Perceived Spousal Concordance on Desired Family Size and Birth Intendedness Among Second and Higher-Order Births in Pakistan

Regardless of intentions to stop or space childbearing, women in many countries experience unintended fertility (having more children than desired or having children when they do not want to do so). In Pakistan, around one-fifth of all pregnancies are unintended, which can reflect limited reproductive autonomy. Using the Pakistan Demographic Health Surveys of 1990–1991 and 2017–2018, we examine whether perceived spousal concordance on desired family size and women’s education influence how women characterize the intendedness of second and higher-order births. Compared to women with perceived concordance, women who perceive their husbands have a higher desired family size are less likely to characterize a recent birth as unwanted than intended, and women who are unaware of their husbands’ desired family size are also less likely to characterize births as mistimed or unwanted. The relative risk of reporting an unwanted birth decreased across all categories of perceived spousal concordance between 1990–1991 and 2017–2018 except for women who reported that their husbands want fewer children than them. Compared to women with no formal education, women with a primary or secondary education are more likely to have mistimed than intended or unwanted fertility, and this link has not changed significantly over time. The results suggest all women continue to face challenges in implementing preferences about birth timing and spacing for second and higher-order births. Although better-educated women do not appear to face issues in exerting stopping preferences, they appear to have greater difficulty exerting timing preferences. This paper extends research on the fertility transition in Pakistan, and continued work is needed to understand why rising levels of education among women are not translating into fewer mistimed births.