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KARACHI: While contraception is widely believed to be a taboo, an increasing number of people in our society agree that sex education is essential.

The use of modern contraceptives has increased over the past few years in the country’s urban centres. There are several types available in Pakistan but the most common method is condoms.

Dr Saadia Virk, a consultant gynaecologist at South City Hospital, believes that condoms are common because “in our society men want control over the use or lack thereof of contraception”.

Another reason for their popularity is their cost-effectiveness. A market leader in condoms, with 55 per cent of the market shares, costs Re1 per condom and is readily available. In fact, the condom industry is twice the size of that for birth control pills.

However, the situation in rural areas is still discouraging as people there have rejected the notion. The current situation of internally displaced persons is an eye-opener to the lack of contraceptive use in rural areas, said Dr Shershah Syed, former secretary-general of the Pakistan Medical Association (PMA) and a senior obstetrician at Qatar Hospital in Orangi Town.

“On an average, women in relief camps have 11 children!” he said, disbelievingly. “This just goes to prove that the billions of rupees and dollars the government pumped into family planning programmes are making no difference,” he added.

During a seminar on World Contraception Day, Dr Sadiah Ahsan Pal, a consultant obstetrician and gynaecologist at OMI Hospital in Saddar, shared some rather depressing statistics.

At least 20 per cent of unplanned pregnancies in developing countries result in abortions and, due to the social taboos, most of them are unsafe and likely to cause complications and, in severe cases, even death.

A study from the Population Council shows that as of 2004, over 900,000 abortions take place in Pakistan every year. Doctors fear that the number is significantly higher now.

“Education on sexual health and proper use of contraception can reduce maternal mortality by about 50 per cent, claimed Dr Virk. “One way of doing this is by introducing the topic in a controlled and safe environment monitored by teachers and relevant doctors to counsel young married couples,” she added.

The reality is much more complicated as Ms P, principal of a private school in Defence, said that the use of the term “sex education” is highly inappropriate. She believed that this leads to an incorrect mindset of the initiative behind teaching young adults about their anatomy and relationships with their spouse.

“Many students, especially girls, get married right after A-levels without talking about intercourse, even after their marriage,” she explained, adding that such girls “may still think that babies grow on trees”. She said that this leads to unplanned pregnancies, resulting in the dangerous option of abortion for some women.

Several parents have also expressed their reservations over discussing such topics or introducing contraceptives in schools. “It puts ideas in children’s minds and then they may even want to experiment,” feared one mother, who requested anonymity.

However, the consequences of keeping children in the dark can be far worse, said Umair Yahya, an A-levels teacher. “I have come across cases where teenage girls end up being pregnant due to lack of information,” he said, adding that they “are left with no option but to opt for shady abortions with added complications”.

Ahmad, an A-levels student, said that while boys may be too immature to know about such things, girls should definitely be given the opportunity to be informed by a qualified professional.

An O-levels student, Rashma, also shared the same views and felt that awareness of one’s anatomy as well as the use of contraception should be available to young adults. “When they don’t know, they end up surfing the internet or asking friends and this leads to a lot of inaccurate information which can be very dangerous,” she added.

Dr Pal suggested that young couples should be advised on the use and effects of contraceptives even before their nikah, both as a means of controlling our population and preparing young couples in the early stages of their marriage.

Published in The Express Tribune, September 26^th, 2010.