Termed obstetric fistula, in the world of medicine, it is caused by long and stressful labour. In its fight to come out and unable to, the baby’s head puts undue pressure on the lining of the woman’s birth canal causing the wall of the rectum or bladder to tear resulting in urinary or fecal incontinence.

Nasreen says she had not slept fitfully in the last three years after her mother developed this condition while giving birth to her eighth child, who did not survive.

Being the eldest and a daughter, she'd have to get up every two hours in the night to change and wash her mother's clothes, she explained.

But not anymore as Bibi is dry now. She is as happy as Nasreen but for a different reason. "As soon as I am up and about, I will get her married off. We had to delay it for too long because she was taking care of me, the house and her siblings," she explains.

According to United Nations Population Fund (UNFPA), obstructed labour, that Bibi suffered from, is especially common among young, physically immature women giving birth for the first time. Her own injury should make Haseena wary of marrying off her daughter, but Haseena says: "The custom is that a girl must be married off as soon as she gets her period."

Fortunately for Nasreen, once married, she does not plan to have as many kids. "I think I will have three or four," she said shyly.

However, she does not know how and from the looks of it neither does her mother. In public healthcare parlance, this is called unmet need. "It means either the couple does not want anymore children or wants to space the pregnancy but don't know how," explains Dr Farid Midhet, a demographer heading Jhpiego, which is an international, non-profit health organisation affiliated with The Johns Hopkins University.

In Pakistan, six million married women say they don't want more children or want to space births, but are unable to do so," says Dr Zeba Sathar, country director of the Population Council of Pakistan. This comes to one in four women with an unmet need. And like Nasreen, most married Pakistani women (and men) want not more than four children on an average.