregnant. We however do not know the wisdom, hikmat, behind the ordaining of iddat.
B. PERIOD OF GESTATION
Legal situations arise in which the court must reach a decision based on knowledge of the minimum and maximum periods of gestation. Bleeding or spotting in early pregnancy (KS 207: Darimi K1 B97, Muwatta K2 H101) that is thought to be an abortion or a menstruation can be the cause of the confusion in computing the period of gestation. The early jurists using medical knowledge available in their times had reached conclusions about the minimum and maximum durations of gestation. These need to be revised in view of modern medical knowledge and the availability of sophisticated diagnostic procedures.
C. PHYSICAL ACTIVITY IN PREGNANCY
PHYSICAL ACTS OF IBADAT
Salat: Standing up, qiyaam; bowing, rukuu; prostration, sujuud, and sitting down in salat may be difficult for a woman in advanced pregnancy. It may also be difficult for her to put her hands on her abdomen.
Siyaam: A pregnant woman may be excused from fasting. If the excuse is based on fear of nutritional deficiency in the mother or in both the mother and the fetus, the missed fasting must be made up. If the exemption is based on fear of harm to the fetus alone, expiation is by feeding the poor.
Hajj: the hustles of movement in hajj may be too strenuous for a pregnant woman
STRENOUS PHYSICAL WORK IN PREGNANCY
A woman in advanced pregnancy has limited ability to do physical work, at home or outside the home, and has to be excused
COITUS IN PREGNANCY
Sexual intercourse is physically cumbersome in advanced pregnancy. It may also introduce infections in the birth canal. In the rare instance of placenta previa it may provoke potentially fatal bleeding.
D. BREAST FEEDING
There is no ruling against breast-feeding in pregnancy. It is a medical necessity since breast milk is the best food for a baby.
E. LEGAL PROCEEDINGS IN PREGNANCY
DIVORCE
A pregnant woman can be divorced but cannot be forced out of her house until after delivery
PUNISHMENTS
Legal punishments, huduud, cannot be carried out in pregnancy until after delivery and suckling of the baby
4.0 DELIVERY, wadhau al haml
A. BIRTHING PROCESS
BIRTH IN THE QUR’AN
The Qur’an mentioned childbirth, wilaadat (p. 1318 3:36, 11:72, 19:15, 19:33, 22:3, 35:11, 41:47, 46:15, 58:2, 65:4, 65:6, 71:27, 90:3)
THE PHYSIOLOGY OF PARTURITION
Studies in sheep have shown that the mature fetus provides the initial stimulus for parturition by secreting cortisol, which acts on the placenta to decrease progesterone secretion, increase estrogen and prostaglandin secretion. This causes cervical ripening and results into parturition. These findings have not been confirmed in humans.
B. TAHARAT DURING LABOR and DELIVERY
Is the show of labor considered blood? Does it invalidate wudhu? Bleeding during delivery and wudhu
C. IBADAT DURING LABOR and DELIVERY
Salat: Salat is not physically possible in the advanced stages of labor and immediately after delivery
Siyaam: fasting in labor is not recommended.
Hajj: Physical activities of hajj are not recommended in advanced pregnancy
D. POST-PARTUM BLEEDING, nifaas
MINIMUM and MAXIMUM PERIODS OF POST-NATAL BLEEDING
PHYSICAL IBADAT
Salat: Women in post-natal bleeding are excused from salat like those in menstruation
Siyaam: Post-natal mothers are excused from fasting but they have to make up later
Hajj: The rules pertaining to menstruation apply to post-natal bleeding
Qur'an: touching the Qur’an is forbidden
COITUS
Sexual intercourse is forbidden
DIVORCE
Divorce of a woman in the post-partum period is prohibited
E. THE NEWBORN
CRYING OF THE NEWBORN
The books of sunnat have given reasons for the crying of the baby at birth (KS 575: Bukhari K65 S3 B2; Muslim K43 H148; Ahmad 2:233, 368). Every new born is touched by the shaitan, mass al shaitan 'inda al wilaadat (KS 575: Bukhari K60 B44; Bukhari K65 S3 B2; Muslim K43 H146-147; Ahmad 2:233, 274, 288, 292, 319, 368, 523).
RIGHTS OF THE FETUS
Right to life
Right of inheritance
RIGHTS OF THE NEW BORN
Choice of a good name
General health care and nutrition
RIGHTS OF THE MOTHER
Health care and nutrition
Shelter
Payment for breast-feeding if divorced
WHAT IS DONE FOR THE NEWBORN
Adhan and iqamat at birth
Naming, tasmiyat: choice of a good name
Circumcision, khitaan
Shaving the hair, halq al sha’r
'Aqiiqah:
5.0 BREAST-FEEDING, ridha’a
A. CONTROL OF LACTATION
Onset, continuation, and end of lactation are under endocrine & neural control, neuro-humoral. It can be affected by the psychological state of the mother. Drugs can also affect lactation so care must be taken in any prescriptions for the mother. Some drugs suppress lactation as a side effect. Some drugs may be taken with the deliberate purpose of suppressing lactation. Drugs given to the mother can be excreted in breast milk and can affect the baby.
B. PERIOD OF BREAST-FEEDING
The Qur'an set the statutory period of breast-feeding as 2 full years, muddat al ridha'a (p 511 2:233, 31:14, 46:15). No maximum period was set.
C. PAYMENT FOR BREAST FEEDING
The father has to give financial compensation to a divorced wife who is breast-feeding his child (p 511 65:6)
D. FOSTER BREAST FEEDING
LEGAL RELATIONS BASED ON BREAST-FEEDING
Breast-feeding is not merely nutrition. Unlike blood transfusion or organ donation, it involves a more intimate biological and psychological interaction between the infant and the lactating woman. Breast-feeding of a child not issued from the mother automatically creates a legal relation that in the regard of the Law is no different from that that of a son or a daughter. The relation encompasses the wet nurse, the children of the wet nurse, and the husband of the wet nurse. The conditions set by the Law for this relation to hold are: the wet nurse must be a female at least 9 years of age, the baby suckled must be less than 2 years old, suckling must be from the breast and not milk expressed in a container, and at least 5 separate breast feeding sessions must be held. The legal relationship thus established leads to marital restrictions between foster brothers and foster sisters (p 511 4:23). If there is doubt whether an infant breast-fed or not, we rule that it did not breast-feed because the maxim of the law is certainty cannot be voided by doubt, al yaqiin la yazuul bi al shakk. Doubts about breast-feeding could arise in situations in which the baby was out to the breast 5 times but it is not known whether he actually suckled or not.
MILK BANKS
On the basis of necessity, dharurat, the Law permits collecting milk from several lactating mothers in a milk bank and using it to feed premature babies or those who have no natural mothers. This does not create legal relations based on ridha’at because the babies did not feed from the breast directly. It is recommended that records be kept of names of donors to the bank and names of babies who fed from the bank.
E. ACITIVITIES DURING BREAST FEEDING
PHYSICAL ACTS OF IBADAT
Salat: a nursing mother is allowed to combine 2 prayers
Siyaam: A nursing mother may not fast and make up later
OTHER ACTIVITIES
Suckling while pregnant: Is allowed
Intercourse with suckling woman, al ghayla, is allowed
Work and maternity leave for lactating woman: New ijtihad is needed on the minimum period of maternal leave since the Qur’an sets a limit of 2 years.
DISCUSSIONS ON REPRODUCTION
MENSTRUATION
Marriage before menarche
Medical complications of coitus in menstruation
Hysterectomy before menarche
Ovariectomy before menarche
Teaching Qur’an while in menstruation
Physiological distress of menstruation
Psychological distress of menstruation
Reason for making up salat and not saum if missed during menstruation
Hormonal menstrual regulation
Criteria for decision that menstruation has stopped in order to bathe and pray
Physiological explanation of the manifestations of the pre-menstrual syndrome
Pre-menstrual syndrome and marital disputes
Pre-menstrual syndrome as legal defense in criminal acts
Salat with pre-menstrual syndrome
Saum with pre-menstrual syndrome
Menopausal mood and mental changes causing marital discord
Menopausal or post menopausal syndrome as legal defense in criminal cases
Artificial menopause, surgical or medical
Pros and cons of using estrogen replacement therapy
Legal rulings on menorrhaghia
Legal rulings on metrorrhaghia
Legal rulings on dysmenorrhoea
HUMAN SEXUALITY
Gender identity
Gender awareness
Legal rulings on trans-sexuality
Legal rulings on sexual abstinence, rahbaniyyat
Sexual attraction: visual, chemical, aural
Use of cosmetics to hide natural defects
Use of defects to enhance appearance
Rulings on the use of perfumes
Rulings on cosmetic surgery
Rulings on male circumcision
Rulings on female circumcision
Problems due to discord between biological and mental maturity
Teenage sexual abstinence
Penalty for non-coital adultery
Definition of female shyness in relation to sexual hygiene
Definition and rulings on awrat
Rulings on khalwat in the car, the office, by telephone, by internet
Rulings on mixing, ikhtilaat, at the work-place, public transportation, hospital, class room
Rulings on what constitutes tabarruj
Rulings on spouse withholding sexual priviledges
Rulings on maharim
CONTRACEPTION
Population control as national policy
Permissible contraception
Haram contraception
Rulings on male methods of contraception
Rulings on female methods of contraception
Disagreement between husband and wife on contraception
PREGNANCY
Legal rulings on the minimum and maximum durations of pregnancy
Determination of date of conception in disputes about parenthood
Determination of the date of conception in disputes about zina accusations
Salat and saum in first trimester pregnancy complications
Saum in early pregnancy
Hajj in late pregnancy
Salat and saum in post abortal period
Rights of the fetus to property and inheritance
Rights of the mother
Rulings about naming a newborn
Rulings about aqiiqat for the new born
BREAST FEEDING
Rulings on the period of lactation/breast feeding
Is refusal to breast feed a form of child abuse?
Rulings on payment for breast feeding
Salat for nursing mother
Saum for nursing mother