ABORTION is a controversial issue, and has always been. Usually women, who bear the brunt of pregnancy and childbirth, have the least say in the decision making process but do want at least to have a choice in the matter.

The Population Council of Pakistan (PCP) data shows that more than 50 per cent of married women do not want a second child. Between 1990-91 and 2006-07, the proportion of women who wanted to limit their family size increased from 40 per cent to 52 per cent, and those in urban areas preferred smaller families.

But Pakistan’s legal system does not give women the control over what is such an important decision. The Section 338 of the PPC says, before the foetus organs are formed, the offence is penalised by imprisonment for 3–10 years. After organs are formed, compensation (diyat) is imposed. Imprisonment may also be imposed.

Abortion is only permissible for saving the life of the mother or providing her ‘necessary treatment’ (until the organs of the child have formed, following which only the life exception applies).

Whether it is a pre-marital teenage pregnancy, with the young girl at the mercy of social stigma, or it is a rape survivor who has been unfortunately impregnated – the choice to lose the foetus during the early weeks is not allowed, unless situation is dire. In many cases as a result girls have even taken the last resort as was the case of one 16-year-old Marium in 2001, who had a choice between giving birth to a baby and face ostracism, or to kill herself. She chose the latter.

But while the law does not allow abortions so easily, during a study the PCP discovered that about 890,000 abortions are taking place nationally. These are only the reported cases. More than half are being performed by quacks. The study shows that 696,000 women with post-abortion complications visit health facilities annually for post abortion care.

On the other hand the Millennium Development Goal 5 calls for a 75 per cent reduction in maternal mortality and universal access to reproductive health by 2015. But in Pakistan, this MDG along with several others, seem to remain as unresolved as ever.

Another study in January 2012 showed that proportion of total abortions carried out by untrained personnel had risen from 44 per cent to 49 per cent between 1995 and 2008. This paradoxical link between illegalisation and an increase in abortions is explained by the fact that those countries that have restrictive abortion laws tend to invest little in family planning and reproductive health measures. This results in higher unwanted pregnancies and resultantly more surreptitious abortions.

The 2012 overall rate of women treated for abortion-related health complications in both the private and public sectors is only 15 in 1,000 women between the ages of 15 and 49. The lowest rate is in Khyber Pakhtunkhwa, and not because of contraception, but because of forced pregnancy terms. Also with the increase in population, the health sector is overburdened and treatment rate decreased from 7 to 6 per 1,000 women of reproductive age.

Those working within reproductive health sectors have been shouting themselves hoarse about giving more leeway to the woman who must make a decision about whether she can bear the child or not. This is an important decision.

However, moral values established in Pakistan’s patriarchal system have led the general population to believe that if abortions are allowed, there will tend to be more irresponsible pregnancies. This is completely untrue.

First of all the majority of women seeking such services are married, above 30 years and are usually uneducated and residents of rural areas with five children or more.

Dr Anila Warsi, who is a reproductive health expert, says the entire problem lies in the lack of family planning. “Because of this, there are unwanted pregnancies and dangerous terminations, which is acting as a burden on the public health system,” she says. “But where campaigning is concerned, the future seems bleak.

“People must understand the basic problem is not abortion, although I myself do not condone irresponsible pregnancies. But if they are so scared of even sex education how can they begin to think of abortion as a choice?”