When ancient meets modern: the relationship between postpartum non-susceptibility and contraception in sub-Saharan Africa

J Biosoc Sci. 2007 Jul;39(4):493-515. doi: 10.1017/S002193200600157X. Epub 2006 Sep 7.


Extended durations of postpartum non-susceptibility (PPNS) comprising lactational amenorrhoea and associated taboos on sex have been a central component of traditional reproductive regimes in sub-Saharan Africa. In situations of rising contraceptive prevalence this paper draws on data from the Demographic Health Surveys to consider the neglected interface between ancient and modern methods of regulation. The analysis reports striking contrasts between countries. At one extreme a woman's natural susceptibility status appears to have little bearing on the decision to use contraception in Zimbabwe, with widespread 'double-protection'. By contrast, contraceptive use in Kenya and Ghana builds directly onto underlying patterns of PPNS. Possible explanations for the differences and the implications for theory and policy are discussed.

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara
  • Amenorrhea*
  • Contraception / statistics & numerical data*
  • Family Planning Services
  • Female
  • Fertility*
  • Health Behavior
  • Health Surveys
  • Humans
  • Lactation*
  • Postpartum Period*
  • Pregnancy
  • Prevalence
  • Sexual Behavior / ethnology*
  • Surveys and Questionnaires
  • Taboo*
  • Time