In this book, Third World Women Speak Out: Interviews in Six Countries On Change, Development, and Basic Needs (Praeger Publishers, 383 Madison Avenue, NewYork, NY 10017 USA, published In cooperation with the Overseas Development Council), about the complex problems experienced dally by women In the developing world, the women themselves describe birth control decisions similar to those ot the Muslim women In the preceding article.

In Mombasa, Kenya, I met with a family planning worker, Mary Mwado, who has worthed in the population field for many years. She met me for lunch in a downtown restaurant one Sunday — accompanied by her husband, who respectfully listened while she told me about some of the problems she encounters in her work :

"We get referrals from other workers. A nutritionist, for example, will come and tell us that she visited a home and feels that the home needs advice on family planning. So we go to the family and talk with them. We also go to the child welfare clinic and talk with mothers there. We find that some do not feel free to talk about their problems there, so we go to their own homes and have further discussions. The woman might say, 'I'm willing to practice planning, but my husband is against it. I've tried to persuade him, but he has refused. So I don't know whetherthere is anything you can do for me'."

I asked Mary Mwado what reasons the men give for their opposition to family planning. "Some say that they are able to care for their children — so they don't see why they should participate in family planning. Others say they don't see why they should plan their families, since the idea is not an African tradition but has been brought in
by Westerners. Also, some men fear that when a woman starts using family planning, she is in that way exposed to the world and can go with any other man, since she knows she won't get pregnant. They don't trust their wives.' Mary Mwado's words were echoed by a group of women I later met in the same town. All were members of local service organizations and thus represented the educated and concerned women of the area. As we discussed barriers to family planning, they explained that superstition, fear, and their husbands' attitudes — as well as polygamy — are the important factors that relate to the family planning issue in their region. One woman told me, "Women fear medicines and they fear their husbands. There are a lot of fears, and it will take much time to catch on." A second woman added ;

   "The men don't understand that family planning is good because it gives the woman time to rest between pregnancies. They don't care much about that, or about the condition of their children. You'll never see a man going to a family planning clinic. The men here believe ; Let a woman be free of childbearing and she will go everywhere. They want a woman to have achild every year until she becomes old, while they are free to go gadding about. So if a woman doesn't keep on having children, her husband will get angry and take another wife."

My conversations with rural women persuaded me that — in contrast to their relatively free resort to folk "remedies", such as those described by the Tunisian woman quoted earlier — they rarely feel free to decide to use modern contraceptive methods on their own, without the approval of their menfolk. If they use such methods, it is either because they have obtained the consent of their husbands, or because the leaders of their nation have urged people to plan their families. If the latter is true, women can then say to their husbands: "The President told us to do it." This was the case in Tunisia, where President Bourguiba repeatedly had taken a public stand on the importance of parental responsibility toward children, and thus the advantages of family planning.

   A nomad woman I met in a public health clinic near Sfax, Tunisia, told me that she had had ten children and then had obtained and lUD despite her husband's objections. When I asked why he had objected, she said :

   "My husband used to say that it isn't normal to avoid a life that you are destined to have. He said that if I had been given a potential to bear a certain number of children, it was necessary to bring them into the world. He said I didn't have the right to prevent it — that I was like a chicken with a certain number of eggs to lay, and that I had to lay them. He said it would be a sin not to.

   "My husband at first didn't know that I had an lUD. I didn't want any more children. My health wouldn't stand it. Now he agrees because they talk about it on the radio."

In Le Kef, Tunisia, I talked one morning with another nomad woman who was still propped up in her bed in the family planning clinic, having undergone a tubal ligation the day before. She said she was relieved that now she could not get pregnant again; she was thirty-five years old and did not want any more children. Her husband is a shepherd, and the family follows the herd of sheep in a seasonal search for grass. They pitch their tent wherever they find water.

   "I was married at thirteen", she told me. "I had just reached puberty. Now I have five children. The youngest is three years old. I had eleven children in all — six others died. Two were stillborn, and the others died before they were a year old."

   Although Tunisia has a relatively well-organized and well staffed medical infrastructure, this woman — because she follows her husband and the herds from one end of the country to the other — had little experience with health-care services. She was visibly nervous about our visit — the hospital surroundings were unfamiliar to her, and this was the first time she had ever been in a bed. I asked her whether a midwife had been present at the births of her children.

   "Sometimes, yes, but sometimes 1 was alone. The last time, I had complications. The child just wouldn't come out. The head came out and then went back in again. Finally, they decided to take me to the hospital, but 1 gave birth on the way. The baby was already dead, so I turned around and went home."

   I asked this young woman how long she generally nursed her children.

   "About two and a half years", she replied. "I wanted to have this operation because I can't care for more children. We are too poor. Before, all the babies were dying. I was afraid to stop having children because I thought they might all die. I want my children to have lots of things, and I want them to have a good place in life, but my husband doesn't agree with these things. My daughters have never been to school. Only one son has attended school, and he has to change each time we move again."

   I asked what her husband thought about her operation to prevent new pregnancies. He had agreed to it, she told me, and then added, "But he wanted me to wait until summer was over, so I could help in the fields.

   "I guess all the women of the world have these same problems. I just don't understand my life. I have nothing to wish for. I am here — that is all. Life doesn't serve any purpose at all."

   When I questioned the woman further, I found that she had never heard about family planning or contraceptives. She had only heard that there was "an operation". A cousin had told her about it.