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Female birth control methods still considered taboo
Friday, August 21, 2009
By Xari Jalil
Karachi
Farhana*, already a mother of three and a banker, wanted tubal ligation— a permanent contraceptive measure for women—for personal reasons.
This basically meant that she could not conceive for the rest of her life. She made a decision after discussing the issue with her husband, who agreed to the idea and subsequently the surgery was carried out successfully.
However, this case is merely an exception.
In another incident, Shaheena*, who is approaching her 40s, and belongs to the lowest socio-economic strata of the city, is a mother of 10 children, each with approximately a year’s gap between them. Shaheena wanted to stop having children and birth control pills were not working since she could not be too regular with them. Thus, she wanted a permanent solution to the problem.
When she spoke to her husband about getting tubal ligation, he not only refused but also threatened to beat her up if she went on with it.
Suffering from constant ill health and little money to feed her starving children, Shaheena had to have the operation done without telling her husband.
The fact is that although the Government of Pakistan has been working on population control methods and has introduced contraceptives, more needs to be done to make men, not women, more open to using contraceptives.
Experienced and renowned gynaecologist, Dr Shershah Syed, while talking to The News, said that “I do not refrain from performing surgery on any woman who wants to have this procedure,” he said. “However, in many clinics and hospitals, doctors refuse to do it if the woman comes alone, because they are afraid that later their husbands will come and cause problems.”
He said that it is not that this procedure is not allowed constitutionally, nor is this question present in the forms which the women fill in for surgery. However, it is the traditional thought pattern that has caused difficulties for women.
“I have had women come to me and complain that they just cannot bear having another child,” said Dr Syed. “They say that they will not tell their husbands anything but they beg me to perform this surgery on them. And I do not think twice because, just as a man in Pakistan has the right to get vasectomy done without the consent of his spouse, I feel a woman should be allowed to do the same thing.”
As tubal ligation has a more permanent effect after surgery, it is frowned upon by the conservative sections of the society. Many blame extremist religious leaders who persuade the men going to mosques that it is an unnatural method, and it is sinful to try and stop babies from being born
Others see children as an investment who will bring in more income for the household. But the reality is that not only does over-population give rise to medical concerns for the mother, the more children there are in a household, the more expenses there will be to take care of the children.
While many doctors condemn that hindrances concerning this method of contraception for women are too many, the Public Relations Officer of the Population Welfare Department, Imdad Bana, admitted to The News that this issue needs to be promoted, agreeing that the main targets should be the men not the women.
“We have door-to-door campaigns, telling females about the methods of contraception, and we tell them how to do it, but the question is how many of them are able to do the same? Their husbands do not let them and promoting the contraceptive method to them is not as easy as it seems.”
Bana revealed that the Population Welfare Department, which has around 2,000 male mobilisers in Sindh, is facing dire circumstances as these so-called mobilisers are not fulfilling their job descriptions.
“They are lethargic, and do not work, so there really is no campaigning aimed at men,” said Bana. “They cannot be made to leave the Department either as there are several political pressures and these people stay on, only drawing their salaries, but not doing any work.”
On a more positive note, Bana added that the doctors that have been stationed at government hospitals in Karachi at the Population Welfare Department Centres, do try their level best to create awareness among couples about contraception.
A study by Dr Shireen Zulfikar Bhutta from Jinnah Postgraduate Medical Centre (JPMC) suggests that the rate of male vasectomies is a lot less than female tubal sterilisation. This shows that male members of the society are not as involved in population welfare and contraceptive methods as the women are.
“I do not think that this issue is on the agenda of the countries’ leaders,” Dr Syed explained. “At present, all they care about is which previous leader has a trial in court but what the poor people of Pakistan are going through is not their concern.”
*Names have been changed to protect privacy
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ISSN 1563-9479 
