Emergency Contraception – The Raging Trend in Pakistan

Women have naturally been assigned the reproductive role. It is our shining glory – the many ranks women get entitled to because of being vessels to carry life are enshrined in religions across the globe. The function of reproduction makes races flourish or dwindle. Though sacred and wondrous –  women mostly aren’t recognized for the toll that reproduction in itself takes on them. Moreover, reproduction and family planning are not seen as a collective responsibility/ burden and there is a way around almost every situation for the burden to reach the woman. This is slowly improving but we still have a long way to go!

If a woman isn’t fertile enough to line up heirs she is socially stripped of the ‘glory badges’ which fertile women can only have. If the pace of reproduction isn’t right; it is also the woman’s issue – either she has nothing to do but to make babies so she remains pregnant year in and year out (also she is much less fun as she conceives too quickly) or she doesn’t care enough to give a substantially sized family to her husband. And if she does not want to reproduce – ummm wait WHAT?

If you are a middle-aged woman living in Pakistan today who is fairly networked in with other women; you undoubtedly know of quite a few interesting cases pertaining to reproduction, contraception or the lack thereof and how in our daily lives we are making the most controversial pro-choice or pro-life decisions. This blog is not a moral yardstick to judge any choice as contexts differ and this tackles a highly personal matter. However, it does narrate how not using contraception effectively affects a family’s health and well-being and how in most cases women alone carry the burden which shouldn’t be there in the first place.

Its public knowledge that the emergency contraception pill (also known as the day after pill) is becoming ragingly popular – and it is available over the counter – costs around PKR 15 (less than 15 cents). It is also widely known that medication which can be used to abort up till 12 weeks of pregnancy is also available over the counter commonly – prices around 350 PKR (3.18 EUR) and less. It is also public knowledge that both these types of medications get sold and used often. Common sense deduces that the more popular these pills get, the less popular the small square boxes of external contraception in the lower shelves of the pharmacies get.  In the absence of effective contraception majority cases witness women having to undertake emergency contraception or measures to ‘deal with it’ which can impact women’s fertility, health and the family’s health. Medications used to ‘deal with the problem later’ overdose the body with hormones and make the environment non-conducive for the fetus/fertilized egg to sustain. Regular use of these medications is not recommended and has various side effects. Many a times there are gynecologists involved –some doctors say a firm no to ‘dealing with anything’ – others are a tad more flexible. I won’t even touch on the unsafe abortions administered by pretend doctors in quiet/not-so quiet set-ups which can result in complications.

With advances in technology and family planning/birth spacing gaining importance there is a wide variety of contraceptives available in the market (urban and rural). So naturally one questions why the use of emergency contraception and abortion pills is on the rise? One of the major reasons quoted is over chit chats is men not being willing to use contraception – and of course a woman objecting would be sacrilegious! Being out of contraceptives, ineffective use of contraceptives, wrong calculation of ovulation cycles, nonconsensual relationships or accidents also feature in citations. The incidents of not using contraception despite not wanting to reproduce seems on the rise because we can visualize the little 15 rupee pills which will make everything right. If all fails – we can invest rupees 350 or see the flexible doctor.

Whatever the case a realization of collective responsibility and making the right choices seems imperative for the overall health and well-being of women and families. A shout out for all the couples we know whose last child came like 8 years after everyone (including them) thought the family is complete…. And for everyone else; better safe than sorry folks!