When we first met, 28-year-old Shazia Khalid was observing her five playing children from a bench in a small park in Lahore. She appeared at least ten years older than her actual age, but she still had a sparkle in her eyes. She was denied the right to take a yearly break from giving birth, save for one instance that cost her everything, when she got married seven years ago.
When Shazia’s family decided to marry her off, she was in her last year of a bachelor’s degree. She wasn’t even permitted to speak with her fiance during the two months she was engaged to her future husband, a small general store owner; it was entirely their decision.
Shazia’s 42-year-old husband has been managing the family business for the past 20 years. Because of their 14-year age difference, Shazia believes that there is less mental compatibility between them, which also affects family planning. “He keeps saying that before he ages, he needs more children. In the first four years of our marriage, we had four kids. I was not at all ready for it. I persisted in asking him to consider family planning or taking a gap, but he would never listen.
Tearful, she described the challenges she faced during her pregnancies. Doctors always recommended her husband to wait a year or two before getting pregnant again. “I nearly passed out giving birth to my fourth child. To get me to wake up, they had to inject me with steroids. I lost a lot of blood giving birth, and I was anemic. Most of what happened after that is hazy for me because I was in shock,” she remarked.
She made the decision to consider her children’s welfare and her own after the near-death encounter. She was plagued by thoughts of what might occur if they were abandoned in this world. The possibility of dying during her subsequent pregnancy appeared plausible. Despite having three daughters before him, her husband insisted that he needed another child. When Khalid spoke with her gynecologist, the doctor sternly forbade her from giving birth again and advised her to wait two years before becoming pregnant.
Her spouse wasn’t persuaded, so she spoke with her doctor in private to find out more about contraceptives. She chose an IUD (intrauterine contraceptive device) after being assured of her discretion; this affected her menstrual cycle for two months before returning to normal.
After six months, Shazia’s husband was getting frustrated that she wasn’t getting pregnant. Her mother-in-law wanted more grandchildren, so she began to discuss getting her son married again. The truth came to light after nearly a year when she was made to go to another doctor of her choosing by her in-laws.
Shazia’s husband beat her, her gynecologist who assisted her was also attacked, the staff at her clinic was beaten, and Akram broke things without hesitation. Shazia, distraught and heartbroken, was returned to her parents’ house and shortly after that, she received divorce papers. According to data from the Consolidated Statement of Family Cases in Lahore, her children remain with her spouse, and she is awaiting a decision regarding custody and visitation rights, just like 9909 other people.
These cases are typical for Mehnaz Asim, a gynecologist and doctor who practices in a lower socioeconomic area of Lahore, and to my surprise, there are other reasons besides religion. The majority of these people desire more children in order for them to enter the workforce and start making money at an early age. They view their children as a source of income and are not concerned about their upbringing or education.
According to United Nations Population Fund (UNFPA) data from 2023, among women between the ages of 15 and 49, the prevalence of contraception using any method is only 26%, while the prevalence of modern methods is only 20%.
Important obstacles to the uptake of IUDs in Pakistan were found in a study carried out by the National Library of Medicine, the biggest biomedical library in the world and a pioneer in computational health informatics research. These obstacles include husbands’ resistance, taboos in society and culture, and growing worries about the alleged negative effects of IUD use. It was also discovered that low socioeconomic status, poverty, and illiteracy were contributing factors to the limited use of IUDs.
Pakistan’s low prevalence rate of 35.4% for modern contraception can be attributed to a number of significant factors, including the conservative social structure that limits women’s autonomy and self-governance.
According to Dr. Mehnaz, it’s critical that people understand the advantages and disadvantages of each method of birth control, and the government should impose strict regulations requiring a minimum of two years between children. Our nation has a large population but little resources. This policy must be put into effect by our government, and those who disobey it will face consequences. This is crucial for both the mother and a safe delivery experience.
