At 2.55 per cent per annum, which translates to an average of 3.6 children per woman, Pakistan’s population growth rate is the highest in our region and amongst the highest in the world.
Earlier this week, Dr Ali Mohammad Mir, Senior Director of the Population Council, outlined decades of haphazard, poor planning and misplaced policy directives on the part of successive governments that have led us to the dismal point we have reached today, where if nothing is done, Pakistan’s population is set to reach 385 million by 2050.
While most of the concern about this rapid growth rate is framed in purely economic terms, very little attention is given to the actual women who bear the burden of both childbirth and childcare.
It is also not a coincidence that Pakistan is regularly placed at the bottom of international indices related to women’s rights, appearing at 148 out of 148 countries in the Global Gender Gap Report in 2025.
The persistence of patriarchy is fundamentally linked with Pakistan’s unsustainable population growth rate. Hence, any effective population policy must place women’s well-being and autonomy at the centre of planning.
The dismal state of women’s rights
In terms of women’s economic participation, Pakistan has been among the bottom ten worst-performing countries in the world, according to the World Economic Forum. Only about 25pc of women are engaged in paid employment, and only 18pc of labour income goes to women. The higher birth rate, linked to the idea that a woman’s primary role is as a mother, is one of the reasons behind a low rate of economic participation.
Women in Pakistan perform the vast bulk of unpaid labour within the home. According to UN Women’s ‘Progress of the World’s Women 2019-2020’ report, for every one hour a man spends on unpaid care and domestic work, Pakistani women spend 11 hours doing the same.
Of course, a higher birth rate means a higher amount of unpaid labour for women who are most often the primary caregivers for children.
In terms of financial security, women are in an extremely poor position, with only three per cent of women as compared to 72pc of men owning a house and two per cent of women as compared to 27pc of men owning any land, according to the National Institute of Population Studies.
This also means women are more dependent on producing male offspring as a form of security, which would incentivise having more children in the hopes of having a son. There is a clear link between the desire for more sons and a higher birth rate.
The Pakistan Demographic and Health Survey (PDHS) 2012-2013 found that 60pc of women with three sons did not want any more children, while only 21pc of women with three daughters felt the same.
When it comes to health and survival for women and girls, Pakistan ranks 149 out of 153, according to the World Economic Forum, which includes a measure for reproductive rights and accounts for a worrying sex ratio of 92pc (as opposed to the naturally occurring rate of 94pc) of girls born as compared to boys.
A skewed sex ratio is an indication of the practice of son preference; this has direct links with higher fertility rates overall.
Pakistan has one of the highest rates of maternal mortality in the region, with 11,000 maternal deaths occurring annually, and with underdeveloped parts of the country, such as Balochistan, showing some of the highest rates of maternal mortality in the world. If contraceptive use rises from 34pc to 52pc, 3,800 mothers’ lives could be saved annually.
It is telling that Aurat March’s slogan ‘mera jism, meri marzi’ was met with severe backlash across the country, underlying the anxiety surrounding women’s bodily autonomy.
This is reflected in statistics related to women’s decision-making surrounding their own health. In Pakistan, 41pc of women reported making decisions about their own health with their husbands, 37pc of women reported that these decisions were made primarily by their husbands, and only 10pc of women reported taking these decisions themselves, according to the National Institute for Population Studies.
This has direct implications for women’s ability to engage in decision-making regarding their reproductive health, as women who report higher decision-making capacity within the family are much more likely to engage in reproductive health-seeking behaviour.
While many may oppose the use of contraceptives for religious reasons, the idea that this is the main reason for the low uptake of contraceptives is largely untrue. In fact, many people would like to use modern methods of contraception,~~ but simply do not have access. The contraceptive prevalence rate in Pakistan is 35,~~pc while the overall demand is 55pc. The overall fertility rate could be decreased to 3.1 births per woman if this need was met.
A lack of female empowerment in terms of education and decision-making is one of the main reasons for such a low contraceptive usage rate, combined with a basic failure in terms of service provision. Because of the high rate of unwanted pregnancies, Pakistan also has one of the highest abortion rates in the world, many of these conducted in extremely unsafe and unhygienic conditions.
One of the factors contributing to high birth rates is the continued practice of early marriage amongst women and girls. According to the PDHS 2017-2018, young women aged 15-19 are more likely than young men to be currently married (14pc versus three per cent), which means both that their childbearing years are extended and that they are less likely to be able to assert any kind of authority over their reproductive choices, according to the National Institute for Population Studies.
Hence, all available evidence points to a clear link between a prevailing lack of gender equality and a continuously high population growth rate.
Empowering women and girls: A virtuous cycle
The long-term success of any family planning policy depends on the empowerment of women and girls, and the empowerment of women and girls can only take place if fertility levels are reduced.
Policies, therefore, must keep women and girls’ empowerment at the centre of planning efforts. This means moving away from blunt targets and focusing instead on improving the economic and educational opportunities for women and girls, along with improving access to quality healthcare overall.
This also requires an overall change in social attitudes, particularly amongst men, who often stand in the way of women’s empowerment.
Pakistan clearly has a long way to go both in terms of the achievement of gender equality and sustainable population growth, but the future need not be so grim. While the indicators may be far from ideal, the last four decades have shown some promising trends.
The fertility rate has declined significantly, even if progress is slow, and the number of women and girls who are gaining formal education and engaging in paid employment is also steadily increasing.
This is the time when policymakers should be making a coordinated push towards accelerating these processes by focusing their attention and investing resources in promoting an approach to family planning that centres the empowerment of women and girls.
Such efforts would spark a virtuous cycle—both helping to stabilise the currently unsustainable population growth rate and moving Pakistan closer to fulfilling its commitment with regard to the achievement of gender equality and the empowerment of women and girls.
Header Image: In this picture taken on August 26, 2022, flood-affected women chop animal feed beside damaged rice crops after heavy monsoon rains in Jacobabad, Sindh province of Pakistan. — AFP/ File
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