Sajjida's husband told her early on that he wanted to have only two children. But Sajjida (not her real name) says he was never ''cooperative'' when it came to using contraceptives, and so she got pregnant more than twice.

The only reason they still have just two children, she says, is that she has somehow managed to get her eight unwanted pregnancies terminated, all through ''unsafe methods''.

Should she get pregnant again, the 45-year-old Sajjida figures she will just have to go through one of these procedures again.

Abortion is illegal here in Pakistan unless it is performed to save the life of the mother. But many Pakistani women are unaware that it is against the law to have an abortion.

What they do know, though, is that cultural and religious norms prohibit the practice, which is why they resort to clandestine — and often very risky — procedures to have one.

And unlike Western countries where most abortions occur among unmarried adolescents, in Pakistan 91.5 percent of the total induced abortions are performed on married women. About nine percent of those who have abortions in Pakistan die.

Abortion methods

According to activists here, some methods used in the illegal abortions in Pakistan involve such ''instruments'' like knitting needles, coat hangers and metal rods, as well as materials like potash and gunpowder.

Activists have repeatedly argued that abortions need not occur under high-risk conditions if only the government made it legal as well for women at least in the first 120 days of pregnancy.

But they also concede that many women may not even have to consider abortion at all if only they have enough knowledge about family planning, as well as access to contraceptives.

Indeed, in the Pakistan Reproductive Health and Family Planning Survey (PRHFPS) conducted last year by the National Institute of PopulationStudies, only 28 percent of the married women respondents said they were practising some form of contraception.

This included so-called traditional methods like withdrawal, which was third among the most popular family planning practices among the respondents.

Space children

Interestingly enough, 42 percent of the married women respondents said they wanted to limit their family size to what they had at the time of the survey, and another 19 percent saying they wanted to space having children by at least two years.

Experts thus say that the unmet need for family planning in Pakistan remains large, with people in the rural areas, as well as the poor, as the most affected by the lack.

Pakistan is acknowledged to have been one of the first countries to implement a family planning programme. It has Family Welfare Centres set up nationwide to help disseminate information about family planning methods. These centres also counsel walk-ins and provide contraceptives.

Yet, this predominantly Muslim country's population of 142 million is still increasing at a steep annual rate of 2.3 to three percent. This means that each year, a figure roughly equal to the population of New Zealand is added to this nation's total number of people.

Officials, however, say that knowledge regarding contraceptives in fact increased from 78 percent of the adult population in 1991 to 96 percent in 2001. The contraceptive prevalence rate also went up during the same period, but it increased to only 30 percent.

Unsafe conditions

It is also telling that 'Seeking Help for Abortion', a 1999 study by the Baqai Medical University, found that 59.1 percent of women who admitted to having abortions under unsafe conditions had been using some contraceptives, but got pregnant nevertheless.

Dr. Sarah Jamil says, ''We have to increase the contraceptive prevalence rate and the awareness about their (proper) use. That limited information is available is obvious from the fact that in 76 percent of unsafe abortions, husbands accompany their wives, meaning contraceptives are not reliable.''

Gynaecologist Salma Kiyyani meanwhile observes that husbands are part of the problem. She says that while they exercise ''veto power'' in determining the size of their family, they do little else, and expect their wives to take care of actually limiting the number of children they will have.

This, Kiyyani remarks, is ''unfair to women''.

No available statistics

There are obviously no statistics available in just how many illegal abortions are being performed in Pakistan each year. But according to a survey by the Agha Khan Hospital, the abortion rate among its married women respondents who belonged to poor families was 25.5 percent per 1,000.

Shirkat Gah, a local non-government organisation, believes the country has a ''high rate'' of unsafe abortion, which it says is a direct consequence of denying women reproductive autonomy, unmet contraceptive needs and legal ambiguities about the subject.

The World Health Organisation defines unsafe abortion as a procedure of terminating an unwanted pregnancy either by a person lacking the necessary skills or in an environment lacking the minimum medical standards, or both.

It also says that aside from death, the other possible consequences of unsafe abortions are infertility and other severe gynaecological problems such as pelvic inflammatory disease, bleeding and infection. — IPS