A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science, School of Environment, Resources and Development

Thesis (M.Sc.) - Asian Institute of Technology, 1999

Manmaiju Village Development Committee is one of the areas nearest of Kathmandu district, the most developed city in the country. Being a traditional society guided by patriarchal ideology, there is a prevalence of inequality in gender roles, relations, responsibilities and access to decision-making among men and women in this VDC. This study intended to study and identify women's autonomy in regulating their fertility and adopting family planning methods. Furthermore, it aimed to identify the reproductive health problems of women that could result from using or not having access to fertility regulation. The field research was conducted utilizing qualitative methods: in-depth interview, focus group discussion and informal talks. The study found that at the surface level, women seemed to be enjoying choice in fertility regulation behavior. At the deeper level, women actually do not have autonomy in this aspect of life. Their attempts to regulate their own fertility have been controlled and influenced by the tradition of values and importance given to male children and insecurity feelings for not having sons. Decisions on number of children, use of contraceptives and pregnancy termination were determined by having or not having living son(s).Other socio-economic factors were found to have negligible influence. Further, the reproductive health of women has been found tremendously influenced by the use of contraceptives. Lack of adequate knowledge and information on side effects of contraceptives have made women vulnerable to suffer from severe health problems that were beyond their control. The field study also shed light on the reason for the wide gap between extent of contraceptives knowledge and their use. The most prominent reason for the discontinuation of contraceptives have been their adverse effects on health. The existing situation of health facilities suggests the need for improving it. It is felt that women should have access to adequate information on natural methods as well as the range of contraceptives available and their adverse effects. Current patterns of promoting contraceptives merely for controlling population growth, disregarding women's health, need to be reconsidered.