At 2.55 percent annually, which translates to an average of 3.6 children per woman, Pakistan’s population growth rate is the highest in our region and one of the highest in the world.
Earlier this week, Dr Ali Mohammad Mir, Chief Director of the Population Council, outlined decades of haphazard, poor planning and misplaced policy directives by successive governments that have brought us to the dismal point we have reached today, where if nothing is done, Pakistan’s population will reach 385 million by 2050.
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While most of the concern about this rapid growth rate is couched in purely economic terms, very little attention is paid to the women who bear the burden of both childbirth and childcare.
It is also not a coincidence that Pakistan regularly ranks at the bottom of international indices related to women’s rights, appearing 148th out of 148 countries in the Global Gender Gap Report in 2025.
The persistence of patriarchy is fundamentally linked to Pakistan’s unsustainable rate of population growth. Therefore, any effective demographic policy must place women’s well-being and autonomy at the center of planning.
The lamentable state of women’s rights
In terms of women’s economic participation, Pakistan is among the ten worst performing countries in the world, according to the World Economic Forum. Only about 25 percent of women are in paid employment and only 18 percent of labor income goes to women. The higher birth rate, linked to the idea that women’s primary role is as mother, is one of the reasons behind a low economic participation rate.
Women in Pakistan do most of the unpaid work within the home. According to UN Women’s ‘Progress of Women in the World 2019-2020’ report, for every hour a man spends on unpaid domestic and care work, Pakistani women spend 11 hours doing the same.
Of course, a higher birth rate means more unpaid work for women who are often the primary caregivers of children.
In terms of financial security, women are in an extremely poor position: only three percent of women, compared to 72 percent of men, own a house and two percent of women, compared to 27 percent of men, own any land, according to the National Institute of Population Studies.
This also means that women are more dependent on having male offspring as a form of security, which would incentivize having more children in the hope of having a boy. There is a clear link between the desire to have more sons and a higher birth rate.
He Pakistan Demographic and Health Survey (PDHS) 2012-2013 found that 60 percent of women with three sons did not want to have more children, while only 21 percent of women with three daughters felt the same.
When it comes to the health and survival of 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 92 percent sex ratio (compared to the natural rate of 94 percent) of girls born compared to boys.
An asymmetrical sex ratio is an indication of the practice of son preference; This has direct links to higher fertility rates overall.
Pakistan has one of the highest maternal mortality rates in the region, with 11,000 maternal deaths a year, and underdeveloped parts of the country, such as Balochistan, show some of the highest maternal mortality rates in the world. If contraceptive use increases from 34% to 52%, the lives of 3,800 mothers could be saved each year.
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It is telling that Aurat March’s motto ‘mera jism, meri marzi’ was met with a strong reaction across the country, underlying anxiety around women’s bodily autonomy.
This is reflected in statistics related to women’s decision-making around their own health. In Pakistan, 41 percent of women reported that they had made decisions about their own health with their husbands, 37 percent of women reported that these decisions were made primarily by their husbands, and only 10 percent of women reported that they had made these decisions themselves, according to the National Institute of Population Studies.
This has direct implications for women’s ability to participate in decision-making regarding their reproductive health, as women who report greater decision-making capacity within the family are much more likely to engage in reproductive health-seeking behaviors.
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While many may oppose contraceptive use for religious reasons, the idea that this is the main reason for low contraceptive use is largely false. In fact, many people would like to use modern contraceptive methods,~~ but they simply do not have access. The contraceptive prevalence rate in Pakistan is 35%, while the overall demand is 55%. The overall fertility rate could be reduced to 3.1 births per woman if this need were met.
Lack of female empowerment in terms of education and decision-making is one of the main reasons for such a low rate of contraceptive use, combined with a basic failure in terms of service delivery. Due to the high rate of unwanted pregnancies, Pakistan also has one of the highest abortion rates in the world, many of them performed in extremely unsafe and unhygienic conditions.
One of the factors contributing to high birth rates is the continued practice of early marriage among women and girls. According to the 2017-2018 PDHS, young women ages 15 to 19 are more likely than young men to be currently married (14% versus 3%), meaning their fertile years are lengthening and they are less likely to be able to assert any form of authority over their reproductive decisions, according to the National Institute for Population Studies.
Therefore, all available evidence points to a clear link between a prevailing lack of gender equality and a continually high population growth rate.
Empowering women and girls: a virtuous circle
The long-term success of any family planning policy depends on the empowerment of women and girls, and that empowerment can only occur if fertility levels are reduced.
Therefore, policies must keep the empowerment of women and girls at the center of planning efforts. This means moving away from strong goals and instead focusing on improving economic and educational opportunities for women and girls, as well as improving access to quality healthcare overall.
This also requires a general change in social attitudes, particularly among men, which often hinder women’s empowerment.
It is clear that Pakistan has a long way to go both in terms of achieving gender equality and sustainable population growth, but the future does not have to be so bleak. While the indicators may be far from ideal, the last four decades have shown some promising trends.
The fertility rate has decreased significantly, even if progress is slow, and the number of women and girls who are obtaining formal education and taking up paid employment is also steadily increasing.
This is the time when policymakers should make a concerted effort to accelerate these processes by focusing their attention and investing resources on promoting an approach to family planning that focuses on the empowerment of women and girls.
Such efforts would trigger a virtuous cycle: they would help stabilize the currently unsustainable rate of population growth and bring Pakistan closer to meeting its commitment to achieving gender equality and the empowerment of women and girls.
Header image: In this photo taken on August 26, 2022, flood-affected women cut animal feed next to damaged rice crops after heavy monsoon rains in Jacobabad, Sindh province of Pakistan. — AFP/Archive
