An obstetrician, she led a groundbreaking effort to put women’s rights to control all aspects of their lives at the heart of the global population debate.

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By Ed Shanahan

Dr. Nafis Sadik, a Pakistani obstetrician who as a top United Nations official ensured that women’s rights — not least the right to choose whether to get pregnant — were at the heart of the global population debate, died on Sunday at her home in Manhattan. She was 92.

The death was confirmed by her son, Omar Sadik.

Dr. Sadik made her most lasting mark as the architect and chief promoter of a broad plan to curb population growth around the world, which 179 counties adopted at a U.N. conference in Cairo in 1994.

The plan, strongly resisted by the Vatican and other opponents of abortion, was widely considered revolutionary because of its emphasis on recognizing that women should have control over all aspects of their lives, including their sexual and reproductive health.

“Healthy families are created by choice, not by chance,” Dr. Sadik, who was then the executive director of the U.N. Population Fund, said after the plan, called the Program for Action, was approved. She received a standing ovation.

Dr. Natalie Kanem, the fund’s current director, hailed Dr. Sadik as a “proud champion of choice and tireless advocate for women’s health, rights and empowerment.”

“Since Cairo,” Dr. Kanem said in a statement, “millions of girls and young women have grown up knowing that their bodies belong to them, and that their futures are theirs to shape.”

Nafis Shoaib was born into a Muslim household in Jaunpur, India, on Aug. 18, 1929. Her father, Muhammad Shoaib, an economist, would go on to be Pakistan’s finance minister and a World Bank executive. Her mother, Iffat Ara Shoaib, was the daughter of a woman who died giving birth to her, according to “Champion of Choice,” a 2013 biography of Dr. Sadik by Cathleen Miller.

Dr. Sadik decided as a girl, Ms. Miller wrote, that she wanted “to do something” that might “change the world.”

Undefined as it was, Ms. Miller continued, such ambition “was unusual for a female of her era,” even in the Sadik family’s privileged circles, because “it was assumed that all girls would become wives and mothers.” Dr. Sadik’s independent streak also led her, at 13, to persuade the family’s chauffeur to teach her to drive — rare for an Indian woman, much less a teenage girl.

Young Nafis weighed various occupations — tennis pro, singer, engineer — but none fit her altruistic goal. “I remember vaguely thinking, ‘I’m going to help the poor,’” Dr. Sadik was quoted as recalling in “Champion of Choice.” She decided to pursue a career in medicine.

Her early education was at Loreto College, a convent school in Kolkata, India, then called Calcutta. At her father’s request, the nuns, who had insisted that she study literature, made sure she got the requisite science classes.

Dr. Sadik earned her medical degree at Dow Medical College in Karachi, Pakistan. She was later an intern at Baltimore City Hospital and studied at the Johns Hopkins University School of Medicine.

She started out working in women’s and children’s wards at Pakistani military hospitals. In 1964, she was named to lead the government planning commission’s health section. Two years later, she joined Pakistan’s Central Family Planning Council. She became its director general in 1970.

Dr. Sadik joined the U.N. Population Fund, the body’s sexual and reproductive health arm, in 1971. She became assistant executive director in 1977 and executive director 10 years later. She succeeded Rafael Salas, who had died suddenly, becoming the first woman to lead a major U.N. agency.

In a 2000 interview with The New York Times as she prepared to retire, Dr. Sadik said that when she arrived at the fund, family planning in developing countries mostly involved pressuring poor women to have fewer babies as dictated by government quotas.

“The world has come very far since then,” she said, noting that such quotas had been eliminated. Gone, too, was “population control” as an acceptable term for what family planners did.

By then, the U.N. supported the idea that women should have the right to make their own decisions about bearing children, and with it access to education and health services, a range of family planning tools and, as a last resort, safe abortions.

This progress, she said, extended to areas where squeamishness about sex had stifled conversations about matters that demanded attention.

“The most difficult issues of behavior or practices like rape, incest, female genital mutilation, the idea of female reproductive rights — all these concepts we would never have been able to discuss just a few years ago,’‘ Dr. Sadik told The Times.

In that interview, she recalled deciding early in her career in Pakistan that it was both pointless and inhumane to try to slow population growth by government fiat.

“When I worked in obstetrics,” she said, “I found that when you told women, ‘You must plan your next birth at least two years later,’ they would say: ‘Not for me. I must have a son.’ They were so anemic, so ill — and yet they had no control over their lives.”

Dr. Sadik harnessed that insight while leading the Population Fund, working with other top U.N. officials, many of them women, to bolster women’s rights with the idea that population growth would ebb as they gained more control over their lives.

She also approached the population issue from the perspective of its impact on the natural environment. She wrote in a 1987 Times opinion essay that some people believed population growth was “environmentally neutral,” but that “deforestation and extinction of species are strong evidence to the contrary.”

“It is now clear,” she added, “that the number of people on earth is having a major impact on the environment, on the world economy and on other people — in short, it is affecting how we live now and how we will live.”

In addition to her son, Dr. Sadik is survived by three daughters, Ambereen Dar, Wafa Hasan and Ghazala Abedi; a sister, Nighat Qureshi; 10 grandchildren; and four great-grandchildren. Her husband, Azhar Sadik, a retired oil executive and former major in the Pakistani army, died in 2011. Another daughter, Mehreen Sadik, died in 2015.

Carol Bellamy, whose tenure as the executive director of UNICEF, the U.N.’s child-aid agency, overlapped with Dr. Sadik’s in the same role at the population fund, called her an “incredible leader” who was “thoughtful but tough, in the best sense.”

In an interview, Ms. Bellamy credited Dr. Sadik’s vision with making the 1994 Cairo conference — which also set goals for improving education opportunities for women and children, and for cutting rates of infant, child and maternal mortality — a “breakthrough.”

“She saw the wholeness of women, in their families, their communities, their own lives, that they were more than merely baby producers,” Ms. Bellamy said.

Dr. Sadik, who in her choice of clothing favored the Indian sari over the Pakistani shalwar kameez, believed her Muslim upbringing and her roots in the developing world had helped make her a persuasive messenger to those who might otherwise be skeptical of her ideas.

She also believed in disarming antagonists by simply listening.

“I always treat everybody’s question as the most serious question,” she told Ms. Miller. “And they really don’t know how to react then.”

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