En aquellas obras que afecten o beneficien únicamente a un determinado

Although a strong ethos of ‘loving children’ was evident, most women at some stage considered birth spacing or limiting family size. When participants were asked the ‘ideal number of children’, most answers fell between three and five. Economic restraints were usually cited as limiting family size, such as perceived increasing difficulty in caring for children properly with ‘prices going up’; decreasing availability of land and food; ‘diseases of these days’; and difficulties in satisfying children’s material aspirations for items such as nice clothes:

‘Mostly, here in the village, the problem is finding money to take care of children, because to find money, farming is necessary. Here in Karonga most people grow cassava, and need to sell it at market. All of us sell cassava, yet very few people buy it. That means some of us stay there for a week, without selling the cassava, whilst at home you have seven or eight children waiting for your assistance, because most of our husbands are jobless, and we all depend on farming. Village life nowadays is [about] money. That is what we need to take care for our children. That is what we are lacking’ WB, G5, age 24

There was wide awareness of government policy towards fertility reduction. Women reported that health centres or ‘the government’ told them they should only have three or four children. Health education talks and songs repeatedly warned women that if they had numerous children they would be overwhelmed with responsibilities and hardship, and would neglect their husband, leading to him being unfaithful and ‘bringing home diseases’.

A number of traditional and modern methods were used by LH women, including the contraceptive pill and injection, condoms, ‘the rope’ or beads (tied around the waist to

prevent pregnancy) and herbal infusions. Women changed methods according to their situation as F69’s case illustrates:

F69. Twenty-nine years old

Two years after her second child was born, F69 went to an elder person for traditional beads to prevent pregnancy. She wore them for a year, but her husband found them and would not agree to her wearing them. He untied the beads, and that month she became pregnant, as her husband was pestering her to have sex even though she wanted to abstain in order to ‘care for the child’. People discouraged her from using modern contraception, saying that she would have miscarriages and problems giving birth in future. She visited the elder person again when her last child was born, but they refused to give her anything, saying she was too young and should carry on giving birth. So she went to the hospital and got the injection instead [likely to have been Depo-Provera], without telling her husband.

Talk of contraception was polarised between enthusiastic accounts of its benefits (possibly because women thought this was what interviewers wanted to hear, as many participants associated researchers with hospitals and family planning provision), and dramatic stories of side effects. Contraceptives were talked about in terms of protecting existing children by postponing the next pregnancy, rather than preventing future pregnancies39, as closely spaced pregnancies were considered unwise:

‘Children grow up healthily, but if you do not practice child spacing they do not look nice and you feel shy showing people that ‘this is my child’. However, if you do family planning, children grow up healthily and their appearance tallies with their age, and you feel proud showing people that ‘this is my child’’ WB, G5, age 24

Although women widely recognised the benefits of birth spacing, they frequently voiced fears of side effects, including ‘sores, uterine cancer, and bleeding’ (F76); pain, sickness and death (F68); and causing periods to stop (F55). Other women talked about how contraceptives can ‘remove your fertility’ (F49). F73 said that some people’s blood ‘fitted’ with contraception, whereas others’ did not: she stated that such women would have future problems giving birth, and their blood might clot and kill them.

The prevailing attitude towards family planning was that married women should only practice it for a good reason, such as child spacing; ‘resting’ after reproductive problems such as stillbirth or miscarriage; kick-starting periods to regain fertility; when they had

39 _{When women were asked when they had used a contraceptive, the way they answered was to say which} child they had used it after: e.g. ‘wachizungu uwo pa mwana wa 1996 uyo’; I used the modern

enough children; or if there were health risks inherent in further pregnancies. Without a good reason, married women were expected to be willing to get pregnant, and it was almost inconceivable that a couple would marry and use contraceptives before having a child. In ANC data, only 2% of nulliparous women had used contraception, and qualitative data suggest this would probably have been before marriage (though this may underestimate condom use, which is often not reported as a family planning method, being seen instead as an HIV prevention method). The percentage of women who had ever used contraception rose to 14% in women attending ANC for their second pregnancy (those who had already had one birth). When F52 was asked if she wanted more than the two children she currently had, she simply replied, ‘can you hate a child?’ The alternative to not wanting more children seemed to be hating them. F44 had never become pregnant in her marriage, and her husband’s attitude was that if she had been deliberately stopping herself from having children (‘like some women with many children do’), he would have divorced her, but as their infertility was ‘the will of God’, he accepted the situation.

Not all women complied with the accepted circumstances for contraceptive use. What constituted a good enough reason for practicing family planning was often contested between husbands and wives, and so women might use hormonal contraceptives in particular without their husbands’ knowledge. F70 described how her second husband wanted a child, but she wanted to ‘rest’ after giving birth a year previously to her first husband’s child:

‘If a woman has a child, you have to say ‘father [husband], let us rest’. But my husband said ‘no, let us be giving birth, because bride price is for giving birth’…Tomorrow they will push you away [if you don’t give birth], so you can’t say ‘I can not give birth and I should rest first’ No, you have to give birth and then see how your life is going and at some point you can be closed [sterilised]. But at the moment I am still young’ F70, age 31

She secretly used traditional contraceptives, and when she did not conceive, her husband asked her ‘why aren’t you getting pregnant?’ and took her for a check up at hospital. After this she stopped using traditional contraception and had a child. Other women who used contraception outside marriage constructed what they thought were more morally acceptable reasons for doing so, such as avoiding pregnancy with boyfriends while they were still evaluating their reliability and ability to provide: ‘when they were not sure if their boyfriend would support them if they became pregnant’ (F7).