Contraception
Contraception is legal and supplied free or at low cost through government health facilities, Lady Health Workers and family planning NGOs. Contraceptive prevalence remains low, and unmet need high, for reasons including stock-outs, distance, provider bias and social pressure rather than legal barriers.
Key points
| Cost | Free or subsidised in the public sector |
|---|---|
| Lady Health Workers | Deliver counselling and supplies at household level — the backbone of rural provision |
| Methods | Condoms, pills, injectables, IUDs, implants and sterilisation |
| Emergency contraception | Available in pharmacies in major cities |
| Consent | No legal requirement for a husband's consent, though it is often demanded in practice |
| NGO providers | Rahnuma-FPAP, Greenstar and Marie Stopes operate extensive networks |
| Postpartum | Family planning counselling integrated into maternity services |
| Public provision | Free through government facilities and the Lady Health Worker programme |
| Home delivery | Lady Health Workers supply contraceptives at home in many districts |
| Unmet need | Officially recognised as high, and a policy priority |
In practice
- Ask the Lady Health Worker for your area: she can supply discreetly and without a clinic visit.
- NGO clinics offer long-acting methods at low cost where public facilities are stretched.
Cost and coverage
Free in public facilities; low-cost through social marketing networks.
Recent changes
Provincial governments have committed to expanding method choice and reducing stock-outs, with postpartum family planning a particular focus.
Where to go
- Lady Health Workers and basic health units.
- Rahnuma — Family Planning Association of Pakistan.
- Greenstar and Marie Stopes Society clinics.
Worth knowing
Spousal consent is not a legal requirement. NGO clinics are generally the most reliable route if you want a method without that conversation. Facilities may ask; that practice has no basis in law.
The general article: Contraception · Compare with another country
Abortion
Sections 338 to 338-C of the Pakistan Penal Code, as amended in 1997, distinguish between the period before the foetus's organs are formed — when abortion is permitted to save the life of the woman or for 'necessary treatment' — and the later period, when it is permitted only to save her life. The phrase 'necessary treatment' has been read broadly by some clinicians and very narrowly by others.
Key points
| Early pregnancy | Permitted to save life or provide necessary treatment |
|---|---|
| Later pregnancy | Permitted only to save the woman's life |
| Interpretation | Varies widely between providers; there is little case law |
| Post-abortion care | Recognised as essential care and provided in public facilities |
| Contraception | Legal and promoted through national programmes |
| Unsafe abortion | A major contributor to maternal morbidity, according to national studies |
| Penal Code | Sections 338 and following distinguish the stage of pregnancy |
| Necessary treatment | Early termination is permitted for necessary treatment, a phrase read narrowly in practice |
| Unsafe procedures | A recognised contributor to maternal mortality |
In practice
- Public hospitals and family planning organisations provide post-abortion care without requiring police involvement.
- Family planning associations offer counselling and contraception confidentially.
- Go to a public hospital for any bleeding or fever after a procedure: treatment cannot lawfully be refused.
- Lady Health Workers can direct you to the nearest facility discreetly.
Cost and coverage
Public facilities are free or low-cost; private care varies.
Recent changes
Public health bodies continue to press for clearer guidance on the 'necessary treatment' ground, which currently leaves both patients and doctors uncertain.
Where to go
- Rahnuma — Family Planning Association of Pakistan.
- District headquarters hospitals for emergency obstetric care.
- Lady health workers, the main community-level contact in rural areas.
Worth knowing
Post-abortion care is owed to every woman regardless of how the pregnancy ended, and health workers are bound by confidentiality. Delay is the main danger. Post-abortion care is legally distinct from abortion itself. Seeking treatment for complications is not an admission of anything and cannot be refused.
The general article: Abortion · Compare with another country
Sexual orientation
A colonial-era provision continues to criminalise so-called carnal intercourse against the order of nature, with heavy maximum penalties, although prosecutions of consenting adults are not the main risk in practice. A 2018 statute recognised transgender persons and self-perceived gender identity, but significant parts of it were struck down by the Federal Shariat Court in 2023. Blackmail and family pressure are the dominant practical dangers.
Same-sex relations remain criminalised in Pakistan under colonial-era provisions and, for Muslims, under Hudood ordinances, though prosecutions are rare and the practical risks are social and familial. The transgender picture moved in the opposite direction twice: a 2018 Act provided for self-identification and protections, and in 2023 the Federal Shariat Court struck down key provisions, narrowing recognition significantly.
Key points
| Criminal law | Same-sex relations criminalised under a colonial-era provision |
|---|---|
| Transgender statute | Enacted in 2018; key provisions struck down in 2023 |
| Discrimination | No protection on grounds of sexual orientation |
| Main practical risk | Blackmail, family coercion and exposure rather than prosecution |
| Digital exposure | Messages and dating applications are the usual source of leverage |
| Health care | Available; services do not generally require disclosure |
| Organisations | Operate discreetly, mostly through health programmes |
In practice
- Be cautious with online meetings arranged with strangers: extortion through this route is common.
- Do not keep messages or images on your phone that could expose you; use locking and automatic deletion.
- Health and testing services are accessible and do not require any declaration.
Cost and coverage
Health services are inexpensive; legal representation is costly but some clinics act without charge.
Recent changes
The Federal Shariat Court's 2023 ruling narrowed the Transgender Persons Act, and subsequent appeals and legislative responses have left the framework uncertain.
Where to go
- Health and testing services run by non-governmental organisations.
- Legal aid clinics in the main cities.
Worth knowing
Prosecution under the criminal provision is rare. Blackmail, and pressure within the family, are the real and frequent dangers, and both begin with digital traces.
Frequently asked questions
What happened to the transgender rights law?
The Transgender Persons (Protection of Rights) Act of 2018 allowed self-perceived gender identity to be registered and prohibited discrimination. In 2023 the Federal Shariat Court held several provisions repugnant to Islamic injunctions, striking down self-identification. Appeals have followed, and the position is unsettled.
What are the practical risks?
Prosecution is uncommon, but blackmail, family coercion and violence are real, and police protection is unreliable. Same-sex couples cannot obtain any legal recognition. Anyone in this situation should think carefully about digital traces and about who holds information about them.
The general article: Sexual orientation · Compare with another country
Drugs and controlled substances
A 1997 Act keyed to quantity, with life imprisonment and the death penalty available above ten kilograms.
The Control of Narcotic Substances Act 1997 sets penalties by weight: up to two years for under one hundred grams, up to seven years between one hundred grams and one kilogram, and death, life imprisonment or up to fourteen years above one kilogram, with the heaviest penalties reserved for quantities exceeding ten kilograms. The Act was amended in 2022 to extend coverage and update procedures.
Enforcement is carried out by the Anti-Narcotics Force alongside provincial police, and special courts hear narcotics cases.
The country borders a historic production region, which shapes both the scale of trafficking and the severity of the response.
Treatment capacity is limited; a small number of public and non-governmental centres offer detoxification and rehabilitation, mostly in the large cities.
Key points
| Main statute | Control of Narcotic Substances Act 1997, amended 2022 |
|---|---|
| Under 100 g | Up to 2 years |
| 100 g to 1 kg | Up to 7 years |
| Over 1 kg | Up to 14 years, life, or death above 10 kg |
| Enforcement | Anti-Narcotics Force and special courts |
In practice
- Public treatment is available in a limited number of centres, mainly in Karachi, Lahore and Islamabad.
- Never accept a package or a bag from anyone to carry across the border.
Cost and coverage
Public treatment where available is free or low cost; private centres vary widely.
Recent changes
The 2022 amendment extended the Act's reach and strengthened investigative powers.
Where to go
- Public detoxification and rehabilitation centres in the major cities.
- Anti-Narcotics Force rehabilitation centres.
- Hospital psychiatry departments.
- Emergencies: 1122.
Frequently asked questions
Does the death penalty apply?
It is available for quantities above ten kilograms, alongside life imprisonment.
Is weight or intention decisive?
Weight. The bands in the 1997 Act determine the penalty.
The general article: Drugs and controlled substances · Compare with another country
General sources
- Government of Pakistan — official government portal