Intended for healthcare professionals

Rapid response to:

Letters Abortion law

Poverty is the real enemy of women’s health

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6712 (Published 03 December 2019) Cite this as: BMJ 2019;367:l6712

Rapid Response:

Pakistani women seek abortions as birth control

Dear Editor,

Pakistani women seek abortions as birth control

The BMJ describes poverty as the real enemy of women’s health because pregnant women are seeking abortions due to lack of financial resources and concern regarding the education or career of children [1]. Unfortunately, the abortion rate in Pakistan is one of the highest in the world because Pakistani women seek abortions as birth control due to lack of sex education and awareness, limited access to contraception [2]. Contraception is still considered a taboo and, in some places, seen as a western concept. Two years ago, Pakistan banned advertising for contraceptives on TV and Radio [3]. The lack of use of contraceptives may also have implications for the spread of sexually transmitted diseases like HIV/AIDS, which United Nations data show claimed over 9565 lives in Pakistan last year [4].

More than 2.2 million women get abortions every year, that’s 350 abortions every hour, and the vast majority of them are married, with three or four children already, who cannot and do not want to have another child [5]. 48% of pregnancies in Pakistan are unplanned and approximately 54% of those end in abortion, carried out in unsafe settings, which leads to health complications, such as heavy bleeding, perforated uterus, and deadly infections. Additionally, Pakistan has the highest maternal and infant mortality rate in the region due to low contraceptive prevalence rates, poor health facilities, malnutrition and underage marriage (at the age of 12). Around 34% of married women use some form of family planning, according to the recent Pakistan Demographic and Health Survey.

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. But the Council of Pakistani Islamic Ideology insists that family planning is against Islam.

References:
1. Uzoigwe, C.E. and Franco, L.S., 2019. Poverty is the real enemy of women’s health. BMJ, 367. (Accessed, December 11, 2019).
2. Pakistani women use abortions as birth control in desperation. Gulf News. (https://gulfnews.com/world/asia/pakistan/pakistani-women-use-abortions-a...) (Accessed, December 11, 2019).
3. Pakistan bans contraceptive advertisements on TV and radio. The Guardian. (https://www.theguardian.com/world/2016/may/29/pakistan-bans-contraceptiv...) (Accessed, December 11, 2019).
4. 165,000 people affected with AIDS in Pakistan. The Express Tribune (https://tribune.com.pk/story/2114005/1-165000-people-affected-aids-pakis...)(Accessed, December 11, 2019).
5. Why does Pakistan have low contraception and high abortion rates? DAWN. (https://www.dawn.com/news/1359935) (Accessed, December 11, 2019).
6. Pakistan’s shocking abortion rates. The Express Tribune. (https://tribune.com.pk/story/1885557/6-pakistans-shocking-abortion-rates/). (Accessed, December 11, 2019).

Competing interests: No competing interests

11 December 2019
Musaddique 1,2,3 Hussain
Pharmacist (Doctor)
Abdul Majeed 1,4, Imran Imran 4, Muhammad Fawad Rasool 4, Ikhlaq Hussain 5, Qasim Barkat 3, Ximei Wu 3
1 School of Pharmacy, The University of Faisalabad, Faisalabad, 38,000, Pakistan; 2 Faculty of Pharmacy, The Islamia university of Bahawalpur, 63100, Pakistan; 3 Department of Pharmacology and The Key Respiratory Drug Research Laboratory of China Food and Drug Administration, School of Medicine, Zhejiang University, Hangzhou City, 310058, China; 4 Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60000, Pakistan; 5 Department of Urology, Nishtar Medical University, Multan, 60000, Pakistan
1 School of Pharmacy, The University of Faisalabad, Faisalabad, 38,000, Pakistan; 2 Faculty of Pharmacy, The Islamia university of Bahawalpur, 63100, Pakistan;