Karachi

Pakistan / Sindh / Karachi

OVERVIEW

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Pakistan, contraception (birth control) is available without a prescription. It is estimated that 38.5% of Pakistani women use some form of contraception. The most popular methods are male condom (9.9%), female sterilization (9.8%), withdrawal (8.4%), injectable (3.2%) and IUD (2.6%). The Pakistani government is concerned about the surging population and maternal mortality rate, so it has sought to emphasize family planning. However, contraceptive usage remains fairly low. This can be partially understood through the social, political and religious lens of modern Pakistan.

The Family Planning Association of Pakistan (FPAP) was founded in 1953. The founder, Saeeda Waheed, was an advocate of birth control. FPAP was a part of Third Five Year Plan (1965–1970), which helped lay the foundation for Pakistani family planning strategy. During that period, the main contraceptive method switched from condoms to IUDs. Yet, in 1977, the government of General Zia ul-Haq banned publicity for family planning, amidst extreme political turmoil and the declaration of martial law. After Zia's power ended, family planning and population control went under the Ministry of Health, which has unfortunately remained fairly unchanged for the last 35 years. In recent years, there has been an effort to bring health care providers to women's homes, similar to the successful Bangladeshi door-to-door services. Yet, Pakistan's family planning policies still lag behind other Muslim nations, like Iran and Bangladesh, while military spending takes precedence over many other aspects of Pakistani society, including family planning. As reported by the Washington Post in 2011, "Over 50 years, Pakistan’s fertility rate has dropped from about six children per woman to an average of about four. But the decline has been far too slow for the country to reach its target of 2.2 children per woman by 2020."

Aside from political issues, cultural and religious issues also play a large role. In Pakistani society, husbands, mullahs and mother-in-laws can play crucial roles in determining women's decisions. Contraception is shunned in traditional Islam, and the Pakistani religious political party has called contraception "un-Islamic." However, the largest determining factor does not appear to be religion. Rather, it is the familial pressure (especially from husbands and mother-in-laws) to have large families. When most Pakistani women get married, they move into their husband's family's home. At that house, they are often expected to become mothers to many children. When health care workers visit these homes, the mother-in-law usually answers the door, and it is common for the mother-in-laws to see no need for their son's wives to take contraceptives. Furthermore, husbands commonly feel that contraceptive decisions for their wives should be determined by Islam or their own mothers (who "know best").

Currently, Greenstar and Marie Stopes are some of the leading providers of family planning in Pakistan. However, the organizations recognize that they are a "drop in the bucket" and that family planning must be embraced community by community.

What to Get & Where to Get It

• Birth Control Pills - While many women face social or religious pressure in Pakistani society, they have the legal right to purchase birth control. Some birth control pill brands in Pakistan are Ovral, Famila-28, Lo-Femenal, Microgynon-30, Novodol, Yasmin, Desogen, Alesse and Nordette. You can get birth control pills at pharmacies, health centers or online. One of the main family planning providers in Pakistan is Greenstar. If you want to get birth control pills from Greenstar, they offer one brand: Novodol. Click here to learn more information. If you would like to buy birth control pills online, you can buy them Yasmin (Rs. 314.29), Desogen (Rs. 124.68) and Generic Alesse (Rs. 104.75) from Pakistan Pharmacy.
• Injectables - If you're interested in injectables, you can get them at Greenstar. They have Femiject (lasts for 1 month), Novaject (lasts for 2 months) or Depo-Provera (lasts for 3 months). Click here for more information.
• Intrauterine Contraception (IUD) - If you're interested in IUDs, you can get them at Greenstar. they have Protect 5 (which is non-hormonal) and Safeload (which is non-hormonal). Click here for more information.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Pakistan, emergency contraception ("the morning after pill") is available without a prescription. There are no age restrictions to purchase EC. You can find emergency contraception in public clinics, private clinics, pharmacies and through community health programs, among other places. In the public and private sectors, he lowest cadre of health worker that is allowed to sell or dispense emergency contraception is auxiliary nurse midwives. According to studies in 2012-13, it was found that 24.1% of married Pakistani women had knowledge of emergency contraception and 1% of married women had ever used it.

What to Get & Where to Get It

• In Pakistan, you don't need a prescription to purchase emergency contraception ("the morning after pill"), and there are no age restrictions. You can go to a pharmacy or clinic and request EC. One EC brands you can expect to see are Emkit Plus (take 1 pill within 120 hours after unprotected sex). You may also see ECP, Emkit or Postinor-2 (for all of these brands, take 2 pills within 120 hours after unprotected sex). While we're not 100% sure you'll find Postinor-2 (since it's not officially registered in Pakistan), you'll be able to find at least one of these brands.
• If you cannot go to a pharmacy or feel nervous to get EC, we recommend you visit Greenstar or Marie Stopes. They can give you EC, and they're very understanding of some of the concerns and questions of women who may be thinking about taking EC. Click here for more information on EC at Greenstar. Click here for EC information at Marie Stopes.
• If you can't access dedicated emergency contraception, you can use regular oral contraceptives (birth control pills) as emergency contraception. For combined pills (progestin-estrogen), you'll need to remember that, in 28-day packs, only the first 21 pills can be used. You can take Ovral (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Famila-28, Lo-Femenal, Microgynon-30 or Nordette (for all of these, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).
• You can have an IUD inserted to prevent pregnancy. Please refer to the "Contraception" section for details.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

The are no travel restrictions related to HIV status. Some people report that recruitment agencies (for teaching jobs) have asked prospective employees to take an HIV test. However, HIV tests are not required to obtain a work permit.

Testing Facilities

• Aga Khan University Hospital: This is considered perhaps the best hospital in Karachi. It will probably be more expensive, as well. However, if you want to go to a high-quality private hospital, it's a recommended place to get tests for HIV, Hep B, herpes, chlamydia and other STIs. Click here to see all the tests they perform.
• Sanity Mental Health Consultancy & Trainings: 213, Balad Trade Center, Alamgir Road, Bahadurabad Karachi, Pakistan. Call Now: +92-21-34893019.

Support

• New Light AIDS - Control Awareness Group: 766/5-D1; Green Town; Lahore. Punjab, Pakistan.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Pregnancy

What to Get & Where to Get It

• Australian Concept Infertility Medical Center: Your first consultation is free. "The “Australian Concept Infertility Medical Center” was established at Karachi in 1998 by transferring technology and expertise from Australia. Since then ACIMC has helped countless couples to have their dream baby – the baby they desired so much! ACIMC is at the fore-front of fertility technology, consistently recording one of the highest success rates amongst the best centers of the world. Our programs address both male and female infertility problems with thoroughness and the most advanced techniques available." Email : info@acimc.org Contact : +92-304-111-BABY (+92-304-111-2229)

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

List of Additional Resources

• Auhung: "Established in 1994, Aahung is a Karachi-based NGO which aims to improve the Reproductive Health (RH) of men, women, and adolescents across Pakistan. The Aahung team works towards enhancing the scope and improving the quality of services that uphold health and rights, while advocating for an enabling environment where every individual’s health and rights are respected, protected, and fulfilled as an inalienable human right."