Islamic marriage advice and family advice

Is Hysterectomy Permissible In This Case?

Say: Shall I give you glad tidings of things Far better than those? For the righteous are Gardens in nearness to their Lord, with rivers flowing beneath; therein is their eternal home; with companions pure (and holy); and the good pleasure of Allah. For in Allah's sight are (all) His servants"

Say: Shall I give you glad tidings of things Far better than those? For the righteous are Gardens in nearness to their Lord, with rivers flowing beneath; therein is their eternal home; with companions pure (and holy); and the good pleasure of Allah. For in Allah's sight are (all) His servants"

 

Assalamualaikum

I'm seeking answers for these 2 questions on this website. I hope I get them.

A very pious lady lives in my neighbourhood. I feel great reverence for her, especially when she wheels out her daughter out in the evening for her recreation. We often exchange greetings and smiles but I could never bring myself to ask her about the details of her daughter's condition. Her face is childlike or should I say like an infant's. She smiles all the time and there is a bib fastened around her neck. Her hands and feet are both twisted and she squeals with joy unexpectedly.. Her mother once told my mum that she is 24. A lot of women have advised the lady to get her daughter's hysterectomy done because she once broke down while explaining how hard it is for her to take care of this daughter - since there is no hope regarding her marriage or anything as such. But the lady refused saying it would be sinful, while she continues to take care of her menstrual mess every month (not to forget other daily changing and cleansing routines). I know this pious lady shall win in the race to jannah and I pray that Allah gives her jannatul firdaus. Even a sinner like me dreams to be elevated on that day and I dare to hope for it since Allah hasn't lost it in me.

My 2 questions are:
1) is the removal of uterus permissible in Islam for such people?
2)Jannatul firdaus is for prophets, martyrs, scholars and the righteous, which category do people fit into it?

I know she will go to heaven but will she get Jannat ul Firdaus?

apple green


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17 Responses »

  1. Salaams,

    As I understand, this woman's daughter is disabled- seemingly both mentally and physically. Generally there would not be any medical reason for a hysterectomy based on that alone. I'm sure that the mother must clean the daughter in other manners (like if the daughter uses the restroom) not just for her menstrual cycle, so using that duty as a reason for a hysterectomy is not adviseable.

    Besides that, when a woman has a hysterectomy (even when it's medically warranted) there are still a lot of hormonal side effects that have to be dealt with and managed. It's very possible that the hormonal effects would make her daughter more difficult emotionally and that may make her care more unmanageable overall.

    I think the people who are advising this woman to have such a risky surgery are ignorant and not looking at the bigger picture. I hope your neighbor stays to her intentions of keeping her daughter's body intact as it is now.

    As far as the hereafter, I don't know the answer to that. Generally we don't know who goes where for sure, but we do know Allah is most merciful and surely the most innocent of His creation will not be slighted in their reward in the next life.

    -Amy
    IslamicAnswers.com Editor

    • hysterectomies do not cause emotional side effects..the emotional hormones that are created that affect our moods are in the brain, the hypothalamus to be exact...

      • Salaams,

        That's not totally accurate. Most women who have hysterectomies go on estrogen replacement therapy afterwards, because the mood swings are as bad as the physical symptoms of low estrogen (like hot flashes).

        "Psychological symptoms related to decreased estrogen include mood swings, crying for no reason, irritability, difficulty sleeping and problems with memory. Headaches can also occur from changing estrogen levels."

        -Quoted from the following website:

        http://www.livestrong.com/article/63884-effects-lower-hormones-after-hysterectomy/#ixzz2W1pBGEnb

        -Amy
        IslamicAnswers.com Editor

        • I have cared for hundreds if not close to thousands of women that were post op after hysterectomies..and estrogen therapy is very if not nil. women get total hysterectomies and move on.

          • Salaams,

            Perhaps that is true wherever you are located. I also have worked with women who have had hysterectomies (though not as many as you've indicated) and where I live they usually start hormone replacement therapy about 6-8 weeks post op, once they are medically cleared from recovery. Of course any woman is free to decline that type of treatment if they don't want it, but the majority of the women I work with say it's the only thing that makes them feel "normal and in control again". In general, the medical culture where I live treats it no different from menopause.

            -Amy
            IslamicAnswers.com Editor

  2. Salaam sister,

    From a medical standpoint, speaking as a nurse..the child sounds like she has brainstem injury or decerebrate brain damage..this could be due to prolonged time in the birth canal, a genetic mishap, or preterm birth earlier than 6 mos..nonetheless, it is well know that people born severely disabled..like with severe down syndrome, cerebal palsy etc even if they do get a menstrual they are STERILE. meaning, normally if a person is impregnated the embryo will not survive d/t chromosonal abnormality..I have been a nurse for over 8 years and i have never seen a severely disabled person d/t brain injuries procreate...ALLAH swt knows best...

    She can always get the girl a mooncup, or a nurse assistant to clean and make sure the daughter is bathed clothed and all hygenic needs met.There are many muslimahs that are trained as CNAs and home health aids..she should keep in mind she is getting older..

    also about the hereafter we do not know as ALLAH SWT is the judge of that.

    ayat

  3. Assalamu'alaikum sister Apple Green,

    You asked the following questions, I will tell you what I think:

    1) is the removal of uterus permissible in Islam for such people?
    2)Jannatul firdaus is for prophets, martyrs, scholars and the righteous, which category do people fit into it?
    I know she will go to heaven but will she get Jannat ul Firdaus?

    I think we are not qualified to say "it is permissible" or "it is not permissible" IN ISLAM. A person who says such a thing without knowledge and it actually turns out to be wrong, then he or she risks his/her deen.

    Your second question is not clear, sister. Are you asking which category these people will fall into? Jannah is something Allah Gives to who He Wills and other than what He Has informed, we do not know which person will be in which level. Al Firdaus is the highest level of the Jannah and we do not know who will be there; I know this for sure about Ibrahim Alaihis Salam (as in the hadith of Isra' and Me'raj), Rasoolullah Sallallahu Alaihi Wasallam (he will have place in the highest part of the Jannah called Maqam al Mahmood) and the ones mentioned in these Aayaat:

    "Verily! Those who believe (in the Oneness of Allah Islamic Monotheism) and do righteous deeds, shall have the Gardens of Al-Firdaus (the Paradise) for their entertainment." (Kahf - 107)

    And Surah al Mu'minoon:

    1. Successful indeed are the believers.
    2. Those who offer their Salat (prayers) with all solemnity and full submissiveness.
    3. And those who turn away from Al-Laghw (dirty, false, evil vain talk, falsehood, and all that Allah has forbidden).
    4. And those who pay the Zakat .
    5. And those who guard their chastity (i.e. private parts, from illegal sexual acts)
    6. Except from their wives or (the captives and slaves) that their right hands possess, for then, they are free from blame;
    7. But whoever seeks beyond that, then those are the transgressors;
    8. Those who are faithfully true to their Amanat (all the duties which Allah has ordained, honesty, moral responsibility and trusts etc.) and to their covenants;
    9. And those who strictly guard their (five compulsory congregational) Salawat (prayers) (at their fixed stated hours).
    10. These are indeed the inheritors.
    11. Who shall inherit the Firdaus (Paradise). They shall dwell therein forever.

    You said: I know she will go to heaven
    The people who are mentally unhealthy and do not have a sane mind are not promised Jannah. According to Ahaadeeth and the view of the scholars, they will be tested on the Final Day when Allah Will Order them and whether they obey Him or not will decide where they will land up.

    Like this hadeeth from Imam Ahmad ibn Hanbal's Musnad:

    The Prophet, Sallaallaahu Alayhi Wasallam, mentioned that four people would be excused on the Day of Judgment: the deaf, the insane, the senile and a person of Ahl Al-Fatrah. They will argue that they did not believe because they were not sent any Messengers. They will pledge obedience to Allaah The Almighty and He will order them to enter the Fire; if they obey Him, that fire will be cool and peaceful for them. [Musnad Ahmad]

    This also applies to people who did not hear about any Prophet, who did not receive the message of Allah in any form.

    According to Islamqa, classical scholar ibn Hajar al Athqalani Rahimahullah has said:

    They will be tested in the Hereafter by having a fire caused to appear before them. Whoever enters it will find it cool and safe, and whoever refuses will be punished. This was narrated by al-Bazzaar from the hadeeth of Anas and Abu Sa’eed, and it was narrated by al-Tabaraani from the hadeeth of Mu’aadh ibn Jabal. The issue of being tested has been proven in the case of one who is insane and the one who died during the fatrah (interval between two Prophets) via saheeh isnaads. Al-Bayhaqi stated in Kitaab al-I’tiqaad that it is the correct view.

    These people are free from sins and Allah Is The Supreme Judge, The Most Just - All Praises to Him.

    And Allah Knows Best.

    Abu Abdul Bari
    IslamicAnswers.com Editor

  4. jazak Allah Khair sisters Amy and Ayat. Mashaallah both of you have good medical knowledge.
    Brother Abu Abdul Bari, thank you for the hadith, I obviously didn't know this.
    just like we have differences on various opinions I was wondering if hysterectomy was also one of the topics discussed upon by our scholars. its quite difficult to guess what our prophet would have said on this issue since medical science and surgical procedures were not introduced.

    I just wonder what will happen of that girl after her mother. besides her mother is old and is in a lot of stress.
    may Allah keep us alive with dignity for as long as we live.
    May she never fall in wrong hands.

    • " its quite difficult to guess what our prophet would have said on this issue"

      Sister, we can not guess what the Prophet would have said. One person may guess one thing while other may guess something else. So, if a ruling is not clearly available, scholars identify possibilities of an action and see if anything goes against the Sharee'ah and follow certain principles while giving a fatwa based on qiyas. I am mentioning this, because there is a sect created in the sub-continent which is based on guessing what the Prophet would have done.

      Abu Abdul Bari
      IslamicAnswers.com Editor

      • I think we can still guess it like this eg. I remember the hadith of a girl who was bald and her parent went to our Prophet to ask if she can wear a wig and he said no she cannot. hence keeping that hadith in mind we can implement it in our lives now. not just for wigs or hair extensions but also for fake eyelashes. Although fake eyelashes were not introduced at that time but we can still tell that it is haram coz hair wigs were. So similarly since surgery was not introduced at that time at all, we have no hadith regarding surgical procedures, it should be hard to guess what can be done in a case like this where the mother is involved and she is aging and being stressed out completely. her Ibadah is probably being affected or lets say her personal cleanliness is being compromised with etc.

        Although its easy for us to guess if plastic surgery is halal or harm but again there are exceptions in that area too...

        • That is called Qiyaas. When ruling of one thing is derived from another, not guessing what the Prophet would have done. 🙂 And it is not an easy job as it has to do with rulings of the deen. It must be left for people of knowledge.

          For example, no where does Quran and Sunnah say that cigarette smoking is haraam, but the scholars have declared it haraam, from the ruling that killing oneself is haraam.

          Abu Abdul Bari
          IslamicAnswers.com Editor

          • ok its called 'qiyaas' and not ' guessing' 🙂

            I was just wondering if a fatwa was available on such a qiyaas.
            I know we have no authority to 'guess' and decide hence I posted my question here.

            jazak Allah Khair for the help.

          • Go to http://alifta.org/default.aspx and do a search with the keyword ' Hysterectomy'. You will find fatawa of permanent committee on this subject.

            Abu Abdul Bari
            IslamicAnswers.com Editor

  5. Salam sisters

    I am a gynaecologist and a member of the Royal College of Obstetricians and Gynaecologists of the UK and I felt I should comment on what has been said so far with regard to the hysterectomy. I will be brief and to the point:

    1. Hysterectomy means removal of the uterus, of which there are two types: subtotal (uterus only removed and cervix conserved) and total hysterectomy (uterus and cervix both removed). Ovaries are NOT removed unless specifically stated as "hysterectomy with bilateral salpingo-oophorectomy" which means removal of uterus along with the tubes (salphinges) and ovaries (oophorectomy). Therefore, someone who has hysterectomy ONLY is not menopausal due to the procedure, hormone-wise. The oestrogen level as well as the FSH and LH will still be within normal limits. On the other hand, someone who undergoes "hysterectomy with bilateral salpingo-oophorectomy" will automatically become menopausal immediately, as both ovaries are removed. If the purpose is simply to stop menstruation, then hysterectomy ONLY will suffice. The ovaries, if they appear normal during the surgery, will be left as they are in the pelvis.

    2. Girls who are mentally retarded, whether as a result of Down's syndrome or cerebral palsy or other causes, as long as she menstruates, has potential to become pregnant, because normal menstruation is a mark of fertility. Each normal menstruation is preceded by ovulation.

    3. Severely mentally retarded girls who are totally unable to care for themselves (e.g. bedridden or wheelchair bound) can be quite a mess when they menstruate, and I truly sympathize with the caretakers. Some may even have primary dysmenorrhoea (period pain) along with it and the poor retarded girl will scream every time that happens, as she is too retarded to know what is going on, apart from feeling the pain. You can imagine the distress the caretaker goes through each month. We have had Muslim consultants who comply to the wishes of the caretakers (usually the mother) for such a procedure after consulting local Muslim scholars. I am sorry I could not find the supporting nas now but I am pretty sure it was based on indirect reference such as qiyas, etc. I have come across one such case of messy menstruation with period pain for which hysterectomy was performed on a young teenage mentally retarded girl, and the mother (who is a pious practising Muslimah) was so relieved and grateful after the hysterectomy on her daughter. Of course, no hormone replacement was needed for this girl as the ovaries were not removed.

    Sis Happy Hippo

    • Salam sis Happy Hippo you are such a sweetheart!!
      Iam so relieved to read your comment coz just about yesterday i was thinking that probably my post has reached a dead end and that there is no ruling or qiyas on it. i was aware of the 2 kinds of hysterectomies but what i was more concerned of was the islamic perspective on such a problem.

      some questions can totally eat up your brain even when they dont concern you directly and this was just one of those for me.

      And what!? you are a gynaecologist?!!
      Im sooo impressed. Mashallah.

      i remember how i would go '' Awwwww... x x '' each time i read your name. Maybe.. i shouldnt do that anymore.
      🙂

      jazak Allah khair.

      • I respect your concern for the lady with the disabled child, Sis. May Allah ease her burden and reward her bountifully for her good deeds, and may He reward you for your kind efforts!

  6. Where are u apple green??? Miss u.... sniff sniff 🙁

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