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Once again, DailyNurse is publishing a series of blog posts on nursing issues in the developing world by MScN nursing students at the Karachi, Pakistan campus of the Aga Khan School of Nursing and Midwifery.

These articles were written as part of a class assignment that involved composing and submitting short research articles for publication in a recommended nursing blog or journal. The object: to help them hone their English language communication skills as future nurse leaders in Pakistan’s healthcare system. As their instructor put it, one of the goals of the exercise is to encourage nursing students to become “Change Agents” in healthcare settings and the world. DailyNurse thanks the instructor and all of the Change Agents who submitted articles. We hope you will find the selected posts informative and thought-provoking.


Encouraging the use of family planning and birth control is crucial. Birth control allows women to make independent and appropriate decisions leading to women’s empowerment and also has immediate positive effects on health.

A number of Pakistani women face serious health consequences both for the mother and the unborn child as a result of their frequent pregnancies. The prevalence of unplanned pregnancies and precarious abortions, which are major contributors to maternal deaths, may decline with the increased use of contraceptives (UNFPA, 2013). Pakistan has the sixth highest population in the world — and cultural and religious influence is so high that talking about family planning is a strange and difficult thing.

According to available research, Pakistani spouses are less likely than other couples to use contraceptives. Here are a few of the most challenging barriers:

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Lack of knowledge: One of the key obstacles to taking on contraceptive methods is the absence of information about health problems that are brought about by the continuation of pregnancies. Another barrier to couples using family planning techniques is the lack of knowledge about contraceptive options or misunderstandings about them (Khan et al., 2015).

Lack of motivation: A lack of drive is another obstacle to utilizing contraception among Pakistani couples. It has several influencing factors. Firstly, the idea of more males is a huge source of delight in Pakistan which enhances a family’s status in the society (WCP, 2016). Because of this, families, especially mothers-in-law, put pressure on the newlywed couples to have many male descendants accordingly. Furthermore, religious convictions (like the notion that God’s will govern potency) affect Pakistani couples’ decision to use birth control practices. Lastly, worries regarding its side effects may result in negative views regarding the usage of methods such as birth control pills and IUDs (WCP, 2016), for instance, using contraceptives would damage a woman’s uterus (Agha, 2010).

Lack of agency: The absence of support and consent from in-laws is another barrier to using such methods which affect women more than men particularly (Agha, 2010). Approval from the husband and mother-in-law is also a crucial factor in deciding whether to initiate contraceptive use (Khan et al., 2015; WCP, 2016). Accordingly, females are unable to make decisions regarding their reproductive habits. Even though women may have varying opinions regarding the usage of contraceptives (Khan et al., 2015), in Pakistani society most females think their husbands should make the decision (Agha, 2010).

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Lack of Communication: Communication is another significant barrier between couples in using contraceptive means (Kiani, 2003), most probably as a result of societal and religious stigmas related to the subject. In some circumstances, shyness between a couple creates confusion when they do not want another child. If they fail to discuss their feelings, the influence of in-laws can in effect push them to have children (WCP, 2016).

Inadequate availability of resources: Moreover, the use of contemporary birth control techniques are also hindered in places where there are no such clinics that provide family planning facilities (Sultan, Cleland & Ali, 2002). However, despite the presence of such centers, they are frequently underutilized as a result of the societal barriers to them (Sultan et al., 2002).

Ways to reduce barriers to family planning

  1. Increasing perception of health hazards of multiple pregnancies and knowledge about family planning options
  2. Address any concern about the use of contraceptives
  3. Address the issue of low motivation and disapproval of family planning
  4. Urging partners to talk about birth control
  5. Increasing the availability of contraceptives on the individual and community level

In conclusion, the societal hindrances to using contraceptives in Pakistan were discovered in this study. Lack of understanding and motivation, in-laws’ resistance, religious and cultural beliefs, availability issues, and lack of communication are a few societal obstacles that affect contraceptive use. Both males and females need to be made more aware of the use of current contraceptives to better understand and use them, and religious experts and community representatives must take part in identifying the social issues relating to family planning.

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