Birth is universal. However, the meaning of giving birth is not universal, but culturally specific. Preventing the process of giving birth is also inevitably replete with cultural significance. To these social actions, the villagers bring an immensely complicated set of assumptions. They are unexamined assumptions, existing as a basis for thought rather than as a conscious plan of action.

In order to understand the cultural significance of birth planning, it is necessary to discuss these culturally specific assumptions. Children are understood as the solution to adult problems that the villagers take very seriously indeed. They can share the work, with all that this implies; if male, they can dignify existence by providing a sense that the family line is being carried on; most importantly, they provide a solution to the burning psychological question, “Who will ever take care of me?” Being a legitimate recipient of care is deferred until old age, in this cultural setting: no care before that time has the legitimacy of the care provided by the young for the old. The dependency needs of the young must wait, since elders have prior claims. By old age, the wish to be taken care of is an unfulfilled desire of long standing. Yet a lifetime of feeling the obligation to care for others, and deferring the wish to be cared for one's self, has provided an experience which makes people doubt that they will ever be cared for, or if it is possible for them to receive enough care.