The limited contraceptive choices for women in Pakistan has led many to seek dangerous and illicit procedures to prevent unwanted pregnancies
Zainab, 35, is a Pakistani citizen, and has discovered she is pregnant. She doesn’t know how far gone she is but she does know that she does not want, and cannot afford, another child. She already has four children and feels her family is complete. She also knows she cannot request an abortion from the local doctor. He will refuse on the basis that it is a breach of his beliefs. She instead seeks out a dai, an informal and often unskilled midwife, in her neighbourhood. An agreement is made and the procedure begins. A 30cm tube is passed into the uterine cavity and is left there. Zainab does not know any details of the procedure other than that it will abort her unborn child. She returns home and bleeds heavily over the next few days, which she has been told is a good sign. Five days later, in the midst of severe abdominal pain and vomiting, Zainab reassures herself that it is a side effect of the procedure and patiently endures. By the end of the week, Zainab is rushed to hospital by her husband and is pronounced dead on arrival.
Zainab’s tragedy offers an insight into an often-disregarded element of Pakistani public policy – abortion. Zainab is not an exception, but rather represents a significant portion of women in Pakistan who resort to backstreet abortions in order to meet the health needs that they are denied by the government. Women similar to Zainab are left in an impossible situation; they are often very young and lack the support structures needed to help raise a child, yet have recourse to no other options.
In societies where women are unable to access abortion services, or where laws criminalise the very notion of abortion, it is feared that women are coerced into seeking unregulated and dangerous treatments that can have horrific consequences for both mother and child. The Guttmacher Institute, which researches sexual and reproductive health, estimates that in Pakistan as many as one in six deaths occur as a result of illegal abortions: “In Pakistan, more than 60 percent of deliveries are handled by unskilled practitioners, let alone induced abortions, that are already illegal in the country.”
An executive member of the Society of Obstetricians and Gynaecologists Pakistan (SOGP) described the desperate measures many women go to in order to induce abortions: “We know of desperate women who have straightened and shoved iron clothes hangers, sharpened sticks and even knitting needles up their vagina with the intention to abort pregnancy. The politics of abortion is to keep silent and not to create awareness of the subject”.
This taboo is even more relevant in the politics of Pakistan, where religious and cultural views of birth control are conservative. Abortions are permitted only to save a woman’s life, or to provide ‘necessary treatment’.
Most Pakistani women treated for complications related to backstreet abortions are already mothers and have an average of four children. In rural areas, Pakistani women have virtually no contraception available. Banning abortion and removing the woman’s right to choose does not reduce the numbers of women who seek it. Rather, it puts the women at risk of death and infection by forcing them to seek alternative methods – methods that are largely unsafe and dangerous.
In a valiant attempt to tackle the growing number of unsafe abortions, an abortion hotline was set up by the charity Women On Waves, working in partnership with the Pakistani women’s group Aware Girls. Its aim was to provide women with a safe means of inducing abortion in the form of a pill. This was immediately met with ferocious criticism and violence, being termed as “anti-Islamic” and “colonial”.
When steps to educate and assist women in safer abortion methods and to help reduce maternal mortality rates are met with such fierce opposition, it would seem that abortion in Pakistan will remain an outlawed topic. However, as President of Guttmacher Institute Dr Sharon Camp points out, “Women will continue to seek abortion whether it is legal or not as long as the unmet need for contraception remains high”. Instead of attempting to mask an issue that is prevalent in Pakistani society, it is pertinent now as much as ever that women’s bodies are discussed in a forum that is driven by women themselves.
Image from: http://www.washingtonpost.com/world/teaching-birth-control-in-pakistan-an-uphill-battle/2011/11/13/gIQAXpGcuO_gallery.html#photo=4
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