My intent of this article is to give a brief outline of pregnancy, and related issues, in the Quran rather than a detailed explanation of embryology in the Qur’an. At this point I will not discuss ahadith literature at this point, which is an extremely large task in its own right. And I will attempt to spread light on the Quranic explanation of lineage. This being important in the discussion of medically assisted reproduction.

SPERM

Nutfa literally means a drop of fluid, it has two distinct meanings in the Qur’an.

1. the sperm

2. the sperm and egg intermingled (nuftatul amshaj)

Mani, which means sperm, was used in the Qur’an on three occasions, twice in conjunction with nutfa.

Was he not a sperm drop cast forth (ejaculated)? 75:37

from a drop of sperm, when it was cast forth (ejaculated) 53:46

Here Allah clearly establishes the ejaculated sperm as a component in creating a child. We also learn that it is a drop of sperm that implants into the egg (53:46). About 0.5 sperm constitute the total amount in semen ejaculated. It is not all of the fluid that is used to make a baby, clearly pointed out in this verse. We also see this in the following aya:

Than He made his progeny from a quintessence of despised liquid 32:8

We also learn that it is the sperm in which determines the gender of a child.

Allah fashioned both male and female form a drop of sperm, when it was cast forth (ejaculated) 53:46

The X and the Y chromosomes are held in the sperm, the egg carries only the X chromosome. If the sperm carrying an X chromosome fertilizes the egg one will have a female child, while a Y chromosome will bring forth a male child.

EGGS

The Qur’an never specifically mentions the eggs, what is addressed is the mixed nutfah of the male and female known as nuftatul amshaj

Verily, We have created man from mixed nutfah (nutfatul amshaj) in order to try him, so We made him hearer and seer. 76:2

WOMB

The word used for womb is Rahim, which comes from the same root as Raheem. It is referred to in the Qur’an on several occasions.

As a form of binding lineage:

Neither your womb relations nor your children shall profit you 60:3

Those who are bound by the womb are nearer to one another in the book 33:6 and 8:75

And break your bonds of the womb 47:22

This is very important when addressing medically assisted reproduction. The bonds of the womb are also seen as a binding lineage that must be honored. On this basis one can see why surrogate mothers are not permissible in Islam, for if we are to ignore this line of lineage we are to ignore what is clearly laid down by Allah.

Cycles of the womb:

Allah knows what any female bears. He knows well to what extent the wombs may increase and to what extent they may increase. To Him everything is well measured and balanced 13:8

A woman’s womb goes through several changes that make it increase and decrease during the month. At the beginning of a cycle the woman’s uterine lining is about 0.5 mm thick. During the month due to estrogen the endometrium grows and proliferates, which causes the uterus to increase. Than under the effect of progesterone there is an increase growth and coiling of arteries for the increased blood supply needed for implantation. The thickness of the endometrium reaches 7mm thick at the end of this stage. Unless pregnancy occurs the uterine lining will shed and the process will start all over again.

If there is implantation during a normal pregnancy the uterus will grow to be about 400 more times than what how started. Normally a uterus is about 50 gm during pregnancy it can grow to 100 gm and this is not including multiples. After delivery the uterus changes to the normal size in about six weeks.

Lodging:

The womb is also the place of lodging for the growing fetus. There are several interesting factors mentioned in the Qur’an about this lodging.

Thereafter We made him as a Nutfah in a qaraar makeyn 23:13

Qaraar in this instance indicates a lodging, fixed place, receptacle. Makeyn indicates sure, firm, secure. So we can understand this as a secure fixed place, or a secure lodging. This is mentioned before the following aya

Then We made the Nutfah into a ‘alaqah, then We made the ‘alaqah into a modgha, then We made the modgha into bones with flesh and then We brought it forth as another creation. So blessed be Allah, the Best of Creators 23:14

From this we learn that the Nutfah, which can be understood from the verses as the mixed male and female fluids, is placed into a secure fixed place and than further developed. During the early stages of pregnancy the fetus is in a position of the womb which it is secure and protected. I found this out when I took a fall in the early weeks of my pregnancy. When I called my doctor out of concern for the baby he said not to worry the place in which the baby is at such an early point it would take a huge blow in order to do any damage.

Three Veils of darkness:

Allah Created you in the womb of your mothers, one act of creation after another, in three veils of darkness 39:6

The three veils of darkness are understood as the abdominal wall, the uterine wall, and the membranes in which the uterus is enclosed. Interestingly enough each layer is itself made up of three layers. The abdominal wall is made up of three muscle layers, the external oblique sheet, the internal obblique muscle, and the transversus muscle. The uterus is made up of the epimetrium (which covers the womb) the myometerium (the muscle layer of the womb) and the endometerium (the inner layer). The embryonic sac is made up of three membranes, the amnion, the chorion and the decidua.

EMBRYONIC STAGES

There are several embryonic stages which are mentioned in the Qur’an.

Then We made the Nutfah into a ‘alaqah, then We made the ‘alaqah into a modgha, then We made the modgha into bones with flesh and then We brought it forth as another creation. So blessed be Allah, the Best of Creators 23:14

We have created you from dust then from a nutfah, then from a ‘alaqah, then a modgha, some formed and some unformed that We may make it clear to you. 22:5

‘alaqah literally means something that clings or attaches to something else. It can also be used to describe a leech that clings to the skin and sucks the blood. As well as a blood clot, or congealed blood. This last definition has been given in most translations but is a poor choice of words.

In the stage of the ‘alaqah the fetus clings and attaches itself to the uterine wall. It has a leech like quality that has been explained by many in these Qur’an ayat.

Modgha means a chewed lump, something that has been masticated which is an amazing way to describe this stage of formation. This is what the fetus tends to look at in the early stages of pregnancy.

In the above verse we see that some of the Modgha do not become formed, this is in reference to miscarriage. Many women can actually be pregnant in these early weeks and not know they miscarried, just notice a heavier flow of blood at their menstrual cycle time.

Forming bones than clothing them with flesh is another stage that a fetus goes through which is described in Qur’an. Than the formation into another creation, this has been understood by many scholars to be the time in which the soul is inspired.

The gestation period, according to the Qur’an can be six months.

And We have enjoined on Man to be dutiful and kind to his parents. His mother bears him with hardship and she brings him forth with hardship, and the bearing of him, and weaning of him is thirty months 46:15

We know from another aya in the Qur’an that the breast feeding continues for up to two years

Mothers shall suckle their children two years completely 2:233

At this point in medical abilities on average the earliest a child can be born and live is in the six month period. Before the sixth month period it is extremely rare that a baby is born and survives, even with all of the medical advancement. For the child is just not capable of living outside of the womb.

BURDEN OF PREGNANCY

In the Qur’an a pregnant woman is literally referred to as one with a burden, dhat haml.

and every pregnant woman (dhat haml) will drop her burden 22:2

And for those who have a burden (pregnant) their term is when they bring forth their burden 65:4

If they have a burden (pregnant) then spend on them until they bring forth their burden 65:6

Yes, pregnancy is a beautiful thing. The bringing of forth life in ones womb is both spiritual and emotional. A mother having such a connection with their unborn is a fascinating event. But let us face it, this is also a time of frequent urination, backache, leg cramps, bleeding gums, hair loss, hormonal overloads, not so nice kicking from the inside out, tender breasts, groin pain, and a slew of everyday complaints.

Pregnancy is also a risk to the health of the mother, ranging from high blood pleasure, low blood pressure, gestational diabetes, forms of cancer, potential blood clotting problems and a slew of other real medical dangers. Pregnancy itself is a burden for the woman, not to mention the burdens of delivery.

These associated risks of pregnancy should be taken into consideration when we deal with the issue of child spacing. If the mother has not had enough time to allow her body to heal, get back in shape and prepare for another pregnancy it can be devastating to both mother and child. While there is no set limit on when to have a child after giving birth, we must use common sense. And we must also not ignore the issue that majority of Muslim women do not have proper diets, access to adequate medical care, or proper health to begin with in order to have pregnancy after pregnancy with no break in-between. So when we address issues related to family planning we must move past our personal experiences and think on the level of Muslim society as a whole.

BREASTFEEDING

The mothers shall suckle their children for two years completely for those who desire to complete the term of suckling, but the father of the child shall bear the cost of the mothers food and clothing on a reasonable basis… if they both decide on weaning by mutual consent there is no sin on them. And if you decide on a foster mother to suckle your children there is no sin on you provided you pay what you agreed on a reasonable basis 2:233

There are many benefits for both mother and child when a woman breast-feeds. Breast milk is perfectly designed for infants in both nutrients as well as digestion. Breast fed babies have fewer colds, ear infections, and less allergic reactions than formula fed infants. The mother benefits with weight loss, bringing the uterus back in shape, lower risk of breast cancer and may aid in non-ovulation, not to mention the economic benefits.

In Islam the maximum allowed time for breast-feeding is two full years. After this a baby should be weaned and left to feed as other children. The father shall bear the burden of supporting the breast-feeding mother, but if they so choose to wean there is no harm in doing so. One can also decide to have a wet nurse but this is not always practical today. The next best choice would be formula.

Milk banks have been under discussion ofMuslim scholars for quite some time and there tends to be no agreement. It would be up to the couple to choose what they understand to be Islamically and medically best for their child.

The setting up of banks of mixed human milk is to be discouraged.

If medical need calls for them, banks of human milk may be set up

for premature babies. A group of participants believe, on the basis

of the opinion of the majority of fiqh scholars, that the collection of

milk should be . done in a way that guarantees the identification of

each donor and each baby receiver. The nursing should be written

down in records that are kept, and everyone involved should be

notified to avoid the marriage of persons who have a milk

relationship entailing the prohibition of their marriage.

Others, however, believe there is no need to identify the donors

and, receivers, on the basis of the opinion of AI-Laith Ibn Sa’d and

the scholars of AI-Zhahiriyah School and their followers, who believe

that milk relationships result only when a baby sucks the breast of a milk mother .

While many assume that breast-feeding is one of the easiest most natural things to do, it does comes with it’s own difficulties for both mother and child. One issue that some infertile couples will face is the lack of milk supply. Try as a woman might she just might not produce enough milk. While many try to downplay the instances of this happening it is a very real event. Many women who don’t produce enough milk, any milk, or suddenly stop lactating are made to feel insecure, crazy, or incompetent in some way. All the while ignoring that infertile women may just endure more problems due to hormonal fluctuations that other women may just not face, such as low thyroid levels.

There are some things that can help aid in milk production. One is to feed more, or express milk in-between feedings. Since lactation is generally a supply and demand issue, it is hoped that the more of a demand the more milk produced. This can be done by hand expressing milk or by pumping the milk. But make sure you use proper storage methods if you’re going to save the milk.

Fenugreek is an herbal remedy that many women take which helps increase milk production usually within 72 hours. Be for warned that you have to take high doses and it leaves you smelling like Sunday morning pancakes. Yes one major draw back is the maple syrup odor that emits from your body. The herb will also increase other fluids in your body, like sweat so that fresh scent of maple syrup will linger in your clothes and anywhere you sit.

Other herbs such as Blessed Thistle, Fennel Seed, and Brewers Yeast are also thought to help in milk production.

Taking care of yourself is also very important. Proper nutrition, enough water as well as keeping the stress level down. Yes your stress level can interfere with the hormone prolactin that aids in milk production.

Domperidone is a drug that is used for disorders in the gastrointestinal tract one of the side affects is the increase of the hormone prolactin, which is a component in milk production. It is not suggested to try this method first, in fact other ways should be tried before resorting to this medication. The drug is taken four times a day, generally for about two weeks. Many women notice an increase in supply within a few days. But if there is no increase within two weeks the drug is generally discontinued.

If nothing works, and yes that happens sometimes, and you still have a low milk supply don’t give up nursing altogether. Suckling the baby with the little that you have can be beneficial to both mother and child, there is no way to replace that bonding time. And many children find most comfort at the breast of their mothers. So even if it is just an ounce that the baby is getting from the mother each time he/she suckles is better than nothing.

Islam Views on Medical Issues