Negotiating Contraception: Case Studies in Rural Mexican Villages

Sonia A. Castañeda, University of Texas at Austin

I use experiences in four Mexican villages in rural Michoacán, Mexico (135 in-depth interviews of providers and village women) to examine the roles (dynamic and passive) of village women and medical personnel in contraceptive choice. Though government normative guidelines stress informed choice and quality of care, public medical personnel seem to prefer recommending certain method types to others. They find themselves in a difficult role: caught between the woman's right to choose, institutional goals, and limited resources to dispense. Among women: history of deliveries (public/private) is related to contraceptive knowledge, decisions to use, and choice of specific methods. Contraceptive choice (and continuance) is a negotiation. Factors such as the influence of medical authority, past experience with providers, side effects, contraceptive failure, and spousal separation due to migration, play important parts. Women's relationship with medical authority, and the attitude of key players with authority also play a role.