“An obedient wife never says "no" to her virtual god.” High fertility conceptions and barriers to contraceptive use among mothers of Southern Pakistan: a qualitative study

Abstract

Abstract Background: In this study, we explore the perceptions and practices of rural mothers about fertility and reproductive health and further examine the lack of preference for contraception and birth spacing in Southern Pakistan. Methods: The qualitative data are collected from 15 healthcare providers and 20 mothers using semi-structured interviews. Results: Our findings reveal that economic, religious, and ethnic barriers cause low birth spacing among mothers. The husband and his family control the women’s bodies because sociocultural constructs normalize this exploitation. In mothers' opinion, contraception brings side effects that are dangerous for women’s bodies. Poverty, masculinity, social disapproval of contraception and admiration for more male children are other significant factors behind high fertility. Some mothers state that they experience malnutrition soon after giving birth to their sons because more care from mothers is required. Frequent births and low-quality care cause low breastfeeding and hidden hunger. Engagement in economic activities, serving the husband and his family, domestic chores, and working in agricultural fields are the predominant reasons that overburden the lives of mothers. Conclusions: The study urges a comprehensive understanding of sociocultural rationales and more natural ways of birth spacing instead of commercial solutions.