(RNS1-MAY11) Reproductive health expert Dr. Douglas Huber, second from left, meets with Afghan tribal and religious leaders in his bid to launch an “Accelerating Contraceptive Use” project to lower the birthrate in Muslim-majority nations. For use with RNS-MUSLIMS-PILL, transmitted May 11, 2010. RNS photo courtesy Douglas Huber.

(RNS) When reproductive health expert Dr. Douglas Huber went to Afghanistan to set-up an “Accelerating Contraceptive Use” project in 2005, the fertility rate among Afghan women was almost seven children per woman.

In order to get people to consider birth control, Huber knew he would first need to persuade the country’s famously patriarchal mullahs.

At the time, Afghan and Western policymakers were skeptical that rank-and-file Muslims would accept, much less use, contraceptives. Yet many Afghan religious leaders became contraception’s biggest advocates, preaching the merits of family planning at Friday sermons and approving Quranic verses that can be placed inside contraceptive packaging.

“The perception that there is strong cultural and religious resistance to family planning in Afghanistan is not true,” said Huber, of Newton, Mass., speaking from Malawi where he was working on another project.

“When you talk to people, you find that the resistance had more to do with misconceptions about infertility or bad health outcomes.”

Fifty years after the introduction of “the pill” in the mass market, Huber is among a growing number of international development specialists who are trying to enlist Muslim clerics to support a culture of responsible family planning.

Those efforts come at a time when many Muslim countries have slashed their fertility rates from six or seven children per woman to two or three — Pakistan, the world’s second-largest Muslim nation, has reduced its fertility rate to 2.48 children per woman, even as its population grows by more than 3 million each year.

Those same countries, however, face population growth that experts say could, if left unchecked, overwhelm resources, jeopardize health, increase poverty, and result in violence and international stability.

While views vary, Muslim clergy generally view contraception as permissible, although there are certain conditions: both partners must consent to using contraception; it cannot be used to escape the responsibility of parenting; vasectomies and tubal ligation are discouraged, and sterilization is generally prohibited.

When the health of the mother is in question, almost all scholars agree that contraception is permitted.

Even so, birth control has its share of opponents within the Muslim world. They often cite a verse from the Quran that says “you should not kill your children for fear of want,” and interpret it as a ban not just on infanticide, but also contraception. Others say birth control is tantamount to changing God’s creation, and therefore is forbidden.

Contraception proponents, meanwhile, cite a different verse in the Quran that recommends that mothers breastfeed their children for two years. Because pregnancy would jeopardize a new mother’s ability to breastfeed, that verse is interpreted to mean that Islam allowed the planned spacing of pregnancies.

There are also some hadith, or sayings of Prophet Muhammad, which say Islam’s founder was aware that some of his peers practiced coitus interruptus — the pull-out method, known as “azl” in Arabic — and did not object.

Egypt’s Al-Azhar University, one of the most prestigious learning centers in Islam, has issued fatwas supporting birth control, and its International Islamic Center for Population Studies and Research disseminates literature that promotes birth control.

One of the greatest challenges to birth control proponents is the idea that the greater the number of believers, the greater the glory to the faith. Conservative Saudi scholar Sheikh Muhammad Salih Al-Munajjid, for example, says contraception is prohibited unless it is to protect a mother’s health. Otherwise, he wrote, Muslims should try to have as many as children as possible.

“No one can deny that having a large number is a source of pride and strength for the (greater Muslim community), contrary to what those pessimists think who say that large numbers causes poverty and starvation in a nation,” he’s said.

The late Islamic scholar Maulana Maududi, who lived under the final years of British rule in the Indian subcontinent, remains a strong voice against contraception. As an independent, Hindu-majority India loomed next door, Maududi believed Muslims should try to have more children, not less, to combat their minority status.

“He believed the birth control movement was a plot against Islam,” said Mehtab Karim, a population expert at George Mason University who has written extensively about demographic trends in the Muslim world.

While a relative minority, there are still many Islamic religious leaders who view modern family planning as a “Western” import, Karim said, and the motives of family planning organizations immediately suspect.

Working alongside religious leaders, reproductive health specialists have tried to help Muslim societies overcome certain medical misconceptions, such as that contraception causes infertility.

“Our approach was to have more of a dialogue with the mullahs to see what worked for them. There were certainly theological issues, but there was also their own interest in health,” said Huber.

“The idea that child health and maternal health could be improved with good birth spacing resonated quite well with them. The well-being of the family was an important component of convincing them.”

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Dr. Murtala Mai, a reproductive health specialist who works in Nigeria for Massachusetts-based Pathfinders International, tells religious leaders that they have a duty to their congregants to protect them from the possibility of pregnancy or birth-related deaths. Clergy, in turn, use their sermons to preach the value of family planning.

“When we go to them in this manner, pushing their responsibility, emphasizing that people value their opinion, you can have a very meaningful discussion,” Mai said. “And inherently, they almost always want what is best for their congregation.”