Contraceptive use and intention in Pakistan is examined in a multivariate analysis of the probability of using contraceptives based on husband-wife communication, son preference, fatalism, female autonomy, and family planning (FP) program accessibility. Data were obtained from the Pakistan Demographic and Health Survey for 1990-91, which was a 2-stage stratified random sampling of 4 regions and urban and rural areas. Control variables were women's current age, living children, education, husband's education and occupation, region of residence, and status of resident as permanent or migrant to an urban area. Fatalism was measured as the response that additional children were up to God. Female autonomy was measured as the ability of the wife to attend a health clinic by herself. Program accessibility was measured by ease in getting to a FP clinic, the hearing of a media broadcast on FP, and knowledge of availability of contraception. The results showed that 86% of women are not currently using contraception; rural use was 6%, and urban use was 21%. Use was found to be higher as socioeconomic status increased. Higher contraceptive usage was related to knowledge and access to FP husband and wife communication, and couple's approval of FP. Several models reflected socioeconomic and demographic characteristics and supply related variables. Multiple regression results indicated that predictors of contraceptive use were living children, women's education, urban residence, autonomy to go the hospital alone, knowledge and access to FP sources, and a high husband-wife communication for urban and rural areas. FP variables were found to account for the influence of husband's education and occupation. The urban sample showed regional residence differences for Sind, NWFP, Baluchistan, and Punjab women. Baluchistan women were less likely than Punjab women to use contraception. Cousin marriage was significant and negative only for urban women. There was confirmation of the important of living sons but also some support for living daughters. Analysis was also conducted on a sample of husbands. Explanatory variables of significance were low level of husband-wife communication, son preference, female autonomy, belief in fate, and the FP program variables. For both men and women, about 33% of the variance is explained by husband-wife communication.