Question

My wife is expecting our 3rd child mashallah. Our other 2 children were born via an emergency c-section therefore she is planning on having a further c section this time as she is unable to deliver naturally.l medically.
At a hospital appointment the consultant mentioned to that each time you have a c section the risk increases for mother.
He asked how many children we wanted and we said 3. He then advised considering have permanent contraception. I am happy for my wife to have this done but wanted to know islamically if this is allowed. Thank you

Answer

Doctors will usually discourage having a child after the third and fourth caesarean section. The advice pack prepared by The Royal College of Obstetricians and Gynaecologists states:

VBAC (vaginal birth after caesarean) is normally an option for most women but it is not advisable when you have had three or more previous caesarean deliveries. [1]

They have also identified the following disadvantages to having a repeat caesarean section:

A repeat caesarean section usually takes longer than the first operation because of scar tissue. Scar tissue may also make the operation more difficult and can result in damage to your bowel or bladder. You can get a wound infection that can take several weeks to heal.  You may need a blood transfusion. You have a higher risk of developing a blood clot (thrombosis) in the legs (deep vein thrombosis) or lungs (pulmonary embolism).

Islam permits the use of temporary forms of contraception where both parties consent. Permanent contraception is not permissible except in cases of necessity such as where the risk to the mother’s life is highly likely. Having a fourth C-section in normal circumstances does not necessarily reach that level of risk. In addition to this, temporary forms of contraception are available and if used properly are also quite effective. For these reasons it would not be permissible to undergo permanent contraception based on your current situation.

[1] https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-birth-options-after-previous-caesarean-section.pdf

Answered by:
Ifta Research Fellow

Checked & Approved by:
Mufti Abdul Rahman Mangera
Mufti Zubair Patel