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ABSTRACT Based on the authors’ interview survey for 275 Muslim women of an ethnically divergent
community in Amman, Jordan, this study examined the psychosocial effects of reproduction
norms on contraception practice, using the normative interpretations of legal provisions in
Islam (hukm). The categorical principal component analysis (CATPCA) reduced the eight
items regarding family planning and contraception use to two factors, i.e. the pressures of
childbearing and acceptability of contraception use, accounting for 55% of the total variance.
Even though the majority of the female subjects were conservative rather than innovative in
terms of reproduction norms and significant interrelations were observed between their
reproduction norms and contraception practice, approximately 70% of the female subjects
who were closely in consonance with the normative interpretations of their religious leader
had used contraception. It is thus indicated that religious leaders may play significant roles in
increase of contraception practice among Muslim women.
KEY WORDS Reproduction norms, Contraception practice, Legal provisions, Islam, Arab population, Jordan
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INTRODUCTION
Considering the apparent difference in fertility rate proximate determinant of a decrease in fertility8. As
among the populations of different religions, repre- a result, fertility rate remains high in this region.
sented by especially high level among Muslim Islam has approved contraception use including
populations, the extents to which such sociocultural nonpermanent modern methods. However, changes
factors as religious belief and norm, which psychoso- in religious beliefs on contraception use among
cially influence reproduction behaviors, have become Muslims have often been observed, mostly because
the focus of attention in fertility studies1–4. normative conditions under which Muslims can use
In Arab societies, women’s subordinate position contraception was declared by religious scholars9,10.
and men’s dominance in decision making regarding Moreover, Muslim religious leaders who strongly
childbirth imposed by Islamic tradition give pressure share ways of thinking on life with their congregants
on the women to bear children and to avoid have often misinterpreted the concept of contra-
contraception use5–7, which is the most important ception11. Although there are many positions and titles
Correspondence: H. O. Al-Khozahe, Amman, P.O. Box 962443, Amman 11196, Jordan. E-mail: ohok_90@yahoo.com
MS 400
of uncorrelated components. The items were treated as method (45%), followed by oral contraceptive pill
ordinal data, and the same direction was assigned to all the (27%). The proportion of modern method users (60%)
categories (obligatory was assigned to the most positive was higher than that of traditional method users (16%).
and innovative norm). In the procedure, the eight items The higher the age the higher the prevalence for any
of the normative interpretations of a religious leader, who contraceptive method, except withdrawal.
was familiar with the inhabitants in the study community, Table 2 shows the percent distribution of interpreta-
were entered in this analysis as dummy variables. After tions among the female subjects by specific items
the distribution of standardized scores for a set of factors in terms of religious and reproduction issues. Regarding
was obtained, the female subjects were divided into the the items on religious issues, that is, male circumcision,
following three groups for assessing variations in the the use of veil, pilgrimage, and individual reasoning,
norms from ‘conservative’ to ‘innovative’: women whose more than 80% of the subjects interpreted these issues as
scores were lower than the normative score of a religious obligatory norms and 70% as forbidden norms. Regard-
leader (group 1), women whose scores were higher than ing the items on reproduction issues, namely, family
the normative score of a religious leader (group 3), and planning and contraception use, the subjects interpreted
the remaining women (group 2). Finally, bivariate the consent of husband and wife (72%) and danger to the
analyses were conducted to reveal the relationships health of mother (54%) as obligatory norms, the decision
between the selected characteristics of the female subjects on birthspacing (66%) and good care of children (57%)
by the three groups. as permissible norms, and the decision on the number of
All statistical tests were performed using SPSS children (75%), the contraception use without the
Version 11.5, and a P value of 0.05 was determined consent of husband (70%), the desire to have only
to be the cutoff point for statistical significance. daughters (63%) and the desire to have no child due to
fear for health (59%) as forbidden norms. These
RESULTS proportions showed high consistency with the norma-
tive interpretations of the religious leader, except for
Table 1 shows the percent distribution of the female two items, i.e. the decision on the number of children
subjects who had used contraception by methods, and contraception use without the husband’s consent.
separately for three age groups. Intrauterine device Table 3 shows the results of CATPCA of the eight
(IUD) was the most commonly used nonpermanent items regarding reproduction issues. The analysis
Table 1 Percent distribution of female subjects who had used contraception by methods, separately for three age
groups
Age group
Category
Religion
Male circumcision 88.0a 1.8 11.1 0.0 0.0
Veil 86.5a 4.0 9.5 0.0 0.0
Pilgrimage 82.9a 5.8 11.3 0.0 0.0
Individual reasoning 0.0 0.0 10.9 16.4 72.7a
Not to have children due to fear for health 0.0 0.0 15.6 25.1 59.3a
a
Normative interpretations of a religious reader.
Sueyoshi et al.
141
Effects of reproduction norms on contraception practice among Muslim women in Amman, Jordan Sueyoshi et al.
Table 3 Results of categorical principal component analysis (CAPCA) of items on reproduction issues
Loading value
Note: Items with factor loading less than 0.4 are not shown.
Table 4 Percent distribution of female subjects categorized into three groups, based on the selected characteristics
Group
1 2 3
Characteristic Total (n ¼ 36) (n ¼ 152) (n ¼ 87) w2 value
period9,20,21. Given this situation, a considerable two distinct factors observed in this study indicate
number of studies have revealed that the religious similar psychosocial situations.
belief of Muslims is against contraception use10,22–24. Secularization, in which religion retreats to more
Previous studies have also explained the contra- remote spheres of life so that most decisions on
ception practices among Arab women in the context reproduction are no longer based on religious beliefs
of Islam. In brief, Arab women tended to avoid or norms, has been progressing in the Third
contraception practice unless they decided to have had World30,31. However, such psychosocial changes were
a sufficient number of children, particularly for a not observed in the present study population, even
certain age and to let God decide on the ideal number though three variables such as educational level,
of children. In addition, men play a more significant birthplace and school of law are more likely to
role than women in determining childbearing25,26. innovate their reproduction norms.
These sociocultural norms explain their inconsistent Nevertheless, it is notable that about 70% of the
behaviors (i.e. not wanting more children but not female subjects, who were closely consonant with the
practicing contraception) and the low effectiveness of normative interpretation of the religious leader (group 2),
contraception (e.g. short duration and/or high had used contraception. For the most influential person
discontinuation rate of contraception use27–29). The when the female subjects decided to do or not to do
Table 5 Several legal opinions in Islamic jurisprudence (Fatwa) and conferences against contraception in the twentieth
century
1937 Fatwa (Sheik* Abdul-Majid Saleem, The use of family planning through al-azl (coitus
Mufti of Egypt) interruptus) and new contraceptive methods is
sanctioned.
1964 Fatwa (Sheik Abdullah Al-Qalqili, Mufti There is clear indication in Sharia that contraception is
of Jordan) definitely allowed.
1965 The academy (high council) of Islamic Couples are free to practice family planning according to
research in Cairo, Egypt individual conscience and sense of religion.
1971 The ‘‘Islam and family planning’’ The Islamic law gives the Muslim family the right to deal
conference in Rabat, Morocco with sterility and to plan suitably spaced pregnancies
using safe and lawful contraceptive methods.
1979, 1980 Fatwa (Sheik Jadel Haq, Mufti of Egypt) The contraception is not antagonistic to the truth of God,
neither is it a contradiction of the will of God.
1988 Fatwa (Sheik Sayyid Tantawi, Mufti Family planning is sanctioned liberally for economic,
of Egypt) cultural or health reasons.
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