“They are being made into like baby-making machines” : a study of the impact of gender structures and norms on family planning for Xhosa women in rural Zithulele, South Africa

Women in rural areas of South Africa battle with many structural issues, including unemployment, education and accessibility to health services, greatly delimiting family planning. However, socially constructed and internalized gender norms pose an additional and potentially greater barrier to family planning in traditional and patriarchal settings. This thesis aims to contribute to the growing research on the relation of gendered structures and norms to family planning outcomes. It explores how gender stratified systems and structural determinants exasperate such norms for pregnant women. A case-study was conducted in rural Zithulele, based on theoretical concepts from public health, feminism, constructivism and development studies, to conduct semi-structured interviews with pregnant Xhosa mothers. It follows a gendered health framework to determine localized socio-economic and family planning outcomes, finding that there are a number of deeply gendered structural determinants, which interplay with gender norms pertaining to masculinity, femininity and contraception, creating restrictive and gender-biased settings limiting women’s family planning options. The found consequences include limited knowledge on family planning and contraceptive side-effects, discontent with pregnancies and not finishing secondary schooling, which affect the long-term socio-economic status and family planning options for individual Xhosa women in rural South Africa