Influence of Marriage on Women’s Participation in Medicine: The Case of Doctor Brides of Pakistan

Abstract

Despite the difficulties women in Pakistan face in their access to education, their numbers have been increasing consistently in medical colleges. However, most of the women medical graduates do not go on to practice medicine after graduation. One of the reasons suggested by Pakistani media and society for this increase in the number of women medical graduates is the desirability of women doctors in Pakistan’s marriage market. Based on an ethnographic study of Pakistani women doctors, I examine why women doctors are considered desirable as spouses and how this influences women’s access to medical education. I found that women doctors are valued as marital partners because of the status granted to them by their academic credentials, chaste educational experience, and potential to contribute to family income. Because of the value of medical education in marriage, parents are more willing to invest in their daughters’ education, facilitating women’s access to medical education. I also found that, as a way of bargaining with the patriarchy, women doctors accept the social norms of arranged marriage because it allows them access to professional education, economic opportunities, and a better bargaining position in the marriage market. Overall, I found that, unless underlying patriarchal norms are addressed, potentially empowering projects like women’s education will be co-opted by the existing structures of domination. I also discuss potential implications for changing marriage patterns and increasing representation of women in Pakistan’s medical workforce.

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References

  1. Abid, A. M. (2014, October 22). Female doctors becoming ‘Trophy’ wives: Is quota the right move? Dawn. Retrieved from http://www.dawn.com/news/1139639.

  2. Abu-Lughod, L. (1990). The romance of resistance: Tracing transformations of power through Bedouin women. American Ethnologist, 17(1), 41–55.

    Article  Google Scholar 

  3. Ahearn, L. M. (1994). Consent and coercion: Changing marriage practices among Magars in Nepal (Unpublished doctoral dissertation). Ann Arbor: University of Michigan.

  4. Ahearn, L. M. (2001). Invitations to love: Literacy, love letters, and social change in Nepal. Ann Arbor: University of Michigan Press.

    Book  Google Scholar 

  5. Allen, I. (2005). Women doctors and their careers: What now? British Medical Journal, 331(7516), 569–572. https://doi.org/10.1136/bmj.331.7516.569.

    Article  PubMed  Google Scholar 

  6. Arif, S. (2011). Broken wings: Issues faced by female doctors in Pakistan regarding career development. International Journal of Academic Research in Business and Social Sciences, 1(3), 69-91. Retrieved from http://EconPapers.repec.org/RePEc:hur:ijarbs:v:1:y:2011:i:3:p:69-91.

  7. Arnold, D. (2000). The new Cambridge history of India: Science, technology and medicine in colonial India (Vol. 3). Cambridge: Cambridge University Press.

    Book  Google Scholar 

  8. Batliwala, S. (1994). The meaning of women’s empowerment: New concepts from action. In G. Sen, A. Germain, & L. C. Chen (Eds.), Population policies reconsidered: Health, empowerment, and rights (pp. 127–138). Boston: Harvard University, Harvard Center for Population and Development Studies.

    Google Scholar 

  9. Bernard, H. R. (2006). Research methods in anthropology: Qualitative and quantitative approaches. London: Sage Publications.

    Google Scholar 

  10. Bernard, H. R., & Ryan, G. W. (2010). Analyzing qualitative data: Systematic approaches. Thousand Oaks: Sage.

    Google Scholar 

  11. Bhopal, K. (1999). South asian women and arranged marriages in east London. In R. Barot, H. Bradley, & S. Fenton (Eds.), Ethnicity, gender and social change (pp. 117–134). UK: Palgrave Macmillan.

    Google Scholar 

  12. Bhopal, K. (2000). South Asian women in east London: The impact of education. European Journal of Women's Studies, 7(1), 35–52. https://doi.org/10.1177/135050680000700103.

    Article  Google Scholar 

  13. Bhopal, K. (2011). ‘Education makes you have more say in the way your life goes’: Indian women and arranged marriages in the United Kingdom. British Journal of Sociology of Education, 32(3), 431–447. https://doi.org/10.1080/01425692.2011.559342.

    Article  Google Scholar 

  14. Blickenstaff, J. C. (2005). Women and science careers: Leaky pipeline or gender filter? Gender and Education, 17(4), 369–386. https://doi.org/10.1080/09540250500145072.

    Article  Google Scholar 

  15. Bloch, F., Rao, V., & Desai, S. (2004). Wedding celebrations as conspicuous consumption signaling social status in rural India. Journal of Human Resources, 39(3), 675–695. https://doi.org/10.3368/jhr.XXXIX.3.675.

    Article  Google Scholar 

  16. Blossfeld, H. P. (2009). Educational assortative marriage in comparative perspective. Annual Review of Sociology, 35, 513–530. https://doi.org/10.1146/annurev-soc-070308-115913.

    Article  Google Scholar 

  17. Blossfeld, H. P., & Huinink, J. (1991). Human capital investments or norms of role transition? How women's schooling and career affect the process of family formation. American Journal of Sociology, 97(1), 143–168. https://doi.org/10.1086/229743.

    Article  Google Scholar 

  18. Blossfeld, H.-P., & Timm, A. (Eds.). (2003). Who marries whom? Educational systems as marriage markets in modern societies. European Studies of Population (Vol. 12). Boston: Kluwar Academic Publishers.

  19. Bourdieu, P. (2011). The forms of capital. In S. Imre & T. Kaposy (Eds.), Cultural theory: An anthology (pp. 81–93). Chichester: Wiley-Blackwell (Original work published 1986).

    Google Scholar 

  20. Buddeberg-Fischer, B., Klaghofer, R., Abel, T., & Buddeberg, C. (2006). Swiss residents' speciality choices–impact of gender, personality traits, career motivation and life goals. BMC Health Services Research, 6(1), 137. https://doi.org/10.1186/1472-6963-6-137.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Caldwell, J. C., Reddy, P. H., & Caldwell, P. (1983). The causes of marriage change in South India. Population Studies, 37(3), 343–361. https://doi.org/10.1080/00324728.1983.10408866.

    Article  Google Scholar 

  22. Carter, A. T. (1973). A comparative analysis of systems of kinship and marriage in South Asia. Proceedings of the Royal Anthropological Institute of Great Britain and Ireland, 1973, 29-54. https://doi.org/10.2307/3031719.

  23. Channel News Asia (2013, September 29). Pakistan: ‘Doctor Brides’ in huge demand [YouTube video]. Retrieved from https://www.youtube.com/watch?v=GbIvMUkbkgg.

  24. Charania, M. (2014). Feminism, sexuality and the rhetoric of westernization in Pakistan: Precarious citizenship. In L. Fernandes (Ed.), Handbook of gender in South Asia (pp. 318–332). New York: Routledge.

    Google Scholar 

  25. Chiappori, P., Iyigun, M., & Weiss, Y. (2006). Investment in schooling and the marriage market. IZA Discussion Papers, No. 2454. http://nbn-resolving.de/urn:nbn:de:101:1-20080702262.

  26. Diekman, A. B., Brown, E. R., Johnston, A. M., & Clark, E. K. (2010). Seeking congruity between goals and roles: A new look at why women opt out of science, technology, engineering, and mathematics careers. Psychological Science, 21(8), 1051–1057. https://doi.org/10.1177/0956797610377342.

    Article  PubMed  Google Scholar 

  27. DiMaggio, P., & Mohr, J. (1985). Cultural capital, educational attainment, and marital selection. American Journal of Sociology, 90(6), 1231–1261. https://doi.org/10.1086/228209.

    Article  Google Scholar 

  28. DiPrete, T. A., & Buchmann, C. (2006). Gender-specific trends in the value of education and the emerging gender gap in college completion. Demography, 43(1), 1–24. https://doi.org/10.1353/dem.2006.0003.

    Article  PubMed  Google Scholar 

  29. Donnan, H. (1985). The rules and rhetoric of marriage negotiations among the Dhund Abbasi of northeast Pakistan. Ethnology, 24(3), 183–196. https://doi.org/10.2307/3773609.

    Article  Google Scholar 

  30. Donner, H. (2005). “Children are capital, grandchildren are interest”: Changing educational strategies and parenting in Calcutta’s middle-class families. In J. Assayag & C. J. Fuller (Eds.), Globalizing India: Perspectives from below (pp. 119–139). London: Anthem Press.

    Google Scholar 

  31. Dorsey, E. R., Jarjoura, D., & Rutecki, G. W. (2005). The influence of controllable lifestyle and sex on the specialty choices of graduating US medical students, 1996–2003. Academic Medicine, 80(9), 791–796.

    Article  Google Scholar 

  32. Drury, D. (1993). The iron school master. Education, employment and the family in India. New Delhi: Hindustan Book Company.

    Google Scholar 

  33. Dube, L. (1997). Women and kinship: Comparative perspectives on gender in south and south-east Asia. Tokyo: UNU Press.

    Google Scholar 

  34. Eccles, J. S. (1994). Understanding women’s educational and occupational choices. Psychology of Women Quarterly, 18(4), 585–609. https://doi.org/10.1111/j.1471-6402.1994.tb01049.x.

    Article  Google Scholar 

  35. Eccles, J. S., Jacobs, J. E., & Harold, R. D. (1990). Gender role stereotypes, expectancy effects, and parents’ socialization of gender differences. Journal of Social Issues, 46(2), 183–201. https://doi.org/10.1111/j.1540-4560.1990.tb01929.x.

    Article  Google Scholar 

  36. Elias, N. T., & Malik, A. A. (2009). Development of Naheed Anila Index for Mate Assessment (NAIMA). Journal of Couple & Relationship Therapy, 8(1), 52–63. https://doi.org/10.1080/15332690802626718.

    Article  Google Scholar 

  37. Etzkowitz, H., Kemelgor, C., Neuschatz, M., & Uzzi, B. (1992). Athena unbound: Barriers to women in academic science and engineering. Science and Public Policy, 19(3), 157–179. https://doi.org/10.1093/spp/19.3.157.

    Article  Google Scholar 

  38. Fischer, M. D. (1991). Marriage and power: Tradition and transition in an urban Punjabi community. In H. Donnan & P. Werbner (Eds.), Economy and culture in Pakistan (pp. 97–123). UK: Palgrave Macmillan.

    Google Scholar 

  39. Forbes, G. H. (1994). Medical careers and health care for Indian women: Patterns of control. Women's History Review, 3(4), 515–530. https://doi.org/10.1080/09612029400200067.

    Article  Google Scholar 

  40. Forbes, G. H. (1996). New Cambridge history of India: Women in modern India (Vol. 2). Cambridge: Cambridge University Press.

    Book  Google Scholar 

  41. Forbes, G. H. (2005). Women in colonial India: Essays on politics, medicine, and historiography. India: Orient Blackswan.

    Google Scholar 

  42. Fricke, T. E., Syed, S. H., & Smith, P. C. (1986). Rural Punjabi social organization and marriage timing strategies in Pakistan. Demography, 23(4), 489–508. https://doi.org/10.2307/2061347.

    Article  PubMed  Google Scholar 

  43. Furstenberg, F. F. (2005). Banking on families: How families generate and distribute social capital. Journal of Marriage and Family, 67(4), 809–821. https://doi.org/10.1111/j.1741-3737.2005.00177.x.

    Article  Google Scholar 

  44. Ghimire, D. J., Axinn, W. G., Yabiku, S. T., & Thornton, A. (2006). Social change, premarital nonfamily experience, and spouse choice in an arranged marriage society. American Journal of Sociology, 111(4), 1181–1218. https://doi.org/10.1086/498468.

    Article  Google Scholar 

  45. Goldstein, J. R., & Kenney, C. T. (2001). Marriage delayed or marriage forgone? New cohort forecasts of first marriage for US women. American Sociological Review, 66(4), 506-519. Retrieved from http://www.jstor.org/stable/3088920.

  46. Grown, C., Gupta, G. R., & Khan, Z. (2003). Promises to keep: Achieving gender equality and the empowerment of women. Background paper for the UN millennium project task force on education and gender equality. Washington, DC: International Center for Research on Women.

    Google Scholar 

  47. Grünenfelder, J. (2013). Discourses of gender identities and gender roles in Pakistan: Women and non-domestic work in political representations. Women's Studies International Forum, 40, 68–77.

    Article  Google Scholar 

  48. Henwood, F. (2010). WISE choices? Understanding occupational decision making in a climate of equal opportunity for women in science and technology. Gender and Education, 8(2), 199–214. https://doi.org/10.1080/09540259650038860.

    Article  Google Scholar 

  49. Hodge, R. W., Siegel, P. M., & Rossi, P. H. (1964). Occupational prestige in the United States, 1925-63. American Journal of Sociology, 70(3), 286–302. https://doi.org/10.1086/223840.

    Article  Google Scholar 

  50. Humayun, M. (2014, September 30). PMDC’s 50:50 quota – playing with our lives and our future [Blog post]. The Express Tribunes Blogs. Retrieved from http://blogs.tribune.com.pk/story/24256/pmdcs-5050-quota-playing-with-our-lives-and-our-future/.

  51. Jafarey, S., Mainali, R. M., & Montes-Rojas, G. (2014). The anticipation effect of marriage on female education: Theory and evidence from Nepal (Report No. 15/12). London: Department of Economics, City University London. Retrieved from http://openaccess.city.ac.uk/13875/.

  52. Jayaweera, S. (1997). Women, education and empowerment in Asia. Gender and Education, 9(4), 411–424. https://doi.org/10.1080/09540259721169.

    Article  Google Scholar 

  53. Jeffery, R., & Basu, A. M. (1996). Girls' schooling, women's autonomy and fertility change in South Asia. London: Sage.

    Google Scholar 

  54. Junaidi, I. (2014, October 22). 50pc of female doctors never work after graduation. Dawn. Retrieved from http://www.dawn.com/news/1139557.

  55. Kandiyoti, D. (1988). Bargaining with patriarchy. Gender and Society, 2(3), 274–290. https://doi.org/10.1177/089124388002003004.

    Article  Google Scholar 

  56. Khan, R. E. A., & Ali, K. (2005). Bargaining over sons and daughters’ schooling: Probit analysis of household behaviour in Pakistan. Working Paper, 01-05, Department of Economics, Bahawalpur, Islamia University. Retrieved from https://core.ac.uk/download/pdf/9315048.pdf.

  57. Khan, M. M., & Reza, H. (1998). Gender differences in nonfatal suicidal behavior in Pakistan: Significance of sociocultural factors. Suicide and Life-threatening Behavior, 28(1), 62–68. https://doi.org/10.1111/j.1943-278X.1998.tb00626.x.

    Article  PubMed  Google Scholar 

  58. Khurshid, A. (2012). A transnational community of Pakistani Muslim women: Narratives of rights, honor, and wisdom in a women's education project. Anthropology & Education Quarterly, 43(3), 235–252. https://doi.org/10.1111/j.1548-1492.2012.01176.x.

    Article  Google Scholar 

  59. Khurshid, A. (2015). Islamic traditions of modernity gender, class, and Islam in a transnational Women’s education project. Gender and Society, 29(1), 98–121. https://doi.org/10.1177/0891243214549193.

    Article  Google Scholar 

  60. Lahiri, S., & Self, S. (2007). Gender bias in education: The role of inter-household externality, dowry and other social institutions. Review of Development Economics, 11(4), 591–606. https://doi.org/10.1111/j.1467-9361.2007.00387.x.

    Article  Google Scholar 

  61. Levy, R. I., & Hollan, D. W. (2015). Person-centered interviewing and observation. In H. Russell Bernard (Ed.), Handbook of methods in cultural anthropology (pp. 333–364). Lanham: Altamira Press.

    Google Scholar 

  62. Lukose, R. A. (2009). Liberalization’s children: Gender, youth, and consumer citizenship in globalizing India. Durham: Duke University Press.

    Book  Google Scholar 

  63. Mare, R. D. (1991). Five decades of educational assortative mating. American Sociological Review, 56(1) 15-32. Retrieved from http://www.jstor.org/stable/2095670.

  64. Marrow, J. (2013). Feminine power or feminine weakness? North Indian girls’ struggles with aspirations, agency, and psychosomatic illness. American Ethnologist, 40(2), 347–361. https://doi.org/10.1111/amet.12026.

    Article  Google Scholar 

  65. Memon, G. R. (2007). Education in Pakistan: The key issues, problems and the new challenges. Journal of Management and Social Sciences, 3(1), 47–55.

    Google Scholar 

  66. Mines, M. (1988). Conceptualizing the person: Hierarchical society and individual autonomy in India. American Anthropologist, 90(3), 568–579. https://doi.org/10.1525/aa.1988.90.3.02a00030.

    Article  Google Scholar 

  67. Mines, M. (1994). Public faces, private lives: Community and individuality in South India. Berkeley: University of California Press.

    Book  Google Scholar 

  68. Nair, J. (1990). Uncovering the Zenana: Visions of Indian womanhood in Englishwomen's writings, 1813-1940. Journal of Women’s History, 2(1), 8–34. https://doi.org/10.1353/jowh.2010.0263.

    Article  Google Scholar 

  69. Pakistan Council of Research and Technology (2013). Pakistani women in science and technology. Pakistan Council of Research and Technology. Retrieved from http://www.pcst.org.pk/wst/.

  70. Pakistan Medical and Dental Council (PM&DC) (2017). Statistics. Pakistan Medical and Dental Council. Retrieved from http://www.pmdc.org.pk/Statistics/tabid/103/Default.aspx.

  71. Pande, R. (2015). ‘I arranged my own marriage’: Arranged marriages and post-colonial feminism. Gender, Place & Culture, 22(2), 172–187. https://doi.org/10.1080/0966369X.2013.855630.

    Article  Google Scholar 

  72. Patton, M. (1990). Qualitative evaluation and research methods: Integrating theory and practice. London: Sage Publishers.

    Google Scholar 

  73. Psacharopoulos, G. (1994). Returns to investment in education: A global update. World Development, 22(9), 1325–1343. https://doi.org/10.1016/0305-750X(94)90007-8.

    Article  Google Scholar 

  74. Qian, Z. (1998). Changes in assortative mating: The impact of age and education, 1970–1890. Demography, 35(3), 279-292. Retrieved from https://link.springer.com/article/10.2307%2F3004036?LI=true.

  75. Rafiq, H. M. W., Fatima, T., Sohail, M. M., Saleem, M., & Khan, M. A. (2013). Parental involvement and academic achievement: A study on secondary school students of Lahore, Pakistan. International Journal of Humanities and Social Science, 3(8), 209–223.

    Google Scholar 

  76. Rose, E. (2004). Education and hypergamy in marriage markets. Seattle: University of Washington Department of Economics.

    Google Scholar 

  77. Samari, G. (2017). Women’s agency and fertility: Recent evidence from Egypt. Population Research and Policy Review, 36(4), 561–582. https://doi.org/10.1007/s11113-017-9427-3.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Sathar, Z. A., & Mason, K. O. (1993). How female education affects reproductive behavior in urban Pakistan. Asian and Pacific Population Forum, 6(4), 93–103.

    PubMed  Google Scholar 

  79. Seymour, E. (1999). The role of socialization in shaping the career-related choices of undergraduate women in science, mathematics, and engineering majors. Annals of the New York Academy of Sciences, 869(1), 118–126. https://doi.org/10.1111/j.1749-6632.1999.tb08366.x.

    Article  Google Scholar 

  80. Shah, A. M. (2012). The structure of Indian society: Then and now. London: Routledge.

    Book  Google Scholar 

  81. Shaw, A. (2006). The arranged transnational cousin marriages of British Pakistanis: Critique, dissent and cultural continuity. Contemporary South Asia, 15(2), 209–220. https://doi.org/10.1080/09584930600955317.

    Article  Google Scholar 

  82. Shaw, A., & Charsley, K. (2006). Rishtas: Adding emotion to strategy in understanding British Pakistani transnational marriages. Global Networks, 6(4), 405–421. https://doi.org/10.1111/j.1471-0374.2006.00152.x.

    Article  Google Scholar 

  83. Shortell, S. M. (1974). Occupational prestige differences within the medical and allied health professions. Social Science & Medicine, 8(1), 1–9. https://doi.org/10.1016/0037-7856(74)90003-1.

    Article  Google Scholar 

  84. Smith, J. L., Kausar, R., & Holt-Lunstad, J. (2007). Stigma consciousness in the classroom: A comparison of Pakistani women’s motivation and well-being in science and non-science fields of study. Sex Roles, 57(1-2), 3–13. https://doi.org/10.1007/s11199-007-9217-1.

    Article  Google Scholar 

  85. Stone, P. (2007). Opting out?: Why women really quit careers and head home. Berkeley: University of California Press.

    Google Scholar 

  86. Sweeney, M. M. (2002). Two decades of family change: The shifting economic foundations of marriage. American Sociological Review, 67(1), 132-147. Retrieved from http://www.jstor.org/stable/3088937.

  87. Valian, V. (2005). Beyond gender schemas: Improving the advancement of women in academia. Hypatia, 20, 198–213. https://doi.org/10.1111/j.1527-2001.2005.tb00495.x.

    Article  Google Scholar 

  88. Wardlow, H. (2006). Wayward women: Sexuality and agency in a New Guinea society. Berkeley: University of California Press.

    Google Scholar 

  89. Wiquar, A. (2014, November 8). The PMDC quota rule: A boon or a bane for Pakistan’s healthcare future? [Blog post]. Journal of Pioneering Medical Sciences Blog. Retrieved from http://blogs.jpmsonline.com/2014/11/08/the-pmdc-quota-rule-a-boon-or-a-bane-for-pakistans-healthcare-future/.

  90. Xie, Y., & Shauman, K. A. (2003). Women in science: Career processes and outcomes. Cambridge: Harvard University Press.

    Google Scholar 

  91. Zakaria, R. (2013, July 26). The doctor brides. Dawn. Retrieved from http://www.dawn.com/news/1032070.

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Acknowledgments

The research for the present paper was supported by grants from Wenner-Gren Foundation, Arizona State University and American Institute of Pakistan Studies.

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Correspondence to Ayesha Masood.

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Masood, A. Influence of Marriage on Women’s Participation in Medicine: The Case of Doctor Brides of Pakistan. Sex Roles 80, 105–122 (2019). https://doi.org/10.1007/s11199-018-0909-5

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Keywords

  • Women in science
  • Technology
  • Engineering and mathematics
  • Marriage and family measures
  • Muslim women
  • Gender gap