Contraception Day: let us put mothers at the centre

The Holy Quran holds mothers in the highest esteem and reminds Muslims of the immense sacrifices they make. It calls upon believers to be grateful to Allah and to their mothers, who carry a child through hardship, give birth with difficulty, and nurture and care for that child. Yet, in Pakistan, this hardship is too often compounded by unintended pregnancies, closely spaced births, inadequate nutrition and limited access to quality reproductive health services. The burden falls most heavily on women from poorer households and those living in rural, remote and underserved communities. Around 37% of births in Pakistan occur within less than two years of the preceding birth, exposing mothers and children to avoidable risks. For women already affected by anaemia, repeated and closely spaced pregnancies can further undermine health and, in severe cases, threaten their lives. The consequences extend to the child. Babies born following short birth intervals are more likely to be born prematurely or with low birth weight, increasing their vulnerability during the critical first months of life. These are not merely demographic statistics; they represent preventable human suffering. They contribute to Pakistan's continuing maternal and infant mortality challenges and to population growth that is increasingly difficult to reconcile with available resources and development aspirations. Other regional countries, including several Muslim-majority countries, have demonstrated that these outcomes can change when reproductive health and family planning are treated as essential components of human development. World Contraception Day, observed on 26 September, should therefore be more than another date on the calendar. It should prompt parliament, policymakers, media, professionals and civil society to ask a fundamental question: what are we doing to enable couples to exercise their reproductive intentions safely, voluntarily and with dignity? Access, affordability and acceptability of services remain deeply unequal. A fragile health system, shortages of commodities, limited counselling and persistent gender norms and other social barriers continue to constrain informed choice. The resulting inequity is a social injustice that should concern us all. Protecting mothers' health and enabling families to plan the timing and number of their children must become central to Pakistan's human development agenda. This requires coordinated action. The federal government must provide strategic direction and coordination; provinces must ensure effective implementation; adequate financing must follow commitments; the private sector must be meaningfully engaged; and communities must have a voice. Healthcare professionals and programme managers must work together to expand access to high-quality, rights-based family planning, including through private providers and the country's large network of male general practitioners. But contraception alone cannot carry the burden of development. We must also ask whether development itself is a powerful determinant of fertility. Universal education improved maternal and child health, skills development, decent employment and higher household incomes can expand women's and couples' autonomy choices and aspirations. The Sustainable Development Goals deadline is approaching rapidly, and progress on health, gender equality, poverty, education and other goals is inseparable from reproductive health and demographic realities. The path forward begins with a healthy, educated and empowered mother and healthy, thriving children. On World Contraception Day, in Pakistan - where use of contraceptives has stagnated for two decades and lags behind much of the region - let us move beyond rhetoric and symbolism to remove barriers to access, expand choice and reduce the unmet need for family planning. Let us build a people-centred development agenda in which every mother can survive pregnancy, every couple can make informed reproductive choices, and every child can begin life with a fair opportunity to thrive.