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Abstract
This dissertation is a study of women's reproductive intentions and changing practices in Dabola, a town of approximately 14,000 in Guinea. Initially a study of women's use of longstanding (traditional) methods of contraception and the newer (modern) pills and injectables provided by the local family planning program, it expanded as a third category of reproductive action emerged, neither contraception nor abortion. By monitoring their bodily experience of menses, women acted to ensure flow, detect changes and blockages ( nyama), and correct problems, with the help of herbal specialists who select plant medicines and instruct the women in their preparation. Through menstrual management, women worked toward the dual goal of avoiding unwanted pregnancies in the short term, and protecting future childbearing potential. Data were collected through a community survey and standard ethnographic methods. Several plant specimens were also collected and identified by an herbarium.
Women's reproductive practices in Dabola were grounded in the knowledge that fanka, their bodily strength or resilience, is depleted with successive pregnancies, births, miscarriages, children's deaths, and other hardships, and can be restored with the proper rest and care. Avoiding pregnancy is one strategy to achieve rest. I found that women varied their strategies of pregnancy avoidance through menstrual response to different social situations and over their life course. After one year of family planning program, 14% of women were using the new contraceptives, more than expected. This high level of use however was consistent with existing fertility goals and with menstrual management as a mechanism to manage fertility.
Although this practice is distinct from abortion in local terms, it is likely to remove some early pregnancies. However, its potential effect on fertility is more likely realized through the women's intervention in menstrual cycles. Recent research indicates that there is more variation in ovarian cycles than had been assumed, which affects fertility. Menstrual management has potential implications for fertility through one of the proximate determinants, fecundability.
