Understanding trends, transitions and perceptions of fertility and family planning in a fragile context : South Kivu, Democratic Republic of Congo

This doctoral thesis illustrates how reproduction evolves as a social process profoundly influenced by but also as an instigator of socio-cultural, economic, political, health and personal lived realities and change. Using a mixed methods approach, this study demonstrates how the social-embeddedness of fertility is manifested in practice and lived reality in South Kivu, Democratic Republic of Congo: the introduction of contraceptive technologies has altered and shifted power dynamics and possibilities while also raising new socio-cultural and political questions, concerns and uncertainties.
Rather than simplifying reproductive realities in South Kivu this work accomplishes the very opposite: rousing and highlighting the complexities underlying, moving, shaping and influencing fertility, family planning discourse and contraceptive use. Findings form a coherent narrative illustrating where reproduction, fertility and family planning are embedded at the intersection of four conceptual categories: the individual (women and men of reproductive age, individual members of kinship networks who stand to benefit from another’s fertility, health providers and religious leaders); society, community and relationships (conjugal and sexual partners, kinship and social networks); institutions (the State, the health system, religious communities and doctrines); and the broader context (political climate, environment and land, safety and security). This thesis describes how these categories are interconnected and mutually constitutive but also fluid and dynamic – and highly influential.
Fertility, reproduction, family planning and contraception sit at the intersection of health, rights and gendered and global power dynamics. The framing of these spaces has far reaching implications for global health discourses, strategies, outcomes and justice movements – the most tangible of which are seen in the shaping of the reproductive choices and realities of women in South Kivu and beyond.