Pakistan’s unsustainable birth rate

Focus on curbing birth rates is needed to enable households and state to ensure quality of life for new generations.

Unsustainable population growth is said to be the underlying cause of varied development challenges. Yet, while rich countries have witnessed a significant decline in fertility rates, the population growth rate of poor countries like our own shows no sign of abatement. Growing by 2.05 per cent per annum, Pakistan’s population has reached the 180 million mark, making it the sixth most populous country in the world. The issue of family planning thus remains extremely relevant in our country where every mother on average gives birth to four children.

Our high birth rates are accompanied by the problems of high infant and maternal mortality rates, which means that many children and mothers perish during the process of childbirth. Since every third pregnancy in Pakistan is unplanned, many people continue having children without giving much thought to the requirements of raising another child that can become a healthy and productive adult. Yet, there is a lingering aversion to the use of contraceptives. Even couples who want to have fewer children lack access to family planning advice. This unmet need also causes unplanned pregnancies, many of which end in unsafe abortions and maternal deaths. According to the Population Council, women who opt for abortions are married with four or more children and have exhausted their economic constraints. For them, abortion seems to be a family planning method rather than using effective contraception. Increased contraceptive use could reduce the number of unsafely performed abortions and resultant deaths.

With the country’s population having doubled, twice over, since 1951 and it being projected to be the fourth most populated country in the world in 2050, some argue that time may be ripe for Pakistan to follow China’s lead and implement the ‘one child’ policy. The notion of family planning, however, is based on birth control by choice, not coercion. Family planning experts focus on the need for increasing the availability and usage of contraceptives through campaigns run by lady health workers and emphasise the need for convincing men and religious leaders to help curb unsustainable family sizes.

Family planning organisations have been using the pulpit to emphasise the need for breastfeeding for two years, which enables birth spacing as well. Such efforts need to be reinvigorated. Moreover, doctors and nurses in Pakistan need to be conversant with all modern and effective contraceptive methods. A premarital visit to a general physician or gynaecologist should become mandatory as there is no formal sex education in schools and colleges. The existing high birth rate is not making life any easier for the average citizen. The inability to adequately manage this problem puts further pressure on the existing population that already lacks access to basic social services.

Mega urban centres such as Karachi and Lahore are being squeezed for space as population densities increase. Yet, there is an influx of rural populations into these and other major urban areas given the dearth of socio-economic opportunities in rural and peri-urban areas.

There are very serious, adverse consequences of unplanned and rapid population growth. The state’s resources are limited and under immense pressure. Urgent focus on curbing the high birth rates is needed to enable both households and the state to ensure a better quality of life for the coming generations.

Published in The Express Tribune, January 7^th, 2013.