Applying Islamic Values to Standards of Care During Pregnancy and Beyond
Deena Kishawi, Brown University, Providence, RI, Darul Qasim College, Glendale Heights, IL; Akbar Ali, Endeavor Health, Evanston, IL, Darul Qasim College, Glendale Heights, IL; and Shaykh Mohammed Kholwadia, Darul Qasim College, Glendale Heights, IL
From a strictly medical perspective, pregnant women are considered a vulnerable patient population. This designation as ‘vulnerable’ is based on the risks associated with becoming pregnant and maintaining a healthy pregnancy. The nature of pregnancy and potential interventions during pregnancy are major reasons put forward by the medical community that increase morbidity and mortality in the pregnant population. The aim of this paper presentation is to propose approaches that mitigate the risks and harms of pregnancy by sharing holistic practices and universally beneficial civilizational values from the Islamic tradition.
We propose a two-pronged approach to mitigate the risks and harms associated with pregnancy. Firstly, we apply the Islamic civilization value of “Do No Harm and Do No Sin” to create testing strategies and to recommend alternative therapies that minimize harm. Secondly, we examine Muslim practices historically and globally that offer tremendous optimism and reassurance in facilitating a healthy disposition following a successful pregnancy. This two-pronged approach is intended to create a universal standard of care and to minimize unnecessary interventions or treatments that could cause future or potential harm.
Regarding testing strategies, applying ‘do no harm and do no sin’ would prioritize testing that is required for the acute well-being of the pregnant patient and the fetus. For example, Rh antigen testing, a blood test that provides critical information for the survival of subsequent pregnancies. In regions where healthcare is limited or access is hindered due to conflict or natural disaster, Rh status is often prioritized, preferably in early pregnancy to ensure that an Rh negative pregnant patient can receive an antibody infusion to be protected against the Rh +fetus in a timely fashion. Hence, the recommendation of a global standard for Rh testing in our estimation would be considered a dire necessity as opposed to testing for fetal chromosomal abnormalities.
Regarding alternative therapies, applying “Do No Harm and Do No Sin” would support the use of IV Iron infusions [in both iron-deficient pregnant populations and postpartum anemia due to blood loss] in lieu of blood transfusions. IV iron infusions have been shown to be effective in treating iron-deficiency anemia (IDA) and in the setting of postpartum blood loss. Implementing a proactive approach, in which pregnant women who have IDA are treated with IV iron infusions before delivery, would optimize the patient's hemoglobin concentration and prevent the need for blood transfusions postpartum. By doing this, we avoid potential transfusion reactions associated with blood products, minimize GI side effects related to oral iron formulations, and provide a sustainable longer-term solution that is generally favored among patients.
Maternal care in Western society, especially in the United States, has recently seen an increase in postpartum depression. Contributing factors include traumatic birth experiences, difficulty with breastfeeding, first experience of pregnancy and childbirth, and lack of community support. Muslim practices to support a healthy disposition following a successful pregnancy are founded on guidance from the Quran that states the following: “We have commanded people to honor their parents. Their mothers bore them in hardship and delivered them in hardship. Their period of bearing and weaning is thirty months.” Surah Al-Ahqaf verse 15.
A major factor associated with maternal depression is the inability or difficulty with breastfeeding. Islam endorsed the cultural tradition of wet nursing as the Prophet Muhammad ﷺ himself was cared for and raised by a wet nurse, Halima Sa’diyya, with whom he maintained a lifelong relationship. We propose bringing back the local/communal practice of wet nursing to alleviate some of the stressors associated with breastfeeding. Traditionally a wet nurse is someone known in the community who is successfully breastfeeding her own child and has adequate milk production that is sufficient for another newborn. Typically, the wet nurse is compensated for her services and expertise is shared with other members of the community. This kind of community resource can reduce postpartum breastfeeding stress while also ensuring that each newborn receives adequate nutrition. This also creates a community for postpartum mothers who share their experiences and challenges with their own newborn children.
By applying Islamic civilizational values and Muslim practices, we propose a holistic approach to mitigate the risks and harms associated with pregnancy. This two-pronged approach is intended to create a universal standard of care, and to minimize unnecessary interventions or treatments that could cause future or potential harm. By prioritizing the health of the pregnant mother during and after pregnancy, we hope to facilitate her ability to provide ‘Aafiyah (comfort and well-being) for her newborn.
We propose a two-pronged approach to mitigate the risks and harms associated with pregnancy. Firstly, we apply the Islamic civilization value of “Do No Harm and Do No Sin” to create testing strategies and to recommend alternative therapies that minimize harm. Secondly, we examine Muslim practices historically and globally that offer tremendous optimism and reassurance in facilitating a healthy disposition following a successful pregnancy. This two-pronged approach is intended to create a universal standard of care and to minimize unnecessary interventions or treatments that could cause future or potential harm.
Regarding testing strategies, applying ‘do no harm and do no sin’ would prioritize testing that is required for the acute well-being of the pregnant patient and the fetus. For example, Rh antigen testing, a blood test that provides critical information for the survival of subsequent pregnancies. In regions where healthcare is limited or access is hindered due to conflict or natural disaster, Rh status is often prioritized, preferably in early pregnancy to ensure that an Rh negative pregnant patient can receive an antibody infusion to be protected against the Rh +fetus in a timely fashion. Hence, the recommendation of a global standard for Rh testing in our estimation would be considered a dire necessity as opposed to testing for fetal chromosomal abnormalities.
Regarding alternative therapies, applying “Do No Harm and Do No Sin” would support the use of IV Iron infusions [in both iron-deficient pregnant populations and postpartum anemia due to blood loss] in lieu of blood transfusions. IV iron infusions have been shown to be effective in treating iron-deficiency anemia (IDA) and in the setting of postpartum blood loss. Implementing a proactive approach, in which pregnant women who have IDA are treated with IV iron infusions before delivery, would optimize the patient's hemoglobin concentration and prevent the need for blood transfusions postpartum. By doing this, we avoid potential transfusion reactions associated with blood products, minimize GI side effects related to oral iron formulations, and provide a sustainable longer-term solution that is generally favored among patients.
Maternal care in Western society, especially in the United States, has recently seen an increase in postpartum depression. Contributing factors include traumatic birth experiences, difficulty with breastfeeding, first experience of pregnancy and childbirth, and lack of community support. Muslim practices to support a healthy disposition following a successful pregnancy are founded on guidance from the Quran that states the following: “We have commanded people to honor their parents. Their mothers bore them in hardship and delivered them in hardship. Their period of bearing and weaning is thirty months.” Surah Al-Ahqaf verse 15.
A major factor associated with maternal depression is the inability or difficulty with breastfeeding. Islam endorsed the cultural tradition of wet nursing as the Prophet Muhammad ﷺ himself was cared for and raised by a wet nurse, Halima Sa’diyya, with whom he maintained a lifelong relationship. We propose bringing back the local/communal practice of wet nursing to alleviate some of the stressors associated with breastfeeding. Traditionally a wet nurse is someone known in the community who is successfully breastfeeding her own child and has adequate milk production that is sufficient for another newborn. Typically, the wet nurse is compensated for her services and expertise is shared with other members of the community. This kind of community resource can reduce postpartum breastfeeding stress while also ensuring that each newborn receives adequate nutrition. This also creates a community for postpartum mothers who share their experiences and challenges with their own newborn children.
By applying Islamic civilizational values and Muslim practices, we propose a holistic approach to mitigate the risks and harms associated with pregnancy. This two-pronged approach is intended to create a universal standard of care, and to minimize unnecessary interventions or treatments that could cause future or potential harm. By prioritizing the health of the pregnant mother during and after pregnancy, we hope to facilitate her ability to provide ‘Aafiyah (comfort and well-being) for her newborn.