Looking After Existing Lives or Bringing New Lives in the World?
Ms. Tehreem Hasan Syed (Pakistan)
One big trend and dilemma amongst an average family in a Pakistani rural set up isfrequent and repeated child bearing. It is appalling to see women bearing pregnancy aswell as looking after their other small children and the entire household.
Khalida is my maid’s daughter who got married at an early age, as is typical of theuneducated strata. Within the first five years of her marriage, she has had twodaughters, one son and two miscarriages. Her life is full of hectic demands that are
made on her by her household, her children and their needs. She admits that it all
becomes overwhelming for her. Now her mother in law is demanding that she produces
a son. This obsession with having sons is very common in Pakistani rural society.
Disaster struck Khalida again when she recently became pregnant.
Closely linked with the problem of repeated pregnancies is the desire for large
families and particularly the obsession with having a male heir. It is not uncommon tohear of families trying again and again, just to have a male child. This practice is tied tofamily pressure.
Another factor which contributes to the poor health of women, particularly in relation
to reproduction is the lack of a sufficient number of paramedical and medical staff in therural areas both in the private and the public sector. In order to overcome this problem
and reach women and children at the grassroots level, the Government initiated a cadreof Lady Health Workers (LHWs) in rural areas in 1984.
Infant mortality is also an outcome associated closely with the trend of repeated childbearing, this trend leads to a disastrous decline in the health of women which in turn,adversely affects a women’s health during subsequent pregnancies.
A draft report on the Situational Analysis of the Status and Quality of Women’s

Health Care in Pakistan (ADB, 1997) gives details about maternal deaths as follows:
A total of about 30,000 women (1 in every 38) die each year due to pregnancy-related
complications. It is estimated that for every maternal death that occurs, 10 to 12 times
that number become disabled for life due to inappropriate care during pregnancy.

Repeated and frequent child bearing exposes women to high levels of deficiencies intheir bodies which make them weak. In addition, their bones become brittle and theirimmunity level falls. Not only do their bodies do not get enough time to recuperate but
looking after so many dependent and small children also affects their mental health. Itis amazing to watch women, who possess a delicate and feminine constitution, emerge
to be so much more tolerant and composed at such turbulent times of their lives.
The situation regarding frequent child bearing in urban areas and the cities ofPakistan, is fast improving through measures like Family Planning and increase incontraceptive prevalence rates. The Pakistan Contraceptive prevalence Survey(1994-1995) indicates contraceptive prevalence has increased from 11.8 percent in 1991
to 17.8 percent. In Pakistan, the total fertility rate has fallen from 6.1 per family in theearly 1990’s to 5.4 but still exceeds the average for low income countries.
Education helps to keep frequent child bearing practice low in urban areas. Thanks tothe spread of education, women become aware of the risks that could confront them ifthey did not space their pregnancies. Having established a reasonable gap, she canprepare her body and mind to give birth to another baby.
In Pakistan, the situation in cities is quite different and women do not go throughrepeated pregnancies as much as rural women do. In my opinion, we need to helpchange the outlook of those members of our society who believe that women are there
only to reproduce at whatever stage or age of their life.
Assisting the creator in bringing a life in the world is a beautiful privilege. However,women also need to value their own health and life. Frequent and repeated childbearing results in disastrous after effects for a woman’s body, mind and spirit.

A typical evening scene in the
lives of Khalida's family members.

Frequent pregnancies does not lift the work
load. This has a disastrous effect on awoman's life in the rural set up of Pakistan.

Khalida attending to her routine chores.