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

Some birth control pill brands that you can expect to see are Ovral, Famila-28, Lo-Femenal, Microgynon-30 and Nordette.

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.

What to Get & Where to Get It

Note: The longest-lasting EC is currently ellaOne. It lasts up to 5 days (120 hours) after unprotected sex. Check to see if your country carries ellaOne. If your country doesn't carry ellaOne, copper IUDs may also prevent pregnancy up to 5 days after unprotected sex. If none of these options are available, and it's been over 3 days since you had unprotected sex, you can still take EC, which may work up to 5 days. Note that EC pills are not 100% effective and should be taken as soon as possible.

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.

What to Get & Where to Get It

Support

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

Medications & Vaccines

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.

Gynecological Exams

Pregnancy

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.

Advocacy & Counseling