Many pregnant women find themselves in a terrible situation when they learn that the child they are carrying is deformed. What should the mother’s position be? Should she abort the fetus in order to spare future pain and complications? Or should she accept the pregnancy and take care of the child, hoping that somehow the child will be able to overcome itsdeformities and handicaps? Women of course have differing opinions.What is important is the Shariah and the medical positions. Essentially,is it possible to detect a deformed fetus during the first 120 days ofpregnancy when the Shariah permits abortion? In this investigation,Sayidaty met a number of women who considered abortion after learning their fetuses were deformed and others who insisted on carrying the child to term, even though they knew it would require life-long special care.
What Do Women Say?
Umm Saleh has a BA and though she could easily find work, she has chosen to devote her time to her home and her children. She has two boys and two girls; her fifth child, Al-Anoud, was born with Down’s syndrome.
Umm Saleh said: “I had German measles early in my pregnancy and my doctor told me the child would be mentally retarded. I refused an abortion because I feared God and His punishment. She was beautiful at birth but her features gradually became those of Down’s syndrome. My doctor told me that she would need special treatment and so I began reading everything I could about children with this disability. When Al-Anoud reached school age, I sent her to a special school for handicapped children and she was soon able to take care of herself in terms of daily matters. There were of course health problems and I found that my social life was more and more restricted because of her. I praise God that I have her and don’t regret my decision at all. She is now 14 and though she needs special care, I am very attached to her and happy that I have devoted my life to caring for her.”
Amal is a 28-year-old physiotherapist. When she was pregnant with her first child, there was no evidence of any abnormality. She said: “My pregnancy was a peaceful one with nothing unusual or disturbing. Hours after birth, however, the doctor told that there was a deformity in the baby’s spine which would affect its growth and ability to move. What was even harder for me to bear was the doctor’s telling me that if the deformity had been detected early enough, it could have been remedied with surgery on the fetus in the womb.”
Would she have considered abortion if she had known about the deformity or if the fetal surgery had been unsuccessful? “Of course, I would have,” Amal said. “It is not right to sentence a child to a life-long handicap which makes normal life impossible. My poor son cannot walk and his health is deteriorating. In addition to everything else, he has kidney failure; I feel so helpless and frustrated because I can do nothing. Though I do not protest against the will of God, I blame myself since if I had known, I might have spared him all the pain he is now enduring.”
Ferial is a 39-year-old housewife who was in her 10th pregnancy when her doctor told her that her baby was deformed and would be partially paralyzed. She was told, however, that the handicap would not affect the baby’s mental abilities but it would affect the child’s ability to move. “Even though it was my 10th pregnancy, I clung to my baby and refused to consider abortion. When my family learned of the problem, they tried to convince me that there was no point in keeping a child that would suffer all its life and cause me to suffer as well. I refused to accept their arguments and continued with nonstop tears until the child was born. I lived between hope in God and fear that the child would die. Now, however, more than 14 years have passed and even though my son needs special care and is in a wheelchair, he’s the smartest of my children and the most compassionate. He has a wonderful sense of humor, is cheerful and is the joy of the household. I thank God that I stood my ground and kept him because I believe it was the right choice. I’m glad I didn’t listen to those around me who’d wanted me to have an abortion.”
Umm Abdullah is a 30-year-old government employee. Her doctor told her that because of a multitude of fetal deformities, she should terminate her pregnancy. “It was my first pregnancy, only a few months after my marriage. My doctor told me that my fetus had a number of deformities all over its body — in its heart, its brain and its spine. He asked me to consult other doctors and get their consent to an abortion but when I consulted them, none would advise me. In the end, I got an official report but still had to get approval from a Shariah committee. Finally, after two and a half months, I got its permission.”
About aborting her fetus, Umm Abdullah said: “I was agreeable to the idea of an abortion because it would have been impossible for the baby to be born alive. If it had had only simple deformities, I would have carried on and gone through anything to help it and take care of it.”
Abeer Manabari, manager of the Anti-Inherited Blood Diseases Project in the Makkah Region, said: “My problem began 15 years ago when Muhammad, my second child, was born. My first child, a daughter, is normal. When Muhammad was six months old, his skin was yellow and he vomited all the time as well as exhibiting other abnormal symptoms. When we took him to the doctor, lab and blood tests were done; my husband and I were also tested. The doctor told us that Muhammad had thalassemia which is an inherited disease. The doctor said that he would have to be admitted to hospital every weeks for a blood transfusion. This was a terrible shock to my husband and me since we are not related. It had never occurred to us that our son had a disease. For five years I was completely occupied with specialists and doctors talking about my son’s disease who said there was nothing that could be done. We turned to other sources, and even went to conferences in other countries which helped us in dealing with the problem. When I went to London, I had a lot of tests done to find out the likelihood of my bearing healthy children. And then despite my fears, I got pregnant. I was terrified until the UK doctors took a tissue sample from the fetus and confirmed that it was normal and healthy.”
Was she prepared to abort the fetus if it had had the same problem as Muhammad’s? “Of course, I would have — especially since one of the doctors had provided me with a ‘fatwa’ that permits abortion if it’s proven that the fetus is dangerously deformed during the first four months of pregnancy and there is no medical remedy.”
Hind, a bank employee, said she learned about her fetus being deformed during the first month of pregnancy. “I went to the doctor for some tests that included X-rays. Because of the X-rays, I learned that I was pregnant; the doctor then ran some other tests because he said the X-rays could cause fetal deformity. He said he would write a report saying that the deformity was due to the X-rays. I consented with my husband’s full support. All of this saddened me and led to severe weightloss. Despite family pressure, I aborted the fetus. When I thought of the suffering the baby would endure, I didn’t have the heart to bear it. Suppose the child’s father or I died? Who would then take care of our child?”
Wafaa, a housewife whose fourth child was born with Down’s syndrome, said: “Even if I’d known beforehand that my child would be born with this problem, I wouldn’t have agreed to an abortion because this is the will of God. We must accept it and be at peace with it. When I look at my daughter, I feel gratitude and joy because of all that she has done in spite of the medical diagnoses and prognoses.”
Medical Opinion
According to Dr. Abdul Karim Qarmali, a consultant gynecologist, “there are fetal deformities that last a lifetime and others that can be treated.”
Does the mother make the decision easily whether to abort a deformed fetus? Dr. Qarmali said: “Some women are quick to make the decision when they learn the fetus is deformed. Many hesitate because they want to make sure that the diagnosis is accurate and that they would be unable to live with the child’s problems. Of course, there are those who want to keep the baby even if it is deformed because they believe it is the will of God.”
Shariah law is clear about abortion. Once the fetus has a soul, abortion is not allowed. What about if the deformity is only detected after a few months of pregnancy? Dr. Qarmali said: “We do ignore the religious opinions. Most scholars prohibit abortion after 40 days; the more advanced the pregnancy the more prohibited the abortion. The upper limit for abortion is 120 days (19 weeks) after conception. From a medical point of view, we can diagnose a deformity from the 10th to the 16th week if we use very sophisticated technology. I want to emphasize that the diagnosis must be very precise so that it doesn’t backfire on the mother if she terminates the pregnancy without confirming the diagnosis.”
Dr. Safia Sultan, head of the Neonatal Department at the National Guard Hospital in Riyadh, said: “We’ve got more fetal deformities than any other country in the world and the reason is husbands and wives who were related. Foreign statistics for deformities are one in every 50,000 births; here it is one every 5,000. There are diseases and deformities we don’t know the reason for except that they are possibly due to marriage between relatives.”
How will she tell a woman that she’s carrying a deformed fetus? “We’ve been trained to do so. Unfortunately, some women don’t trust modern technology and so begin running to other hospitals in search of information that they want. There are others who accept the situation and cause us no problem. Of course, there are religious rulings we have to consider; abortions are not allowed unless the mother’s life is in danger and even then, it must take place within the first 120 days of pregnancy.”
What advice will she give a woman who wants to have a normal baby? “I would advise her to take care of herself both physically and in terms of her diet. If she has diabetes or blood pressure problems, we must monitor the situation closely. If there are diseases which run in her family, she should avoid marrying a relative.”
Dr. Maher Al-Bughdadi, a consultant psychiatrist, said: “I consider cases in which a mother keeps a deformed fetus to be rare, especially now with health awareness available in Arab countries. There are statistics for the number of mothers who did not terminate their pregnancy even after learning that the baby would be deformed. Women have to choose what to do after finding out the health of their unborn child. The development of medical equipment along with early discovery of fetal deformity enables the woman to make the decision earlier so there are no unexpected and unpleasant surprises. Some women, however, are prone to feelings of guilt and most are emotionally attached to their unborn child.”
Religious Opinion
Sayidaty then spoke to Islamic scholar Sheikh Muhammad ibn Saad Al-Majed. They specifically asked him if a woman is told of a fetal deformity, does she have the right to abort?
The sheikh said: “Whether the baby is deformed or not, it is not permissible to abort it if God has already given it a soul unless there is clear danger to the mother’s life. And this is something that scholars have discussed and agreed upon. If the abortion is because the baby is deformed or illegitimate or any reason that would compel a woman to consider abortion, the only condition would be that it be done before the fetus has a soul. That is the only condition.”
What if the mother decides to keep the baby, knowing that it is severely deformed and that it will live in a state of constant suffering or that it will die immediately after delivery or birth?
The sheikh said: “This would be preferable. She would be doing a good deed for which God would reward her, whether it is for her full-term pregnancy or because of her endurance and her care.”
What advice would he give a mother facing such a problem? “First she should know that it is the will of God. A person with faith should be aware that nothing goes unrewarded or unaccounted for in caring for such a child and bringing it up. Everything happens with the knowledge of God and there is always wisdom in everything created.”