Traditional practices and beliefs around placental disposal in Pakistan: Community perspectives and implications for environmentally safe and culturally sensitive practices.

Objective: This study explored the traditional beliefs, practices of the community and health system in relation to safe placental disposal in Pakistan, focusing on implications for environmental health and climate change. Methodology: A qualitative exploratory study was conducted from June 2025 to September 2025 at Primary Healthcare (PHC) centers of Indus Hospital and Health Network located in Sindh, Punjab, Baluchistan, and Kashmir. Data were collected through 14 in-depth interviews with women of reproductive age and three focus group discussions with midwives and the community health workers CHWs. All in-depth interviews (IDIs) and focus group discussions (FGDs) transcripts were created from verbatim data and then coded, triangulated with field notes, and thematically coded by following Braun and Clarke's six-step framework for thematic analysis. Results: The five themes that emerged were knowledge and understanding of the placenta, cultural and symbolic beliefs, disposal practices, intergenerational roles, and cultural logic beyond hygiene. IDIs yield personal overtones such as the ideas of impurity, beliefs related to fertility, rituals and distrust of hospitals. FGDs highlighted shared consensus, where burial was a practice of honor and security and women were shown to be deprived of agency in hospitals. Conclusion: In Pakistan, placenta disposal is a culturally symbolic practice that has not been adequately incorporated into safe clinical protocols, which leaves gaps in environmental safety. The current challenges need culturally sensitive, environmentally sustainable and climate resilient approaches in healthcare systems.