I must have read that Happy Home magazine about 40 years ago, but things haven’t changed much here when it comes to conversations about how babies are made. Despite warnings about a population explosion, we still don’t talk about population control. Talking about population control might require talking about sex, and you can’t really talk about sex on prime time TV or the radio, in Parliament or at village gatherings. Ads for condoms are often banned. There’s the occasional valiant attempt — like Clinic Online, a call-in TV show about sexual health — but “sex” remains a dirty word. As if just saying it was the same as doing it. We don’t even talk about sex with the person we’re doing it with.

The Pakistani government could have involved the clergy to dispel the common myth that contraception is somehow un-Islamic, but it hasn’t. There also used to be a myth about the campaign to vaccinate children against polio: That it was a cover for an American conspiracy to sterilize Pakistanis. Then the government got imams to explain on TV that it really wasn’t Allah’s will to cripple the next generation. Yet clerics aren’t preaching that even though God wants you to have good, wholesome sex with your legitimate partner, that shouldn’t stop you from using a condom or taking a birth-control pill.

Pakistan could also have learned from its former sibling Bangladesh, which has had remarkable success at controlling its population by putting women at the center of door-to-door family planning efforts. Bangladesh, which was more populous than Pakistan when it broke away from it in 1971, now has a head count of 163 million — 44 million less than Pakistan. But following Bangladesh’s lead would require acknowledging that women need to be educated about what they can do to not make more babies, and in Pakistan we find it difficult to talk about women’s reproductive health, let alone their sex life.

So most Pakistanis are left to figure things out for themselves. Some believe that children come from God and invoke God’s name to resist contraception. Every baby is born with one mouth and two hands, it’s often said. For the poor, children are a potential source of income; in some families, they are put to work at the age of 5 or 6. Since the state seems to feel little responsibility for the poor, the poor are banking on having more children to improve their lot — hoping those children will rise above poverty and take care of them in old age.