Q. Cesarean section, is it allowed or not? I am in my 40’s, my husband has no opinion regarding me having a cs. My friends feel that due to my age having it would be best for my health. Can you help with a religious ruling.

A. Cesarean Sections (cs) have become popular among Muslim woman in western and Islamic oriented countries, as a result of western influence regarding the birth-giving process. Sometimes, the decision for a cs is due to employment issues, liberal thought, anxiety,  ‘woman peer  pressure,’ the fear of natural birth, maintaining of the body in a certain way, etc. Some of these excuses have little to no validity in Islam. Thus, hereunder, we would discuss the conditions under which a woman can take part in cs, and under what conditions it would be best to abstain from having a cs.

Cesarean Section should preferably be performed with the recommendation of a pious Muslim doctor (preferably female, since they are prevalent and possibly more knowledgeable about a woman’s body than that of a male doctor.)  Islam sanctions the natural birth process as its first choice. The natural process, despite its anguish and pain wipes away believers’ sins and attains her higher rank before Allah (The Greatest).  It also creates a greater bond between a mother and child, due to the sacrifice a mother undergoes as a result of the natural birth process. Although a cesarean section may also be painful, if chosen out of a personal desire or a fad among working class mommies, then such pain in Islam is viewed as a voluntary request of pain – something Islam prohibits. Piety is never attained by self-infliction of pain.

CS must exist as an exception and not a rule.  Woman must also be reminded that once a CS has been performed, the chances of her having another CS increases to an average of 70%. Thus, the decision to have a cs without a valid reason, makes a woman susceptible to 2nd and later a 3rd cesarean section. Also, having a CS without a necessitating cause also limits the maximum amount of children the family can have, for it has been accurately stated that woman having a cs limit the amount of children to an average of three. To intentionally limit oneself without any valid reason would be a violation of the Hadith that stresses the importance of not limiting the amount of children one can have.  As mentioned in Abu Dawood:

Sayidinah Ma’qal ibn Yasar narrated that a man came to the Rasulullah (Sallallaahu alayhi wa sallam) and said: I have found a woman of rank and beauty, but she does not give birth to children. Should I marry her? He said: No. He came again to Rasulullah (Sallallaahu alayhi wa sallam), but Rasulullah Sallallaahu alayhi wa sallam prohibited him (again). He came to him (for a) third time, and he (Sallallaahu alayhi wa sallam) said: Marry women who are affectionate and fertile, for I shall outnumber the peoples by you.

Book 11, Number 2045.

By contrast, if there exists valid reasons such as hemorrhaging for the woman, or issues limiting a child’s oxygen as a result of natural birth, etc. then to save the mother’s and or child’s life, to commit towards a CS would become not only Islamically lawful and but highly  preferred. .

Should a husband insist on his wife having a CS, so as to ‘dislike intensely’ the change in the shape of her body which may take place after a natural child birth and the husband feels that a regular birth would minimize the couple from attaining greater pleasure in adult functions; and the wife also fears infidelity on his part, or he threatens it, then common sense should be smacked into such a male. Should he still refuse the natural process, then she may have a CS so as to prevent chaos in the marriage and family life.

As can be noted, the decision of having a cs should be made preferably in conjunction with a pious Muslim doctor and a truly religious scholar. CS must be done out of a genuine need, and prove that it is to safeguard lives or function to eliminate any greater harm.  Should time not permit for such a time consuming and evaluative process due to an emergency situation, then the doctor must be listened to, in hopes that his/her decision is based on the health of the mother and child, and a decision that is not based on seeking primarily a greater monetary gain.

Allah certainly knows best.