Contraceptive discontinuation and abortion: exploring the links in Pakistan

Pakistan’s high rate of abortion estimated at 29 per 1,000 women aged 15-49 in 2002 (Sathar et al. 2007) may be explained by the low CPR and high unmet need for family planning (30 percent and 25 percent, PDHS 2006-2007). Using national level qualitative and quantitative data we show that in fact a significant proportion of pregnancies and abortions occur due to contraceptive discontinuation. In-depth interviews with 44 women who had experienced abortion reveal that half of them were contraceptive users at the time of pregnancy. Inconsistent and ineffective contraceptive use, typically involving condoms and explained by a lack of motivation on the part of husbands and ambivalence of wives, lead to unwanted pregnancy. Under-studied in countries with low CPR, contraceptive failure merits research in Pakistan as this can help family planning providers and policy makers support more effective contraceptive use to avoid unwanted fertility and abortions and their consequences.