Available on request No
Additional requirements: Information is not readily available.
REPRODUCTIVE HEALTH CONTEXT
Government view on fertility level: Too high
Government intervention concerning fertility level: To lower
Government policy on contraceptive use: Direct support provided
Percentage of currently married women using
modern contraception (aged 15-49, 1996/97): 17
Total fertility rate (1995-2000): 5.0
Age-specific fertility rate (per 1,000 women aged 15-19, 1995-2000): 90
Government has expressed particular concern about:
Morbidity and mortality resulting from induced abortion No
Complications of childbearing and childbirth Yes
Maternal mortality ratio (per 100,000 live births, 1990):
South-central Asia 560
Female life expectancy at birth (1995-2000): 65.1
Until 1990, abortion in Pakistan was regulated by century-old provisions of the Penal Code of 1860 which had been developed for India by the British colonial government and remained in force in Pakistan following independence. Under this Code, abortion was a crime unless performed in good faith in order to save the pregnant woman’s life. Article 312 of the Penal Code provided that any person performing an illegal abortion was subject to imprisonment for three years and/or a fine; if the woman was “quick with child”, the penalty was imprisonment for up to seven years and payment of a fine. The same penalty applied to a woman who caused herself to miscarry.
Following a 1989 decision of the Pakistani Supreme Court, which held that part of the Penal Code of 1860 dealing with offences against the human body was invalid because it was repugnant to the injunctions of Islam, Pakistan revised its law in this area, reformulating a number of its provisions to conform to the principles of Islamic law. The revised law came into effect provisionally in 1990 and became permanent law in 1997.
Under the new law, abortion offences are divided into two categories depending on the stage of pregnancy during which the abortion is performed. Abortions carried out before the unborn child’s organs have been formed are prohibited except when performed in good faith for the purpose of saving the life of the woman or providing necessary treatment. The punishment is the imposition of the penalty for a ta’zir crime—that is penalties other than the traditional Islamic penalties of retaliation and compensation—in this case, imprisonment for up to three years if the woman consented and up to ten years if she did not. Abortions carried out after some of the unborn child’s organs or limbs have formed are prohibited except for the first of the above reasons. The penalty is, in general, the imposition of diyah, or compensation to the heirs of the victim by the offender. If the child is born dead, the amount of diyah is one twentieth of that for a full person; if the child is born alive but dies as a result of an act of the offender, a full diyahis payable; if the child is born alive, but dies for any other reason, ta’zir shall be imposed consisting of up to seven years’ imprisonment. Under Islamic law, organs and limbs are usually deemed to be formed in a foetus by the fourth month of pregnancy.
There are a number of interesting features of the law. One is that it appears to represent an expansion of indications for abortion in early pregnancy. Abortions are allowed not only to save the life of the pregnant woman, but also to provide “necessary treatment,” a phrase that, although not defined, is likely to encompass threat to health of some sort. Another is the law’s hybrid nature. On the one hand, the law retains features of the old law. Penalties for the crime are still dependent upon which of two stages of development the pregnancy has reached and on whether the woman consents or not. In some cases, they also include imprisonment, now denominated a ta’zir penalty. On the other hand, the law defines the stages of pregnancy in terms of the formation of organs or limbs according to Islamic law principles and it introduces the distinctive Islamic law penalty of compensation or diyah in the case of late-term pregnancies. Finally, the new law is somewhat ambiguous: there is no clear demarcation of the two stages of pregnancy or definition of what constitutes “necessary treatment”. Indeed, the law has been criticized for just this reason.
In part because of the lack of data on the incidence of induced abortion, illegal abortion has not been an area of major governmental concern in Pakistan. However, illegal abortion does take place and complications from septic abortions are believed to be a major cause of maternal mortality. Only 5-10 per cent of births occur in hospitals. According to a study conducted in a hospital at Karachi in 1985, about 300 maternal deaths per 100,000 live births were due to complications from abortion. Multiple unspaced pregnancies combined with poor maternal nutrition and scarce maternity services have resulted in high (though declining) maternal mortality rates, estimated at 340 deaths per 100,000 live births (1990).
Family planning in Pakistan has a long history. A family planning association was established in 1953, the National Population Programme was begun in 1955 and the Population Welfare Programme has been part of the National Five-Year Plans since 1960. Despite these early efforts in family planning in Pakistan, modern contraceptive prevalence remains low. It was estimated in a Demographic and Health Survey at 11 per cent in 1991 and 17 per cent in 1994-1995. Under 5 per cent of the population is estimated to have easy access to family planning services. However, although contraceptive use remains low, demand is increasing and the Programme has succeeded in creating awareness and demand for family planning services.
The total fertility rate has hovered since the late 1960s at about 6.0 children per woman and is currently (1995-2000) at 5.0 children per woman. Greatly concerned by the rapid population growth, the Government of Pakistan formulated a new population policy in 1991 that included an improved family planning programme. The Population Welfare Division’s 1993-1998 comprehensive programme sought to reduce the average annual rate of population growth from 2.9 to 2.6 per cent, mainly by increasing coverage of the family planning programme from 5 to 70 per cent in rural areas and from 54 to 100 per cent in urban areas. The 1996 population growth rate was 2.8 per cent. Following the International Conference on Population and Development (ICPD), held in Cairo in 1994, Pakistan has gradually integrated family planning with reproductive health services and adopted a voluntary and target-free approach to family planning services. The Government continues to focus on improved delivery of health care to an overwhelmingly rural population.
Source: Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. For additional sources, see list of references.