Last year, Mariam – a 32-year-old marketing professional posted about her choice to remain childfree on a women-only Facebook group for the first time, even though she had been previously been vocal about her choice among friends and family. In her post she requested the members to respect other people’s reproductive choices and to ‘normalise childfree couples’ and refrain from asking invasive questions from women if they are childfree by choice or due to infertility. “One shouldn’t simply ask questions like that,” she said. The purpose of her post was to educate people about different perspectives and the freedom to adopt a different path without scrutiny by society.
“Women get judged left, right and centre from the colour of their chapal to the number of kids they have. Everything is criticised. Let them live. It’s their way of life. There is nothing wrong with it,” she said.
Mariam was mentally prepared that her post may open a floodgate of hateful messages but she was pleasantly surprised that it started a relatively respectful debate instead. Many women thanked her for writing something that also validated their feelings and thoughts – something they were afraid to say out loud. She did receive some verbal bashing but other commenters came to her rescue and delivered rebuttals to the haters on her behalf.
“There were a few that said this is not normal behaviour but much of conversation was pretty civil because a lot of women are more aware and understanding,” said Mariam.
Mariam is happily married to her husband whom she has known since high school. The realisation that she wants to remain childfree was not something she always knew – it was a journey that spanned over years that she took by herself – not knowing another soul who shared a similar mindset.
Coming from a broken home Mariam grew up with an abusive parent who had undiagnosed mental health issues. When she got married six years ago, it was the most peaceful stage of her life but paradoxically it triggered her anxiety and brought her worst fears alive – one of which was pregnancy. She said that even the thought of getting pregnant would make her feel as if she will die – her head would start spinning, her breathing would become shallower and her heart would beat so fast as if it would burst open.
“My therapist told me that if you decide to have children you will have to work with two doctors – a gynaecologist and a therapist. That’s how mentally messed up I was that I needed a therapist to endure my pregnancy,” she said.
The toll of childbirth and pregnancy on women
Mariam later found out that her fear of pregnancy and childbirth was not just a fear but a medical condition called Tokophobia. Fear of pregnancy is not just an irrational thought but it is a big life event that may take a severe toll on a woman’s physical and mental health and may even cause death. In Pakistan, 186 out of 100,000 women die during childbirth according to Pakistan Maternal Mortality Survey (PMMS) 2019 - the first stand-alone maternal mortality survey conducted in Pakistan.
According to Clinical Psychologist and Psychology teacher Najda Khawaja, tokophobia and other similar conditions may be triggered due to a past traumatic event, medical procedure, painful sexual contact, sexual abuse or it could just be an unknown fear. She believes that it should be dealt with a combination of therapy and medication.
“Here psychiatrists prescribe medicines but they do not give preference to therapy,” she said. “Therapy means that you are going to be heard, validated and to be given solutions that’s why I believe medication without therapy is a recipe for disaster,” she added.
Khawaja believes that professionals in Pakistan usually do not take phobias like these very seriously due to a judgemental attitude towards women and also stereotypical beliefs of society in general. She said that it is expected that motherhood should come naturally to every woman. The decision of not having children is another story but even psychological trauma is taken very lightly and brushed under the carpet saying that every woman goes through it. As a result, many women supress their phobia because they are afraid to get a divorce or be abandoned by their family. But going through the pregnancy anyways may have long term consequences for both mother and child – leading to postpartum depression after pregnancy – which if left untreated may even become a lifelong state.
“A mother’s psychological health affects the child. Do you think a woman who is getting pregnant despite her phobia, will go through the entire nine months of pregnancy without any mental breakdowns or psychological traumas? She is not going to be psychologically healthy so how can you expect the child to be psychologically healthy?” she said. “No amount of motherhood bliss is going to undo the damage,” she added.
Mariam was lucky that she got proper counselling for eight months and with the help of her psychologist and support of her husband - she was able to rein in her out of control anxiety. Her therapist explained to her that up until now her body had been in a constant state of survival that made the body release abnormal amount of cortisol i.e. a stress hormone. When her life finally became peaceful the body didn’t know how to handle the security of a normal life - that brought on hormonal changes that resulted in anxiety, fear and panic attacks.
With long-term therapy she was able to overcome her fears and thoughts of pregnancy didn’t send her into a state of panic anymore but the newfound peace in her life also made her reflect on her own life and whether she even wants to have children.
“Earlier I thought that I only had a fear of pregnancy. As I grew older, I realised it was not just that. You can go through it one way or the other but the main thing is to take care of a tiny human being that is dependent on you for the rest of your life. I realised that I truly don’t have any maternal feelings at all,” she said. “I had to deal with a higher sense of responsibility my whole life - even as a child - due to my mother’s mental condition. I have realised I don’t want any more responsibilities,” she added.
A selfish choice or a responsible decision?
Unlike Mariam for Beena - a 42-year-old software engineer from Pakistan who has been living and working in Germany for the last six years - the choice to not to have children was a no-brainer. She wants to focus on her career and hobbies like traveling the world, experience dance, music, surfing which she thinks is not possible with children in tow.
“People have children and don’t think that they also have to do something for the child like providing good food, clothing and education. In our society, there is a tendency to leave these things on circumstances,” she said.
She also believes that parents should not only plan to have children when they are financially stable but also save enough resources for their old age and should not become dependent on their grown children. She said she is childfree but even if she had children – she wouldn’t have depended on them to be her caretakers in old age – a lesson she has learnt from her own childhood trauma of her grandmother causing friction between her parents as a control tactic – which may have arisen from fear of abandonment in her old age.
“Our paternal grandmother ruined my parents’ marriage and our childhood by instigating fights between my parents and insulting my mother,” she said. “I will call this madness, nothing else” she added.
Beena firmly believes that children need love, attention, time, money and a loving relationship between the parents. She wants to make up for her unhappy childhood by taking full responsibility for her happiness and to enjoy the things that she couldn’t when she was younger. She believes it is a responsible choice for her to not bring children to this world when they are not her top priority.
Mariam says that some people appreciate her that at least she is self- aware that she is not fit to do the job of raising a child or she knows herself that she doesn’t want to take responsibility for such a thing but there is no shortage of people who call her ‘selfish,’ ‘self-centred’ and doing something ‘against nature.’ While she knows lots of people who are not fit to be parents but they are still having children.
“Their kids are spoiled, they lie, they misbehave and grow up to be absolutely messed up men and women,” she said. “So am I a more responsible person for knowing this about myself. I am making a conscious decision to not to do that. Am I irresponsible or selfish or are those people?” she added.
Fallout of toxic parenting
Khawaja says that although she has talked to people who don’t want to bring more children into the world due to the rapidly increasing population and environmental concerns but in her practice, she has never come across any woman who doesn’t want to have children due to career (which she believes is also a perfectly valid choice).
“Every woman who has come and said to me that I don’t want to have children right now or ever - 99 per cent of the time they have been victim of child sexual abuse and victim of parental abuse. These two had are the most prominent reasons why women do not want to bring another life into this world,” she said.
Mariam shares that although she doesn’t want to be a parent, she often talks about good parenting with her friends and on public forums. Being a victim of toxic parenting, she knows very well how it affects the life of the children who go through it.
“I believe that every child deserves to have loving parents. I myself come from a broken home. I am the last person who is going to tell you that people like me should have kids who can’t give them love - the way they deserve [to be loved],” she said.
Khawaja believes that majority of psychological problems in children or adults stems from bad parenting. It’s not always overtly abuse but parental neglect also amounts to abuse. Individuals who have been abused and neglected by their parents in childhood often can’t point a finger towards the culprit i.e the parent.
“It’s ingrained in our culture that parents can do no wrong or parents can’t be held accountable for anything,” she said. “They [the children] keep battling that idea and end up hating themselves. All these things lead to a long term and undiagnosed depression, which affect lots of areas,” she added.
Khawaja who has also been working as a school therapist with children ages 12 to 20 during her day job for the last seven years, says that at school the children who come to her for their problems, eight out of ten times the problems are related to home not school. Either the parents and siblings are bullying or abusing the child themselves or turning a blind eye to sexual abuse that is being done to the child by a relative.
“At the end, the source of the problem happens to be the parents even if you don’t see it on the surface,” she said.
Bad parenting leaves lifelong marks on the child even after they have grown up and have been out of that environment. Khawaja says that some people who have been abused and neglected as children often question their own parenting even if they are doing a good job – they don’t want to turn into their parents. Then there are other people who decide not to have any children but there are more that go on and perpetuate the same cycle of toxicity.
“It’s better not to have children rather than having them and then messing them up and kicking off a cycle of toxicity - something that happens often in our society,” said Mariam who has spent better part of her life living and overcoming the trauma perpetuated by her mother’s toxic parenting and neglect. She believes that it is natural to reproduce that’s how life is created and it is also sunnah to have children. But it’s not a sin to remain childfree if a woman’s physical or phycological health is threatened by pregnancy or childbirth.
“it’s not farz [religious duty] like namaz is farz. Anyone who tells you otherwise is talking absolute nonsense,” she said.
Mariam believes a fulfilling relationship can exist without children and people need to normalise conversations regarding a woman’s choice even in an arranged marriage because irresponsible reproductive choices have consequences not only for the women but also for the children.
“I know it’s a very tough choice. It’s a very hard decision. It is something you are going to lose family and friends over or even your life. But in the end, that’s what you need to do to be heard,” she said.
*Some names have been changed for priva