Although teenage marriages are on the decline in Pakistan, one out of six women aged 15-19 years is married [
1]. Strong societal, cultural and religious expectations are attached to the sexual innocence and ignorance of women as a sign of purity and virginity, with marriage marking the beginning of sexual relations and childbearing [
2]. There is great societal pressure on parents to arrange marriages for their daughters [
2], with marriages traditionally arranged by families with minimal involvement of the couple [
3]. In the 2002 Adolescent and Youth Survey of Pakistan, 80% of women and 85% of men reported being married to relatives [
4]. Marriage initiates new living arrangements and many new relationships, including the husband and his family, and most women find motherhood the main focus of their new life at the expense of personal or relationship development in other areas [
3]. Existing literature shows that young people, especially women, have poor knowledge about sexuality and reproductive health [
5‐
10]. A community-based study by Sajan & Fikree (2002) in the squatter settlements of Karachi found a high prevalence of gynaecological morbidity among young married women. Women who began sexual activity in their teens, as compared to women who started after 25 years of age, reported a greater burden of reproductive ill-health. This affirms the risks associated with early marriage and the need to improve and broaden reproductive health services and education [
11]. In an earlier study the authors interviewed newly married young women in the same slum area about their experiences of marriage. A narrative analysis of the interviews revealed the submissive nature of the respondents [
12]. The submission described by participants was instilled in the young women through the impact of diverse levels of the family, community and society on their lives: their parents deciding about their marriage, often without their consent, the extensive demands placed on them by their parents-in-law and the pervasive societal expectations for them to be obedient in all spheres of life. Many of the difficulties young women experience are related to societal beliefs and expectations that make them more vulnerable to reproductive ill health [
11,
13,
14].
To further investigate the situation of young women living in the slum area in Islamabad this study explores how they are prepared for marriage and perceive their transition to marriage and start of sexual and childbearing activity.