Capacity Of Women Research Articles

The Spanish Monarchy in Mary Hays’s Biographical Works

ABSTRACTEnglish writer Mary Hays published two collections of women's biographies: Female Biography (1803) and Memoirs of Queens (1821). There are few Spanish queens in either text, and most of them appear as queen consorts and regents in other European courts. Of note, however, is the biography of the mythical Catholic Queen Isabella of Castile, who was a Spanish queen by birth and right. Given the exogamic dimension of monarchy throughout history, some other Spanish sovereigns, including Charles V and Philip II, are also present in these texts. Accordingly, this study intends to analyse the Spanish monarchs in Hays's biographical works, in that they operate as a convenient site for negotiating Hays's most valued assumptions, such as vindicating women's capacities—in this case the capacity to rule—and also some of the ubiquitous convictions of the Romantic period involving Spain, particularly those related to religious intolerance.

Communication Between Health Workers and Ethnic Minorities in Vietnam.

Background:Vietnam has made notable progress in reducing maternal mortality rates during the past 2 decades, but this overall improvement conceals regional and ethnic inequalities. Ethnic minorities in Vietnam experience high rates of poverty and mortality, and they face communication and cultural barriers when accessing health services. Poor communication with health professionals combined with limited health literacy is concerning, particularly in the maternal health context, and may exacerbate existing inequalities.Objective:This study explores primary health care professionals' perceptions of the quality of their communication with ethnic minority women during and after pregnancy.Methods:Semi-structured interviews were conducted with 22 primary health care professionals in Dien Bien province. A thematic analysis was performed using a framework analysis method.Key Results:Health professionals had mostly positive perceptions about their communication with ethnic minority women. However, they generally perceived the effectiveness of their communication as being based on women's individual capacities to understand health information (both the language used and the content) and factors such as ethnic and cultural differences, rather than reflecting on the suitability of information and materials or on their own communication skills. This placed much of the burden of communication and understanding health information on ethnic minority women and their families.Conclusions:Health professionals perceived of communication as being mainly a one-way street for the provision of health information, and rarely acknowledged the interactive nature of communication. Patient-professional communication and health literacy in Dien Bien province may be improved through the introduction of patient-centered communication skills training that applies health literacy approaches at the health professional level. [Health Literacy Research and Practice. 2017;1(4):e163–e172.]Plain Language Summary:We looked at how primary health care professionals in Vietnam perceive their communication with ethnic minority women, particularly about pregnancy. Health professionals generally perceived the quality and effectiveness of their communication as being based on ethnic minority women's individual capacities and limitations. Applying a health literacy approach to communication skills training could improve patient-professional communication and health literacy.

An ethnography on perceptions of pain in Dutch “Natural” childbirth

Objectivethis study offers insight into how women perceive childbirth pain and how they make decisions about whether to use an epidural during childbirth in the low technology context of the Netherlands maternity care system. Designethnographic research consisting of participant observation at births and prenatal and postnatal appointments; semi-structured interviews with a sample of recently post-partum women; coding and triangulation of data to determine key themes in the interviews. Setting and participantsthe study was carried out with participants in thirteen urban cities around the Netherlands. The 40 post-partum women had lived in the Netherlands for at least 10 years prior to participation in the study, spoke English proficiently, and had a vaginal birth within the past 18 months. Additionally, participant observation occurred in midwifery practices. Findingsanalysis of the interviews revealed three key themes: first, participants perceive childbirth pain as “natural” and positive, and approach its management through non-medical birth methods; second, participants prioritize autonomy in childbirth which they see as something they can “do on [their] own” without pain medication; and third, participants’ decisions about using an epidural was supported by professional advice and social connections, such as friends and family members. Key conclusions and implications for practicewomen's conception of pain is central to decisions about childbirth in the Netherlands. This ethnographic research illustrates how perceptions and attitudes toward childbirth pain are affected by definitions of a “natural” birth, women's capacity to give birth, and the presence of professional and social support for non-medical births.

Strengthening community mental health competence-A realist informed case study from Dehradun, North India.

Few accounts exist of programmes in low- and middle-income countries seeking to strengthen community knowledge and skills in mental health. This case study uses a realist lens to explore how a mental health project in a context with few mental health services, strengthened community mental health competence by increasing community knowledge, creating safer social spaces and engaging partnerships for action. We used predominantly qualitative methods to explore relationships between context, interventions, mechanisms and outcomes in the "natural setting" of a community-based mental health project in Dehradun district, Uttarakhand, North India. Qualitative data came from focus group discussions, participant observation and document reviews of community teams' monthly reports on changes in behaviour, attitudes and relationships among stakeholder groups. Data analysis initially involved thematic analysis of three domains: knowledge, safe social spaces and partnerships for action. By exploring patterns within the identified themes for each domain, we were able to infer the mechanisms and contextual elements contributing to observed outcomes. Community knowledge was effectively increased by allowing communities to absorb new understanding into pre-existing social and cultural constructs. Non-hierarchical informal community conversations allowed "organic" integration of unfamiliar biomedical knowledge into local explanatory frameworks. People with psycho-social disability and caregivers found increased social support and inclusion by participating in groups. Building skills in respectful communication through role plays and reflexive discussion increased the receptivity of social environments to people with psycho-social disabilities participation, thereby creating safe social spaces. Facilitating social networks through groups increases women's capacity for collective action to promote mental health. In summary, locally appropriate methods contribute most to learning, stigma reduction and help-seeking. The complex social change progress was patchy and often slow. This study demonstrates a participatory, iterative, reflexive project design which is generating evidence indicating substantial improvements in community mental health competence.

“It's a real negotiation within yourself”: Women's stories of challenging heteronormativity within the habitus

Drawing on Bourdieu's conceptual schema, this article examines heteronormative themes within the habitus and how women may come to challenge such understandings. Ten women were asked in semi-structured interviews to reflect on how they came to understand constraints in their sex lives, and how they have negotiated these constraints. Four themes emerged in regards to women's habiti, reflecting prevailing discourses of heteronormativity. However despite Bourdieu's scepticism of change, the data also suggests that women are challenging these notions, albeit in ambivalent and uneven ways, through a process of critical reflexivity, sitting with vulnerability, and the adoption of alternative discourses. These stories suggest Bourdieu's concepts are insufficient for understanding women's capacity to resist heteronormativity within the habitus without further development by feminist scholars.

Trust women to choose: a response to John a Robertson's 'Egg freezing and Egg banking: empowerment and alienation in assisted reproduction'.

In ‘Egg Freezing and Egg Banking: Empowerment and Alienation in Assisted Reproduction’, John A Robertson responds to the American Society of Reproductive Medicine's statement that oocyte preservation should no longer be considered an experimental treatment. He explores the implications of this development, focusing on the potentially empowering impact of oocyte preservation as a means for women to preserve their fertility. He also engages with concerns about the possibility that such a development may raise issues of alienation. He highlights some of the potential problems that may emerge as women gain the capacity to store and either donate or sell any eggs they do not need for their own reproductive purposes. Much of his paper is valuable and considered, but in places, his views rest on assumptions about women's attitudes to their fertility, understanding of the technology, and relationship with their gametes that are open to dispute. This paper teases out some of these assumptions and puts pressure on them by drawing on the growing body of data about what women actually do think and feel about fertility issues. It focuses on two of his main concerns—that social egg freezing may give women a false sense of security and that women may be harmed if a market in eggs leads to their alienation from their gametes. Via this response to Robertson, I aim to redress the tendency often seen in discussions around women, infertility, aging, and empowerment to unquestioningly accept what I argue are stereotypes and assumptions about women's views and capacity to reason.

Beyond the latch: A new approach to breastfeeding.

Health professionals supporting breastfeeding play an important role in women successfully achieving their breastfeeding goals. Instrumental knowledge has dominated health professionals' breastfeeding education and practice. Because breastfeeding is a contextual and embodied experience, a relational orientation is required to identify effective strategies to support women. A relational inquiry approach to breastfeeding practice offers a practical way to support women to better achieve their breastfeeding goals within the complexities of their own lives. Incorporating a relational inquiry approach to breastfeeding practice may assist health professionals to more effectively respond and engage with women in practice so that women's breastfeeding goals are protected; women's capacity and self-efficacy are promoted; and women feel and experience the support from health professionals that they require to be successful with breastfeeding.

The Relationship between the Values of Leptin, Interlukin-10, and TNFα with Fatigue and Aerobic Capacity in Women with Multiple Sclerosis

The Relationship between the Values of Leptin, Interlukin-10, and TNFα with Fatigue and Aerobic Capacity in Women with Multiple Sclerosis

525. The Temporal Stability of Cognitive Functioning and Functional Capacity in Women with PTSD

In addition to clinical symptoms, patients with post-traumatic stress disorder (PTSD) often experience considerable disability and evidence deficits in cognition and functional capacity (FC).

Food insecurity during pregnancy and the early postpartum period is associated with reduced exclusive breastfeeding at four months postpartum in a cohort of women in Western Kenya

BackgroundHousehold food insecurity (FIS) is a global public health issue in both developed and developing countries with consequences for maternal physical and mental health and women's capacity to care for young children. Research on whether FIS influences breastfeeding practices is limited and inconsistent.ObjectiveWe assessed the effects of household FIS experienced during pregnancy and the early postpartum period on exclusive breastfeeding (EBF) during the first four months of life.MethodsData were from 399 mother‐child dyads residing in Western Kenya and participating in a nested cohort study examining the impacts of an integrated agriculture, nutrition, and health intervention on maternal and child nutrition. Data on FIS were collected with the FANTA household food insecurity access scale at three time points: enrollment in early pregnancy, one month prior to delivery and at four months postpartum. Breastfeeding practices were assessed by maternal recall at 4 months postpartum and included timing of breastfeeding initiation, exclusivity of breastfeeding in the first week postpartum, exclusivity from birth to four months, and EBF in the previous 24‐hours. Multivariate logistic regression was used to assess the associations of these exposures with the four outcomes.Results47.9% of infants initiated breastfeeding within the first hour of birth. While 64.4% reported EBF in the 24 hours prior to the four month postpartum visit, only 34.8% reported EBF from birth through to the four months postpartum visit. During at least two study visits, 62.4% of women reported household FIS; only 19.3% were food secure during all three study visits. In adjusted analyses, household FIS was not associated with timely initiation of breastfeeding. Compared to women who were never FIS during the follow‐up period, women reporting household FIS for at least two of three follow‐up visits had a 45% lower odds of EBF from birth through four months of life (aOR: 0.55 [95% CI: 0.30–0.99]), and a 61% lower odds of EBF in the previous 24 hours (0.39 [0.20–0.76]). Compared to never FIS, those who reported FIS only once during the follow‐up period had 55% lower odds of EBF from birth through 4 months (0.45 [0.22–0.94]) and 60% lower odds of EBF in the previous 24 hours (0.40 [0.18, 0.87]).ConclusionsBoth chronic and acute household FIS were each associated with reduced EBF at four months postpartum in Western Kenya. FIS should be considered when devising strategies to improve exclusive breastfeeding initiation and maintenance.Support or Funding InformationThis project was funded by the Bill and Melinda Gates Foundation and Emory University.

Defamilization/familization measures and women's pension income—The case of Taiwan

This paper examines how defamilization and familization measures can affect women's capacity to accumulate pension income and their subsequent standard of living after retirement. Firstly, it highlights the concepts of defamilization and familization and discusses the potential of these measures in assisting women to save pension income through the “commodification” and “decommodification” of labor. Secondly, it examines the major pension policies and examples of defamilization and familization measures in Taiwan. It shows how the current limited provision of such measures could create “double jeopardy” for women, affecting access to paid employment or resources to enable women who wish to undertake caring responsibilities to do so, ultimately impacting their capacity to accumulate pension income. Thirdly, it suggests ways to strengthen defamilization and familization measures in order to enable women to accumulate sufficient retirement income on the basis of three preconditions: policy attention to the reciprocal relationship between familization/defamilization measures and pension schemes for women; a recognition of differences between women in their preferred strategies to accumulate pension income; and an emphasis on a life course perspective to understand the double jeopardies faced by women in saving for retirement.

Innovation and gendered negotiations: Insights from six small‐scale fishing communities

AbstractThere has so far been limited investigation into gender in relation to innovation in fisheries. Therefore, this study investigates how gender relations shape the capacity and motivation of different individuals in fishing communities to innovate. We compare six fishing communities in Cambodia, the Philippines and the Solomon Islands. Our findings suggest that gendered negotiations mediate the capacity to innovate but that wider structural constraints are important constraints for both men and women. Our findings show that men's and women's capacity to innovate is strongly mediated by the behaviour of their marriage partner. Consequently, we argue that gender research from a social relational perspective has an important contribution to make in understanding poor fishing communities where new ways of doing things or new technologies are being promoted.

Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study

The oldest-old (those aged ≥80 years) are the most rapidly growing age group globally, and are most in need of health care and assistance. We aimed to assess changes in mortality, disability in activities of daily living, and physical and cognitive functioning among oldest-old individuals between 1998 and 2008. We used data from the Chinese Longitudinal Healthy Longevity Study. Three pairs of cohorts aged 80-89 years, 90-99 years, and 100-105 years (in total, 19 528 oldest-old participants) were examined; the two cohorts in each pair were born 10 years apart, with the same age at the time of the assessment in the 1998 and 2008 surveys. Four health outcomes were investigated: annual death rate, Activities of Daily Living (ADL), physical performance in three tests and cognitive function measured by Mini-Mental State Examination (MMSE). We used different tests and multivariate regression analyses to examine the cohort differences. Controlling for various confounding factors, we noted that annual mortality among oldest-old individuals was substantially reduced between 0·2% and 1·3% in 1998-2008 compared with individuals of the same age born 10 years previously, and that disability according to activities of daily living had significantly reduced annually between 0·8% and 2·8%. However, cognitive impairment in the later cohorts increased annually between 0·7% and 2·2% and objective physical performance capacity (standing up from a chair, picking up a book from the floor, and turning around 360°) decreased anually between 0·4% and 3·8%. We also noted that female mortality was substantially lower than male mortality among the oldest-old, but that women's functional capacities in activities of daily living, cognition, and physical performance were worse than their male counterparts. Advances in medications, lifestyle, and socioeconomics might compress activities of daily living disability, that is, benefits of success, but lifespan extension might expand disability of physical and cognitive functioning as more frail, elderly individuals survive with health problems, that is, costs of success. National Natural Science Foundation of China, National Institute on Aging/National Institutes of Health, United Nations Funds for Population Activities.

Women's entrepreneurship in Northern Portugal: psychological factors versus contextual influences in the economic downturn

The study's purpose is to identify the psychological profile of women entrepreneurs, and assess the extent to which their entrepreneurial motivation may be influenced by the territorial and conjunctural contexts in which they operate, and by their capacity to reconcile the demands of family and business. A questionnaire was used to gather data on recent entrepreneurial initiatives by women in Northern Portugal. Structural equation models validated the links between women's dual role (family/business) and their psychological/cognitive profiles, their business start-up propensity and the firms' success. The study suggests that while a correlation exists between motivation and business environment that positively influenced women's start-up decisions and subsequent success, the motives underpinning decisions in rural and urban contexts differ. However, women prove capable of effectively managing their dual role as wife/mother and entrepreneur regardless of territorial context. The paper confirms women's capacity to reconcile the demands of work and family as a key variable, offers tentative conclusions as to how the current economic and financial crisis may influence women's entrepreneurial motivation, and recommends new directions in research that may better inform entrepreneurship theory, practice, policies and teaching.

American Child Bride: A History of Minors and Marriage in the United States by Nicholas L. Syrett

Reviewed by: American Child Bride: A History of Minors and Marriage in the United States by Nicholas L. Syrett James Schmidt American Child Bride: A History of Minors and Marriage in the United States. By Nicholas L. Syrett. Chapel Hill: University of North Carolina Press, 2016. xiv + 354 pp. Cloth $34.95. In 2017, New Yorkers made a shocking discovery: children as young as fourteen could legally marry. "I don't think people even knew this," New York Governor Andrew M. Cuomo told the New York Times. Governor Cuomo's paucity of historical knowledge could have been remedied if had he read Nicholas Syrett's brilliant new book, American Child Bride. Syrett provides a sweeping history of youthful brides from the colonial era to the present and simultaneously offers a trenchant critique of the institution of marriage itself. Despite numerous waves of reform, child marriage has been relatively common and relatively accepted throughout US history, a fact that evinces Americans' "great faith" in the "powers of marriage" (7). Indeed, as Syrett demonstrates throughout the book, marriage turns a young person into a legal adult, and frequently "this was an appealing prospect for many youth" (9). Arguing strongly for youthful agency, the book stresses that many, if not most, child brides and grooms "believed that they were making choices" (9). Arranged roughly chronologically, the book opens with an investigation of child marriage in the period before it became a cause for concern. Early chapters hinge on the notion that "age-consciousness—the belief that one's age is a fundamental part of one's personal and social identity—did not exist as it does now" (20). Earlier restrictions focused on parental rights to property or service. Youthful matrimony in early American history also contained considerable diversity, and Syrett devotes valuable sections to such topics as Mormon plural marriage and Native American marital traditions. [End Page 470] The mid-nineteenth century saw both critical legal developments that shored up youthful marriage and the emergence of the first full-blown critiques. Syrett restores Parton v. Hervey, an 1854 Massachusetts decision, to its rightful place as a leading case in US legal history. The case upheld youthful marriage to ensure "the maintenance of public morality" (78). Even as youthful matrimony gained judicial sanction, critics began to examine the practice. Medical authorities offered a physiological argument, while early women's rights advocates such as Elizabeth Oakes Smith focused on the harm to women's legal capacities. As the century drew on, these critiques morphed into a full-blown assault, and waves of legal restriction began. These departures depended on "the growing belief that children were fundamentally different from adults and that marriage was an adult institution that needed protecting from those who might not take it seriously, children among them" (122). While early reformers had focused on preventing divorce or sheltering women, campaigns after World War I rested squarely on "the language of child protection: youthful marriage was bad for children" (168). Although legal reform occurred in the usual scattered pattern, the right for young people to marry became increasingly restricted in the twentieth century. The final chapters follow the story to the present and center on examples of resistance, whether that be the continuity of child matrimony in rural areas such as the South, the crisis over middle-class youth of the baby boom generation, or the teen pregnancy panic of the 1970s and beyond. Throughout, Syrett stresses that young people, and young women in particular, married for reasons they saw as beneficial. The level of nuance in the book's argumentation is astonishing, and it makes the book highly valuable beyond the history of childhood and youth. Legal historians will observe the best of law and society studies practiced here, and social historians will find the perfect blend of demographic trend and illustrative narrative. Along with other works of the last decade or so, the book definitively establishes age and age-consciousness as major questions and categories of analysis. A book devoted to legal and social change could easily have lost sight of the real lives involved, but Syrett masterfully avoids this pitfall by opening and closing each chapter with a deeply narrated...

Productive Capacity of Women and the Structure of Capital Accumulation

Productive Capacity of Women and the Structure of Capital Accumulation

The impact of women’s agency and autonomy on their decision-making capacity in Nuevo Leon, Mexico

Women’s decision-making capacity is central for promoting their wellbeing. When women are unable to decide for themselves independently means to promote their wellbeing, scarce r esources are likely to be underutilized. Women’s capacity to make decisions especially on matters that influence their wellbeing is of central concern for the provision of social services as well as health care services. Thus, determinants of women’s decision-making capacity are essential for improving their status in society and households. The aim of this work is to analyze relationship between level of autonomy and agency of women in conjunc tion with their effects on their decision-making ability using structural equation modeling in Nuevo Leon, Mexico. Participants of this study are women older than 15 years old resid ing in Nuevo Leon, Mexico. Results reveal that women’s agency positively influences their decision-making capacity. Also, autonomy has a significant and positive indirect effect on women's decision-making capacity, but its direct effect decreases when agency is included.

A concept analysis of women's vulnerability during pregnancy, birth and the postnatal period.

To report an analysis of the concept of vulnerability associated with pregnancy, birth and the postnatal period. The concept of vulnerability during childbirth is complex and the term, 'to be vulnerable' frequently attains a vague application. Analysis about vulnerability is needed to guide policy, practice, education and research. Clarity around the concept has the potential to improve outcomes for women. Concept analysis. Searches were conducted in CINAHL, EMBASE, PubMed, Psychinfo, MEDLINE, MIDIRS and ASSIA and limited to between January 2000 - June 2014. Data were collected over 12months during 2014. This concept analysis drew on Morse's qualitative methods. Vulnerability during pregnancy, birth and the postnatal period can be defined by three main attributes: (a) Threat; (b) Barrier; and (c) Repair. Key attributes have the potential to influence outcome for women. Inseparable sub-attributes such as mother and baby attachment, the woman's free will and choice added a level of complexity about the concept. This concept analysis has clarified how the term vulnerability is currently understood and used in relation to pregnancy, birth and the postnatal period. Vulnerability should be viewed as a complex phenomenon rather than a singular concept. A 'vulnerability journey plan' has the potential to identify how reparative interventions may develop the woman's capacity for resilience and influence the degree of vulnerability experienced. Methodology based around complex theory should be explored in future work about vulnerability.

“Woman” in the European Human Rights System: How is the Reproductive Rights Jurisprudence of the European Court of Human Rights Constructing Narratives of Women’s Citizenship?

Abstract Reproductive rights are constructed through a gender-conscious reading of already recognized human rights. We argue that despite increasingly strong recognition of reproductive rights in international human rights law by treaty-monitoring bodies and international tribunals, jurisprudence of European Court of Human Rights (ECtHR or the Court) reflects a limited understanding of women's experiences, does not adequately challenge gender stereotypes, and often ignores reproductive rights dimensions in standards it is setting, as well as narratives it is creating. Our analysis of Court's jurisprudence on abortion, home birth, non-consensual gynecological examinations, forced sterilizations, and assisted reproduction reveals that a woman's reproductive capacity continues to be her defining feature. Motherhood is seen as a woman's default life plan, her decisions regarding her body, health, and ultimately life, are perpetually under scrutiny and contours of her agency subject to medical professionals ' views, legislators and general public. INTRODUCTION In her much-celebrated novel The Handmaid's Tale, Margaret Atwood created a society where women's function was reduced to breeding, and those who failed or tried to escape from this labor were labeled as Unwomen and punished. (1) Atwood's 1985 book may have been science fiction, but story she tells is distressingly not too dissimilar from women's stories in twenty-first century--even in what is known as most progressive of regions: Europe. Indeed, when we study how woman has been constructed in human rights system that was founded upon European Convention on Human Rights (hereafter, the Convention), we find disturbingly essentialist gender roles. The ECtHR is judicial forum of most established regional human rights system in world, grounded in norms of European Convention on Human Rights. The Court's decisions are binding upon forty-seven member states of Council of Europe, and are implemented through domestic legislation and regulations. Moreover, ECtHR's jurisprudence is regularly looked to and cited by other regional tribunals, treaty-monitoring bodies that adjudicate cases, and domestic courts. (2) Thus, ECtHR sets standards in human rights law both within and beyond Europe and presents an important construction site for rights narratives, including reproductive rights narratives. As questions around women's reproductive health are often deeply contested, ECtHR arguably has an especially important role to play in fostering public learning regarding reproductive rights as integral to full participation of women in European society. Indeed, we argue in this Article that by using law to publicly and authoritatively proclaim and transform unacknowledged harmful experience into legally cognizable wrongs requiring redress, Court could play a potentially transformative role in narratives of women's citizenship in European context. (3) The Court has decided a number of cases concerning matters of human reproduction (for example, restrictive abortion laws and access to in vitro fertilization). Nevertheless, ECtHR itself has neither referred to reproductive rights as human rights (and accordingly forming a part of Convention) nor specified that cases about reproduction entail questions of reproductive and decisional autonomy that go beyond private sphere and could entail needed shifts in social norms as well as institutional practices. Through examining how Court has addressed specific issues relating to reproduction, we reflect on what ECtHR's jurisprudence tells us about narratives of women's identity and citizenship in Europe more broadly. Based on a systematic review of Court's jurisprudence from 2003 to 2015, we consider nineteen cases that Court has decided regarding issues of reproductive freedoms and entitlements: four abortion cases, (4) two cases concerning home birth, (5) six cases about assisted reproduction, (6) three forced sterilization cases, (7) three forced gynecological examination cases, (8) and one landmark domestic violence decision. …

Closing the Womb Door: Contraception Use and Fertility Transition Among Culturally Tibetan Women in Highland Nepal.

Objectives Whether in metropoles or remote mountain communities, the availability and adoption of contraceptive technologies prompt serious and wide-ranging biological, social, and political-economic questions. The potential shifts in women's capacities to create spaces between pregnancies or to prevent future pregnancies have profound and often positive biological, demographic, and socioeconomic implications. Less acknowledged, however, are the ambivalences that women experience around contraception use-vacillations between moral frameworks, generational difference, and gendered forms of labor that have implications well beyond the boundaries of an individual's reproductive biology. This paper hones in on contraceptive use of culturally Tibetan women in two regions of highland Nepal whose reproductive lives occurred from 1943 to 2012. Methods We describe the experiences of the 296 women (out of a study of more than 1000 women's reproductive histories) who used contraception, and under what circumstances, examining socioeconomic, geographic, and age differences as well as points of access and patterns of use. We also provide a longitudinal perspective on fertility. Results Our results relate contraception usage to fertility decline, as well as to differences in access between the two communities of women. Conclusions We argue that despite seemingly similar social ecologies of these two study sites-including stated reasons for the adoption of contraception and expressed ambivalence around its use, some of which are linked to moral and cosmological understandings that emerge from Buddhism-the dynamics of contraception uptake in these two regions are distinct, as are, therefore, patterns of fertility transition.