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Pakistan currently has one of the highest abortion rates in the world. Abortion in our country has become the means to exercise birth control, and most of these abortions are being conducted in unsafe environments.
It’s totally normal to have a lot of different emotions after your abortion. Everyone’s experiences vary, and there’s no “right” or “wrong” way to feel. Most people are relieved and don’t regret their decision. Others may feel sadness, guilt, or regret after an abortion. Lots of people have all these feelings at different times. These feelings aren’t unique to having an abortion. People feel many different emotions after giving birth, too.
While our own media has not given this issue much attention, a recent in-depth story on America’s National Public Radio has revealed the shocking number of unsafe abortions which are taking place in our country, and their adverse impacts on the health of women.
The deaths, serious health complications and long-term disabilities that result from unsafe procedures place an enormous burden on the nation’s health care system, as well as on the women themselves, their families and their communities. A national survey of public-sector facilities estimated that about 200,000 women were hospitalized for abortion complications in 2002. In addition, many other women suffered complications but never reached hospitals.
Current law permits abortion only to save the woman’s life or, early in pregnancy, to provide “necessary treatment”. Because almost all abortions take place illegally and in secret, information about abortion in Pakistan comes largely from studies of women hospitalized for abortion complications. While the evidence is limited, it is clear that post-abortion complications account for a substantial proportion of maternal deaths in Pakistan.
Estimates cited by the above report indicate that 48% of pregnancies in Pakistan are unintended, of which 54% are terminated, mostly in an unsafe way. Around a third of all women who undergo abortions suffer complications, ranging from heavy bleeding to a perforated uterus and deadly infections.
Pakistan has a high number of unintended pregnancies due to very low contraception use rates. According to the recent Pakistan Demographic and Health Survey (2017-2018), around 34% of married women use some form of family planning. Yet, only 25% of them use modern contraceptive methods, while the others rely on less effective traditional methods (withdrawal and breastfeeding). The use of contraceptive methods has remained stagnant over the past five years, when the last such survey was conducted.
In 2002, Pakistani women experienced about 2.4 million unintended pregnancies; nearly 900,000 of these pregnancies were terminated by induced abortion. Because abortion is legal only in very limited circumstances, women who seek it subject themselves to clandestine and often unsafe procedures. Poor women, in particular, are forced by circumstances to rely on untrained providers.
There are many married women who want to have more time between pregnancies (birth spacing) or limit the number of children they have. If all these women used family planning methods, our contraception prevalence rate would be much higher.
Because women are unable to access effective contraception, many of them resort to abortion as the means to exercise birth control. Since mainstream hospitals remain reluctant to offer abortion services, many women get abortions through informal providers, especially dais.
There is no abortion-specific legislation in Pakistan. Our antiquated Penal Code does however criminalise abortion seekers and providers. There is however provision of ‘necessary treatment’ which allows for abortion if a woman’s pregnancy has not gone beyond 120 days. The term ‘necessary treatment’ remains vague. Doctors are unsure if the term justifies consideration of the psychological and economic welfare of a woman seeking an abortion, or else, if this term must be subjected to more stringent criteria.
According to the recent Pakistan Demographic and Health Survey (2012-13), even when women (26%) do use an FP method they discontinue and the rate is shockingly high at 37%, and within 12 months of their initiation. Ten percent of episodes of discontinuation occurred because the woman experienced side effects or had health concerns.
Little wonder then that in Pakistan 48% of pregnancies are unintended, of which 54% are terminated in an unsafe way.
Overall, 1 in 4 women in the U.S. will have an abortion by the time they’re 45 years old.
Ethical and religious dilemmas by healthcare providers, an unresolved moral battle raging in the mind of the woman seeking termination makes the decision to terminate pregnancy very difficult.
“Fears about confidentiality, stigma, not knowing the law, expenses and most importantly because public hospitals don’t entertain these clients,” are some reasons why women continue to seek abortions by unskilled providers said Dr Laila Shah, director of the Sukh Initiative at Jhpiego, which is promoting LARC in 42 public health facility hospitals in four towns of Karachi.
A lack of clarity and even awareness of this provision evidently makes doctors reluctant to administer safe abortions. Pushing for separate law for allowing women autonomy to secure safe abortion would be ideal, but it will not be an easy battle.
Unsafe abortion is one of the major health problems in developing countries and a serious concern for women in their reproductive years. It is estimated that globally about 20 million unsafe abortions take place each year, which is one in ten pregnancies. Around 13% of maternal deaths globally are due to abortion, 95% of these occur in developing countries.
In Pakistan complications of miscarriages/abortion account for 10-12% of maternal deaths. These include spontaneous and induced abortion. The number of women seeking abortions for unwanted pregnancies is also high as evidenced in the survey by Population Council. An estimated 890,000 induced abortions occur annually, which means that 1 out of 6 pregnancies is terminated by induction of abortion mostly in an unsafe manner. Moreover about 197,000 women are treated each year for complications resulting from unsafe induced abortions.
Unwanted pregnancies, poverty, lack of availability and accessibility to contraception and contraceptive failure are some of the factors that account for the rise in the number of women seeking termination of pregnancies in unsafe conditions. The unbelievably high numbers of induced abortions are a possible explanation for the apparent inconsistency between the persistent low levels of contraceptive Prevalence Rate (CPR) and the rapid decline in family size.
Majority of women seeking termination of pregnancy are married and they do it either to limit the family size or space pregnancies. Some seek termination of pregnancy on medical grounds or for socio economic reasons also. Pregnancy outside of a marriage constitutes a very small component of the total numbers seeking termination of pregnancy.
Despite restrictive laws abortionists, trained or untrained, exist in the society. Doctors constitute only a small proportion of the providers who terminate pregnancies on request. Majority of unsafe abortion providers are lady Health visitors, nurse/midwives and dais. This is a point to ponder as almost all Post Abortion Care trainings are given to doctors and not to the actual providers who currently offer this service.
Therefore termination of pregnancy carried out by untrained providers often end up with complications as sepsis, hemorrhage, uterine perforation, visceral injuries, or long-term sequel like infertility with its psychological effects. This results in significant increase in Maternal Morbidity and Mortality.
How widespread is abortion in Pakistan?
A nationwide study estimated that 890,000 induced abortions took place in 2002. This amounts to 29 abortions per 1,000 women of reproductive age. Of every 100 pregnancies, 14 ended in induced abortion.
Abortion rates appear to be substantially higher in the two more rural of Pakistan’s four provinces. In North West Frontier Province, an estimated 37 abortions took place per 1,000 women aged 15–49 and in Balochistan the rate was 38 per 1,000. By comparison, rates were lower in the two more urban provinces: 25 in Punjab and 31 in Sindh, where contraceptive use is also somewhat higher.
Because it is almost impossible to obtain reliable data on induced abortion through direct interviews with women, these rate estimates derive from an established indirect method that uses health facility data on women treated for post-abortion complications and experts’ estimates of the likelihood of hospitalization after abortion. Given the stigma and illegality of abortion in Pakistan, women themselves are very reluctant to admit to having had induced abortions. For example, at a Karachi teaching hospital in 1997–1998, only 7% of the women presenting with post-abortion complications acknowledged that their abortions had been induced.
Some small-scale community-based studies provide measures of the prevalence of induced abortion and also support the conclusion from the national study that the level of abortion is moderately high in Pakistan. A study in an urban slum in Lahore in 1992–1993 found that 16% of a random sample of women reported having had at least one induced abortion.
More recently, a qualitative 2006 study of a village in Rawalpindi district found that 20% of pregnancies resulted in abortions or “attempted abortions.”
The latest Demographic and Health Survey (DHS) in Pakistan, conducted in 2006–2007, found that 24% of births were unplanned. While the level of induced abortion may not be known with precision, it is clear that the procedure is common in all regions, despite its illegality, and that it is a response to the high level of unintended pregnancy.
Who are the women having abortions?
If the women hospitalized for abortion complications are typical, most women who have induced abortions in Pakistan are married and already have more children than the average Pakistani woman wants (Figure 1). In one study, 70% of women were aged 25–39; in another study, 78% were aged 25–34. The average age of the women reported in several studies was just under 30. Moreover, almost all the women were married. This pattern is typical of many Asian countries: Most abortions occur among currently married, older women and not among unmarried adolescent women, as is more typical in regions such as Sub-Saharan Africa.
The number of living children that women already have when they decide to abort is quite high, and since Pakistani women want an average of 3.1 children, the women who seek abortions most likely have already had more children than they wanted. Some studies of post-abortion care patients have found that the average is around four children. Other studies show that about 50% or more of women hospitalized for post-abortion complications had five or more living children.
With regard to other possible contributing factors, evidence to date does not indicate that either women’s education or their contraceptive-use behavior influences whether or not they resort to induced abortion. In fact, some studies show that the educational profile of women who have induced abortions is similar to that of the female population in general.
The legal status of abortion in Pakistan
In 1990, the Pakistan government revised the colonial-era Penal Code of 1860 with respect to abortion. The revisions sought to conform better to Islamic teachings regarding offenses against the human body. Under the 1990 revision, the conditions for legal abortion depend on the developmental stage of the fetus—that is, whether the fetus’s organs are formed or not. Islamic scholars have usually considered the fetus’s organs to be formed by the fourth month of gestation. Before formation of the organs, abortions are permitted to save the woman’s life or in order to provide “necessary treatment.” After organs are formed, abortions are permitted only to save the woman’s life.
Likewise, the penalties for illegal abortion depend on the fetus’s developmental stage at the time of the abortion. Before organs are formed, the offense is penalized under civil law (ta’zir), by imprisonment for 3–10 years. After organs are formed, traditional Islamic penalties, in the form of compensation (diyat), are imposed. Depending on the outcome of the abortion, imprisonment may be imposed as well.
What are the consequences of unsafe abortion?
Unsafe abortion in Pakistan contributes significantly to avoidable illness and death. Studies document that when women who have had unsafe abortions do reach health facilities, they commonly suffer from a range of post abortion complications—incomplete abortion, hemorrhage or excessive bleeding, trauma to the reproductive tract or adjacent anatomical areas, sepsis (bacterial infection) and a combination of these complications.
Excessive bleeding may have life-threatening consequences, such as anemia or shock. Perforations and lacerations may occur to the vagina, cervix or uterus and may involve injury to adjacent areas, such as the bowel, requiring surgery with full anesthesia. Hysterectomy (removal of the uterus) may be required, leaving the woman permanently infertile. If not treated in time, sepsis can lead to peritonitis (inflammation of the abdominal lining), septicemia (blood poisoning), kidney failure and septic shock, all of which can be life-threatening.
In 2002, an estimated 197,000 women were hospitalized for complications of unsafe abortion. This amounts to 6.4 hospitalizations per 1,000 women aged 15–49. High as this figure is, it likely represents only a portion of the actual number of women experiencing complications. For instance, Pakistani experts estimate that only around half of poor women who need treatment for severe complications of abortion reach hospital-based care. More affluent women are considered to be more likely to obtain care for abortion complications—about four in five who need hospital-based care receive it. In addition, women who are poor and live in rural areas are considered to be least likely to obtain care when they have complications.
A few small-scale facility-based studies have given us a partial, incomplete picture of the true extent of the tragedy of death resulting from an unsafe abortion. They show that even when women do reach hospitals, perhaps one in 10 die. During a 21-month period in 1997–1998, for example, 10% of women admitted to a large teaching hospital in Karachi for post abortion care died of complications. Septicemia was the most common cause of death.
Unsafe abortion is also the cause of a substantial proportion of maternal deaths occurring in hospitals. A 1999–2001 university hospital study found that 11% of all maternal deaths that occurred in the hospital during this period were caused by complications resulting from unsafe abortion. In an earlier hospital study (1992–1994), unsafe abortion caused 15% of maternal deaths.
These studies likely reveal only the tip of the iceberg. Little is known of the fate of the women who need treatment but do not receive it. In addition, other important consequences of unsafe abortion have not been studied in Pakistan—in particular, long-term disabilities, infertility and the economic costs to individuals, families, the health care system and society.
Who performs abortions, and how are they done?
Both formally trained health personnel and traditional practitioners perform abortions in Pakistan, often under unsafe conditions. Who performs the abortion and how safe it is often depend on where a woman lives and how much she can afford to pay for the procedure.
Poor rural women are much more likely to obtain abortions from untrained providers than are non-poor urban women. As part of the 2002 national study, more than 100 knowledgeable health professionals, drawn from all four provinces, considered how women’s economic status and residence influence access to formally trained abortion providers. They estimated that, on average, only 7% of poor rural women obtained their abortions from doctors, while 42% went to dais(traditional birth attendants). By comparison, an estimated 49% of non-poor urban women had doctors perform their abortions, while only 9% went to dais. Among poor women who lived in urban areas, an estimated 34% went to dais.
According to the 2002 survey of health professionals, the price of an abortion varies greatly, depending on the type of provider and the woman’s ability to pay. For example, poor rural women pay an estimated US$21 for an abortion provided by a nurse-midwife, non-poor rural women and poor urban women pay US$30 and non-poor urban women pay US$48. Poor rural and poor urban women who go to dais or other lay practitioners pay the equivalent of US$8–17. These prices highlight the inequity in Pakistani women’s access to safe abortion: More affluent women can afford expensive, safer abortion procedures, while poor women must make do with untrained personnel whose care is less expensive but often riskier and more harmful.
Going to a trained health care provider for an abortion is no guarantee of safety, however. Many women who experience complications have had abortions performed by doctors or nurses. At a large teaching hospital in Karachi in 1997–1998, 30% of women receiving care for abortion complications told researchers that a doctor had performed their abortions, and 36% said a nurse or lady health visitor had done the procedure. Dais had performed the abortion for 32% of the women. Only 2% had a self-induced abortion. In urban squatter settlements in Karachi, women listed private hospitals, clinics and dais’ homes as the most common places to obtain abortions.
Abortions can be obtained in clandestine clinics, at least in large urban areas and provided one can afford the cost—but again, they are not always safe. Of 32 clinics studied in 1997 in three provincial capitals, 10 clinics were run by female doctors, 13 by lady health visitors, six by other types of nurses and three by paramedics. Although most clinics employed trained personnel, only seven were properly equipped to carry out abortions safely. Providers typically performed dilatation and curettage procedures. They almost never used manual vacuum aspiration, a less invasive procedure.
Abortions seem to take place at a fairly early gestational age. Among women receiving post abortion care at a large teaching hospital in Karachi, 43% of the abortions had taken place in the first eight weeks of gestation and another 39% took place between the ninth and 14th weeks.
Nonetheless, 18% occurred at 15 weeks or later, when the probability of severe complications is elevated. The study of clandestine abortion clinics found that abortions at such clinics took place at an even earlier gestational age, on average.
In general, what we know about how abortions take place in Pakistan is limited to information obtained through facility-based investigations. Since women who either have no negative health consequences or who endure illnesses without treatment are not reached through facility-based studies and are very unlikely to have reported their abortion experiences in the few existing community-based studies, the patterns of abortion procurement described here may well present an incomplete picture.
Why do women have abortions?
Given the health risks, the illegality and the stigma, why do so many women have abortions? While unintended pregnancy is the primary reason women seek abortions, studies have probed the underlying reasons for the unwanted pregnancies. Poverty and having had all the children they want are the two most common factors cited by women as their reason for deciding to terminate a pregnancy. In a 2002 study in three of Pakistan’s four provinces, 54% of women who had had abortions said that they could not afford to have another child, and 55% said that they had “had enough children”; 25% said that it was “too soon” to have had another child (women could give more than one reason). Similarly, in low-income areas of Karachi, “too many children,” “poverty” and “unemployed spouse” were the most common reasons why women sought abortions.
In 1997, clients at clandestine abortion clinics in three provincial capitals reported a somewhat different mix of reasons for abortion. While 64% said their primary reason was “too many children,” which is consistent with both of the major reasons mentioned above, other reasons were also cited. For example, 20% said their contraceptive method had failed; nearly all of these women—96%—had been using traditional methods. Some 5% cited “medical reasons” as the primary rationale for their abortions. “Premarital affairs” were mentioned by 9% of women, and “extra-marital affairs” by 1%, confirming that in Pakistan relatively few pregnancies occur outside marriage.
These findings suggest that many married women and their husbands have difficulties obtaining contraception or using it effectively, and that abortion is often used as a back-up when unintended pregnancies occur. The predominantly economic reasons for abortion speak to the burden that adding another child to the household can place on some Pakistani families. This same rationale could motivate wider contraceptive use if effective family planning methods were more available and their use were more acceptable.
How does contraceptive use relate to unintended pregnancy and abortion?
While contraceptive use increased gradually in Pakistan until 2003, it has changed relatively little since then (Figure 2). Nationally, only about 30% of married women of reproductive age currently use a contraceptive method, according to the 2006–2007 DHS survey.
Moreover, more than one-quarter of contraceptive users rely on traditional, low-efficacy methods such as withdrawal or periodic abstinence, leaving themselves largely unprotected against unwanted pregnancy. The survey asked women who were not currently using a method about their intention to use one in the future. Encouragingly, half said that they intended to use contraception in the future; it is not known why these women were not using a method at the time. Most of the rest said they did not intend to use in the future, and a small proportion were unsure what they would do. Women who did not intend to use contraception in the future were asked why. Among the key reasons were fatalism (for example, “it’s up to God”), cited by 28%; a perception that they are not at risk of pregnancy (25%); and opposition by the respondent, her husband or others (23%). About 15% of the group gave reasons related to side effects or lack of knowledge about contraception.
Compared with the cross-section of Pakistani women in the DHS survey who were not using contraception and did not intend to do so in the future, a higher proportion of clients interviewed at clandestine abortion clinics in 2002 expressed concerns about the safety of contraceptive methods (46%).To a very great extent, however, among women having abortions, most of those who report that they experienced contraceptive failure were using methods with relatively low levels of effectiveness (condoms, withdrawal and rhythm).
While Pakistan’s fertility rate is high compared with more developed countries, it is lower than would be predicted by the country’s low level of contraceptive use: On average, women have 4.1 live births, and, in metropolitan areas, the rate is just 3.0 live births. It is difficult to explain such fertility rates solely in terms of contraceptive use. Widespread induced abortion is likely to an important contributing factor. The fact that women in the two less developed provinces—Baluchistan and North West Frontier Province—have lower contraceptive use rates and higher abortion rates than women in the more developed provinces supports this interpretation.
There appears to be a great need to increase and improve contraceptive use in Pakistan. One-quarter of currently married women —an estimated 7.4 million women in 2006–2007—have an unmet need for contraception (Figure 3). In other words, they either do not want any more children or do not want a child at the present time, but they are not using contraception. Moreover, there continues to be a significant gap in women’s ability to have the family size they want—women report that they want three children, even though on average they are having four.
Here are the top 10 countries with the highest abortion rates
China legally allows abortion and therefore it has quite a high number of abortion rates, with millions of abortions taking place every year. The abortion rate in China is around 27.85%. About 23 million unborn children are aborted annually in China and legally, about 13 million abortions take place.
Despite the Chinese one-child policy with a two-child limit last year, the abortion rate is continually on the rise. Instead of having a decrease in forced abortion and forced sterilization due to the introduction of modern methods, there has been a continuous increase.
Bulgaria is another popular country with high abortion rates. The percentage of pregnancies aborted in Bulgaria is around 30.75%. In Bulgaria, abortion is allowed within the first 12 weeks of pregnancy. Between 12 to 20 weeks, it is only permitted if the woman suffers from certain diseases that pose a threat to her life and well-being, and after 20 weeks, it is only permitted if the fetus is severely harmed. This 12 week abortion time period was enforced in 1956 and has been legally applicable ever since, leading to millions of abortion each year.
The UN conducted a recent survey which included nations with varying abortion laws. The result of the finding was that Bulgaria was a country with unlimited number of abortions without any particular reason.
Martinique is a small island in the Caribbean, with unbelievably high abortion rates. The percentage of aborted pregnancies is about 31.2%. Despite health insurance coverage and access to contraception, Martinique has a high abortion rate. The reasons behind this aren’t yet known.
A recent study was also conducted in Martinique to find out the reasons for the high abortion rates. About six hundred patients were included. Around 60% of the women had no reliable method, just before abortion. The lack of recognition of pregnancy risk was one of the main reasons leading to abortion.
The percentage of pregnancies aborted in Estonia is around 32.65%. Abortion was legally allowed in Estonia about half a century ago, in 1955, when Estonia was still a part of Soviet Union.
Estonia allows the legal abortion before the 11th week of pregnancy. After that, abortion are permitted up to the 21st week only if the woman is younger than 15 or older than 45, if the life of the woman is in danger or the woman is undergoing a serious mental or physical problem.
The highest number of abortions in Estonia were in 2010 with about 9087 abortions; this means 57.4 abortions for every hundred births.
The abortion is Czech Republic has been practiced in restricted terms for many decades. It wasn’t until 1986 that abortion was fully legalized. The abortion is allowed for up to 12 weeks of pregnancy. However, between 12 and 24 weeks of pregnancy, the abortion is only allowed if there are problems to the fetus.
Many surveys and polls have been undertaken between the periods of 2000 to 2010. The main focus of these surveys was asking people whether women should have the right to decide abortion or not. In the results of all these polls, the majority of people supported the fact that a woman should have the right to decide her own abortion.
Nagarno-Karabakh is considered to be an independent republic, according to the United Nations. Itis legally a Christian population, however, it legally allows abortion which results in a surprising high number of abortions.
However, recently the situation in the area is changing as a recent Law on Reproductive health and human rights was passed, according to which the selective abortions will be banned in the country. As the law was passed recently, it will take effect on March 30.
Cuba is another one of the top countries with high abortion rate. The total percentage of pregnancies aborted is 38.25%. Cuba has allowed abortions since 1968, and it is one of the only countries in Latin America with abnormally high proportion of abortions.
Other contraceptives and methods of birth control are also used in Cuba. Although abortion is a popular method for the regulation in Cuba, other methods are also being used like IUD and the use of contraceptives.
Hungary also has a high abortion and the main reason for this is that the country has a pro-choice stance for its existence. Abortion has been legal in the country since the 1950s.
In Hungary, a pregnancy can be terminated up to the 12th week. But the catch here is that a woman has to go to a family planning twice to receive the proper information. The woman must have counselling, pay for the termination and wait for at least three days after requesting it. Other than abortion, the modern methods of contraception are also being used in different pharmacies and clinics. Family planning services are also available in the country, however, its quality is a bit low.
Russia has about the second most number of abortions. This might be quite surprising to you, but considering the fact that the country resides in a number of different cultures with their own unique backgrounds, it seems a little less surprising. Moreover, abortion was legalized in the country, dating back to the 1920s and these regions include Crimea, Belarus, Ukraine, Estonia and others.
The abortion in Russia is available up to the 12th week of pregnancy, and in special circumstances, at later stages.
The abortion rates have been amongst the highest in Russia since the 1990s. In 2001, 1.31 million abortions took place and in 2005, 1.6 million abortions were reported, which involved 20% girls under the age of 8 years.
The percentage of pregnancies aborted in Greenland is about 50.45%. This is a bit shocking, considering the fact that Greenland provides free contraceptives to women. However, most of them don’t use it. The result of this is an abnormal increase in the abortion rates, which outnumbers the births.
From 2006 to 2013, the abortions were consistent between 800 and 900 but after the abortion rates have significantly increased.
The combination of a relatively high national level of fertility with a relatively low level of contraceptive use and a moderately high rate of abortion suggests that many Pakistani women are using abortion as part of their strategy to avoid unwanted or mistimed births, notwithstanding the illegality of the procedure and the considerable health risks it entails, as evidenced by the large number hospitalized for treatment of complications each year.
The need to seek recourse to abortion is likely to be especially prevalent among women who fear that contraceptives will damage their health, who believe that their husbands object to family planning, or who feel that religious and social norms do not endorse contraceptive use. In addition, many women may have difficulty obtaining the modern methods they need. Under current circumstances, many Pakistani women are paying with their health—and even their lives—to avoid births that they cannot afford or do not want. Helping them avert unintended pregnancy and supporting them in achieving their fertility goals would significantly reduce maternal morbidity and mortality and the associated costs to families, communities and society as a whole.
Many people across the country seem convinced that the welfare of their potential progeny is preordained, and not anything for would-be parents to worry about. Family planning is readily labelled a Western conspiracy to curb Muslim populations, whereas having more children is often portrayed as a vital service for proliferation of the Ummah.
Even leading big powers such as the US have seen populist backlash against family planning. The Trump government has cut US assistance to international NGOs, including those providing family planning services in Pakistan.
Family planning was a federal responsibility till some years ago, which was then devolved to provincial governments. The issue however continues to receive inconsistent and inadequate attention. Lady health workers are in short supply and they are poorly trained to provide contraception advice and to conduct the needed follow-up. Long-acting reversible contraception procedures are also not readily available within the public health system.
Last year, the Supreme Court constituted a bench to focus on the country’s family planning failures. One hopes that the recent Supreme Court’s intercession will help address the above-described inadequacies.
Without effective family planning, many Pakistani women will continue to seek unsafe abortions leading to a range of health complications, as well as unmanageable population growth rates.