Is it permissible for a woman who has become pure before the end of forty days of confinement to perform different acts of worship? and is it lawful for her husband to have sex with her?

Once postpartum bleeding ceases and she is certain that it won`t happen again, she becomes pure, and so she should perform Ghusl (ritual bath), pray, and fast. She can also have sex with her husband even before the end of (40) days because the minimum of postpartum bleeding is a moment, and the maximum is (60) days. However, the postpartum bleeding for the majority of women is (40) days, but this does not apply to rest of them.

Is it permissible for a Muslim physician to specialize in gynecology obstetrics, and what is the ruling on working as such?

Some fields of knowledge are an individual duty while others are a collective one, and specializing in gynecology obstetrics is a collective duty. However, if there were female physicians to treat women, then there is no need for a male gynecology obstetrics specialist to look at women`s Awrahs (private parts) except in necessary situations since the jurisprudential maxim says:” Necessity must only be assessed and answered proportionately.” And Allah Knows Best.

 Is it permissible to pay the Zakah to my grandmother who lives alone in a rented accommodation with bad conditions noting she had three sons. 

Zakah cannot be given to ascendants (parents and grandparents). It is obligatory for her sons and grandsons to provide for her, and they would be sinful if they fail to do so. And Allah Knows Best.

Is it permissible for the heirs of the person who caused the accident (The Killer) to fast (The intended as an expiation for unintentional killing) on his behalf if the latter died in the crash?