Answered by : Mufti Muhammad ibn Adam
Question : Permanent Contraception (Female Sterlisation) – Does Intention affect Permissibility?
Answer : Under normal circumstances, female sterilization is considered to be absolutely and decidedly prohibited (haram) in Shari’ah. The irreversible nature associated with both the male and female sterilizations clearly contradicts one of the primary purposes (maqasid) of marriage which is to have children, as mentioned by Imam Abu Hamid al-Ghazali in his Ihya’ Ulum al-Din.
Furthermore, sterilization is a form of mutilation of one’s body (muthla), which has been clearly forbidden in the Shari’ah. Allah Most High mentions in al-Nisa’ the words of Satan, when he said:
“I will mislead them, and I will create in them false desires; I will order them to slit the ears of cattle and to deface the (fair) nature created by Allah.”
However, in cases of absolute necessity, sterilization does become permitted. The well-known principle of Islamic jurisprudence based on the guidelines of the Qur’an and Sunna states: “Necessities make prohibitions lawful.” (Ibn Nujaym, Al-Ashbah wa al-Naza’ir 85)
Cases of absolute necessity include a woman’s life or her permanent health being severely threatened by pregnancy, or her facing the risk of losing her life with additional births after having gone through Caesarean operations on previous occasions. As such, if unbiased and professional medical advice is taken, and one comes to the conclusion that the life or permanent health of a woman would be seriously affected by pregnancy and that there is no other cure for her illness, only then would female sterilization be permitted.
You state that the woman in question has a serious congenital heart condition and as such her becoming pregnant might be risky. In light of the above explanation, she will need to obtain professional medical advice ideally from an experienced and upright Muslim doctor (who knows the severity of the prohibition of sterilization in Islam) and then act accordingly. If the medical expert feels that pregnancy is a severe risk to her life or permanent health, then she may undergo sterilization.
The other reasons outlined in your question do not justify sterilization. In fact, some – such as seeing children as a financial burden thus fearing poverty and thinking that the world was already burdened with enough people – are in direct conflict with the teachings of Islam. Even reversible contraception is not permitted due to “such” reasons and intentions in mind.
As for the doctor and medical practitioner, if sterilization is justified (in light of the above-mentioned explanation), then it is permitted to carry out the operation on the patient. If, however, it is not Islamically justified, such as when there is no absolute necessity, or when alternatives are available, then it is not permitted for the Muslim doctor to perform the operation, since this would be held as assisting another in a sinful act.
I hope the above answers all your questions.
And Allah knows best
Muhammad ibn Adam
Darul Iftaa
Leicester , UK