Did you know how high maternal mortality is in Pakistan? In 2015, according to World Bank statistics, it was 178 per 100,000 live births. Which means for every lakh people, almost two hundred women die. And for every thousand infants born, sixty-six die at birth. This doesn’t sound like so many, but these two combined make up for half the burden of mortality in Pakistan. Essentially that means that half of the deaths in Pakistan are explained by the deaths of babies and their mothers. To add to that is the under-five mortality rate—eighty one per thousand. These rates are among the highest in South Asia. Why is this happening?
On the one hand the population keeps growing—our growth rate is around 2%, which is quite high. On the other, 20% of deaths in women of reproductive age are caused by complications during pregnancy or childbirth. Given that the average age of first-time mothers in Pakistan is sixteen, one can safely assume teenagers and young women are dying all the time. Just imagine for two minutes a sixteen year old girl. This is the average age, which means that many girls are older than sixteen but many are also below sixteen. Like twelve, or thirteen, when they give birth to their first baby. The onset of puberty means nothing but biology, and in cultures where marriage is a constant obsession and economic transaction, woe betide you if you hit your menarche earlier than your peers. According to research conducted by the Nur Foundation in conjunction with the Fatima Memorial System, 44% of married girls (since they are hardly old enough to be called women) don’t believe in using contraception. This means that not only are they too young to be mothers, they don’t really want to prevent pregnancy either.
It’s understandable, given that all females in Pakistan, when they marry, are presented with the bogeyman of contraception as the tool of the devil himself. You’re told in hushed whispers that any kind of pill, potion or contraption is going to wreck your insides forever, that you’ll never get pregnant and also that it’s a particular kind of ungratefulness to your Maker, because all children are Gifts from Heaven. Of course, no man is ever told to hold off making babies or that the health of his wife should be his paramount concern if he ever wants healthy children from her. So not only are you a veritable child yourself, you are sternly told to not protect yourself because That Is Bad and Wrong, and when things go south, people throw up their hands and blame it on fate.
It is not fate that you had no access to healthcare, scans or supplements during your pregnancy. It is not fate that you had to give birth at home with the local crone, because you couldn’t afford a clinic and the free hospital was worse than the crone. It’s a colossal failure of state and society, and because it’s just women and children, it doesn’t matter much to the thousands of men that run the country and decide budgets for piffling things like healthcare. What does it matter that a hundred kids in a thousand die every year? In the whole entire year what is a hundred children in a third world country when there are wars to be fought and roads to be made? My daughter’s class has twenty-five children in it, and there are two sections. So a hundred kids are all of Class 1 and Class 2 at her school.
According to the NUR-FMS data, 40% of women, married and unmarried, haven’t ever been to their nearest healthcare facility. Why? Are they so healthy they have never needed to see a doctor? It seems unlikely that they have never had a urinary tract infection, a yeast infection, a blighted ovum, a miscarriage, a stomachache, appendicitis, tonsillitis, conjunctivitis, the list is endless. Do women not need to see doctors regularly in order for them to safely have healthy babies? Is all our best blather reserved only for making women the mothers of the nation and taking no real, concrete steps to ensure those mothers don’t die giving birth to that nation? Or that nation die in infancy? It is criminal that newborns die in the country because their mothers never had a decent meal to eat their entire lives, and so gave birth to tiny babies who never stood a chance. According to UNICEF statistics, Pakistan’s average infant birth weight is the lowest in South Asia—lower than even Bhutan. Malnourished, neglected mothers give birth to underweight babies who are growing into stunted toddlers. It is not God’s will when these women and their babies die. No mother should have to bury her child because there just wasn’t any help, there was no doctor, no medicine. Not in a country where on the one hand we can make babies in a test tube, but we can’t save the lives of babies born to poverty, because they just don’t matter enough. As far as burdens go, their mortality is the biggest one we bear.