Cultural Factors Affecting Human Fertility*
Department of Anthropology Wheaton College, Wheaton, Illinois

From: JASA 22 (June 1970): 52-59.

*This paper is a modified version of one presented in a panel discussion on "Problems Associated With Increasing World Population" at the fall meeting of the Chicago Section of the American Scientific Affiliation held on December 6, 1969, in Chicago at the Illinois Institute of Technology.

Human fertility remains high in many countries because cultural values influence parents to procreate many children. From Biblical cultures in antiquity down to the present, religious views are integrated with various cultural factors in encouraging human reproduction rates although the New Testament does not seem to be explicit in suggesting family size or encouraging human reproduction. Among a range of cultural factors influencing population are such values as virility, prestige, security and others held by parents in a cultural milieu. If one adopts the Malthusian, or pessimistic, view that human population will eventually outstrip food resources, birth control measures, especially contraceptives, will be effectively disseminated in non-Western cultures only by cognizance of crosscultural appreciation of values and acculturational processes.

"So God created man in his own image. in the image of God he created him; mole and female he created them. And God blessed them, and God said to them, 'Be fruitful and multiply, and fill the earth and subdue it ...'" (Genesis 1:27-28, RSV).

Perspectives on Fertility

With these words the Bible introduces the divine intention that human fertility is to be the means for populating the earth by man still free from sin with its pervasive and dire effects. Undoubtedly this directive influenced early man's view about human reproduction which, when coupled with subsequent events, eventuated in an attitude toward children epitomized in the agonizing plea by Rachel to her exasperated husband. "When Rachel saw that she bore Jacob no children, she envied her sister; and she said to Jacob, 'Give me children or I shall die!' Jacob's anger was kindled against Rachel, and he said, 'Am I in the place of God, who bath withheld from you the fruit of the womb?"' (Genesis 30:1-2). Childlessness, ag gravated by envy of her sister and co-wife, prompted Jacob's favorite wife to consider suicide in her belief that barrenness is a divine reproach.

At the inception of Christianity, Paul perhaps echoes a similar opinion towards human fertility in instructing Timothy thus: "So I would have younger widows marry, bear children, rule their households, and give the enemy no occasion to revile us" (1 Tim othy 5:14, RSV). As the Roman Catholic Church became dominant, it adopted like ideas which have persisted through the centuries and, excepting recent opposition by liberal members in Europe and America, instilled the attitude among Catholics so effectively that a devout member in Malitbod, a small barrio in the Philippines, summarized a consensus of opinion regarding birth control by women practising contraception and abortion with these words:

"When these women die, they will be brought before our Lord who will ask: 'Why did you kill your child?' And what will they say? Surely, they cannot tell lies because God can see through their hearts; He knows what we humans are doing. If our hearts are black, as these women's, God will certainly say: 'You have murdered an innocent child; you have rejected my gift. Go and burn in hell for all the mortal sins you have committed in my name'" (Jooano, 1969:17).

A maxim among the Lughara people in Uganda, "The work of women is to bear children" (Middleton, 1965:57) expresses a view widely shared among peoples throughout the world. To be more precise, we should rather say that the attitude of this maxim is common to most maledominated societies. This belief is opposed. Sabamma, a mother in Gopalpur, a village in south India, offers what may be a representative opinion among women in countries marked with high birth rates. After eleven pregnancies and bearing eight living children, Sabamma sums up her motherhood by saying, "Thank God, those pregnancies finally stopped" (Beals, 1962:14).

Sex is of course a primary drive among most species in the animal kingdom. The urge to perform the sexual act is powerful quite apart from intention to propagate the species. Among many animals, this drive is controlled by instinctual mechanisms so that sexual activity is confined to annual rutting seasons although man in domesticating certain animals has altered their sexual habits. In contrast, man is normally characterized by an oestruality favoring sexual activity throughout the year, hence birth of offspring may occur throughout the year. Also in terms of human biology, a healthy female is fecund for about thirty years. This biological potential rarely operates freely, however, for man possesses culture with ideas restricting his biological nature. The central assumption in this essay, therefore, is that human fertility with attendant population problems should he considered from a cultural perspective if programs to ameliorate a critical world problem are to achieve success.

Cultural Influences

The view emphasized here then is that to understand human fertility rates and threatening population increases, cultural influences must be identified and modified. Admittedly one can be either pessimistic or optimistic in appraising man's growing numbers and the potential food resources (or other materials essential to human life), for disagreement exists among scholars with some holding to the Malthusian theory while others think scientific ingenuity can increase productivity adequate for probable population increments. Whether the pessimistic or the optimistic view is valid cannot be argued here, but it does seem reasonable to conclude that ultimately there must be limits to the "carrying capacity of the land"-to borrow a phrase used by ranchers in western range country.

Culture is the central concept in anthropology denoting man's distinctive quality setting him apart from all other life forms. Simply defined, culture may he considered the total way of life or the design for living characterizing each human society. It includes in a complex integrated whole all learned and shared behaviors stemming from themes or values witbin an emotional matrix or ethos. Animal behavior seems to be dominated by instincts which in man are greatly modified by cultural influences. Although culture channels most human thoughts, feelings, and actions, we need not adopt extreme cultural determinism for each individual can exercise freedom in varying degrees of deviation from cultural patterns.

As defined by anthropologists, culture is significant in understanding human fertility rates in modifying sexual activity by relating sex and reproduction to the culture's value system. For example, anthropologists agree that the incest taboo preventing sexual mating between certain men and women considered relatives is culturally proscribed. Hence relationships subject to the incest taboo vary considerably from society to society. In many of our states, the mating of first cousins is illegal because it constitutes incest, but among many societies marriage of first cousins is approved and preferred especially if these cousins are "cross-cousins" (i.e., father's sister's children, or mother's brother's children).

Likewise shame and guilt feelings associated with sexual matters and activity invariably stem from cultural views with some societies holding strict taboos against open discussion and education while others are relatively free from these restrictions. One may ask to what extent current opposition to sex education in public schools in the United States springs from a pur itanical ideology long characteristic in American culture. We may have seemed to stray from our subject, but these observations are relevant in this study because cultural values are inextricably woven in decisions to favor or oppose programs affecting sexual activity and human fertility.

Several Questions

Several questions emerge in this and other studies seeking a solution to the ominous population increase. With developed communication and dissemination of information about growing population pressure in the world, and the effectiveness of inexpensive contraceptives, why haven't birth rates declined more rapidly? Why do parents in various cultures continue to have large families when privation and even starvation confront them? What influences are at play causing fecund women to bear unwanted children? Why have some governments failed in their efforts to initiate successful programs for birth control? Our contention is that answers to these and similar questions can be offered only by understanding the cultures, including religious beliefs, of the countries where human fertility rates remain high. We will examine briefly, therefore, selected attitudes held by various cultural groups about the birth of children.

With developed communication and dissemination of information . . , and the effectiveness of inexpensive contraceptives, why haven't birth rates declined more rapidly? Why do parents in various cultures continue to have large families when privation and even starvation confront them? What influences are at play causing fecund women to bear unwanted children? Why have some governments failed in their efforts to initiate successful programs for birth control?

Hebrew Culture

In ancient Hebrew culture, the bearing of many children was viewed as evidence of divine approval and blessing. A simplistic explanation for this attitude is to attribute it to obedience to God's injunction to Adam, "be fruitful and multiply" (Genesis 1:28) which was reiterated to Noah (Genesis 9:1,1) and to Jacob (Genesis 35:11). However other factors undoubtedly influenced the Hebrews, so often prone to disobeying God, in observing this command by incorporating it into their cultural values. For example, we may infer from God's covenant with Abraham, with its dual promise of possession of the Holy Land and "I will make you exceedingly fruitful" (Genesis 17:6), that many children provided economic security for old age in a pastoral economy as well as populating a sparsely populated country much desired by more populous and stronger neighbors. This pro-fertility theme is unequivocally advocated by the Psalmist in these lines:

"Lo. sons are a heritage from the Lord, the fruit of the womb a reword.
Like arrows in the hand of a warrior are the sons of one's youth.
Happy is the man who has his quiver full of them!
He shall not be put to shame tv/zen he speaks with his enemies in the gate" (Psalm 127:35 RSV).

Such thinking promoted a rapidly expanding population to foster an abundant society where a man was surrounded by many children to care for him in old age, to expand flock and field, and to increase the tribe with numbers and prosperity for strength and security in the nation. This attitude also met the concern to preserve the family name and lineage insuring inheritance continuity in the land-a theme that reinforced the abundant society goal, for to fail to have offspring to carry on the family name was a misfortune imperiling the social structure. The levirate, a cultural practice requiring a man to marry his deceased brother's wife to produce offspring to preserve the dead brother's name and inheritance, illustrates Hebrew thought. When judah's son, Onan, refused to honor his levirate responsibility, the Lord 'slew him," to emphasize a cultural value which reinforced prolific human fertility patterns among the Hebrews (Genesis 38).

New Testament Times

When one considers cultural factors affecting human fertility in New Testament times, there is some evidence that marriage and children were accorded high evaluation and were cited as models of acceptable faith in God. There is, however, no detailed or extended statement suggesting explicitly what family size should be. As a matter of fact, Fagley has observed correctly that parenthood in the New Testament is considered in dialectical fashion (1960:124). In a thesis and antithesis pattern there is a yes and a no in both the Gospels and the Epistles. Seemingly negative and affirmative utterances regarding family conditions were made by Jesus to his disciples. Later, embedded in a Judaie ethos but alertly sensitive to pervasive Hellenistic influences, Paul spoke both for and against family ties when he sought to cope with emerging problems within the first struggling churches. In short, we cannot conclude that the-New Testament presented an explicit view to influence human fertility rates among the first Christians.


It seems, therefore, that early Christianity contained opposing views with some leaders advocating such an extreme as celibacy while others favored marriage and the procreation of offspring. The patristic writings reveal an ambivalence stemming from the conflicting opinions. As the Christian movement developed through history, the Eastern Orthodox Church, the Roman Catholic Church, and later the Protestant churches, made interpretive pronouncements about parenthood and childbearing. These doctrines were usually fashioned to influence cultural attitudes among the people where the churches flourished. The Eastern Orthodox Church viewed marriage and sexual relations primarily as a means for procreation of children even to the point that coitus within the marital state was tinged with sin if procreation was not the purpose. Any form or method of contraception was condemned as evil.

In Roman Catholicism, marriage became a sacrament intended to sanctify conjugal activity primarily
for producing offspring. While in time permission was given to couples to practice the rhythm method for contraception, the Roman Church condemned "artificial" contraceptives in maintaining that coitus is ultimately justifiable only for begetting children. The current controversy and dissension within the Roman Church includes papal authority in banning contraceptives, although it is common knowledge that many Catholic couples, especially in urbanized Europe and the United States, disregard the official dictum.

Protestantism originally shared Roman Catholic views in opposition to limiting births by contraception, but the tendency has been increasingly to view marriage as a function for companionship and parenthood with the conclusion that the former does not require the latter to justify conjugal relations. Even among the conservative and evangelical segments of Protestantism, sexual intercourse in marriage without procreative intentions is widely accepted and the employment of contraceptives is common (Vincent, 1968).

Non-Christian Cultures

Outside the culture areas where Christianity dominates, religions views within cultural settings affecting human fertility vary considerably according to Fagley's survey (1960:94108). Among Hindu and Buddhist peoples there are few religious or legal restrictions preventing artificial means of birth control. The portentous population growths in countries like India and China are due to other cultural factors, for contraception is legal and sterilization is usually allowed on both social and eugenic grounds. In Japan abortion is permitted for economic reasons under medical sanction.

In Islamic countries, "The cradle is proving more potent than the sword" (Fagley, 1960:101) with Middle Eastern countries marked by population growth rates of nearly three per cent annually-a rate second in the world only to some Latin American countries. The pro-fertility patterns rest upon a cultural system where children are much desired for the labor services relating to employment on the land when the children are young, or numerous children enhance the parental prestige with much honor ascribed to large families, or children are the only means whereby the Islamic law of inheritance can he realized. Despite these cultural views favoring population increases, contraception is legal in some Muslim countries, as in Egypt and Pakistan, but somewhat surprisingly it is not in Turkey which has been receptive to many modern ideas. Whether contraception is allowed or forbidden in Muslim countries, policies determining the practice within the culture seems to be primarily for political reasons rather than religions. Paradoxical situations also exist in some Muslim countries; for instance Turkey considers contraceptives illegal but is quite lenient in penalizing abortionists, (As a Judaic enclave within the Islamic World, Israel has legalized contraception but severely penalizes those guilty of induced abortion.)

Latin America

As stated earlier, this paper sees religion and ideology of peoples as integral and pervasive parts of cultures. Evidence leads us to conclude also that religious beliefs commonly influence, or serve as sanctions for, most cultural traits, complexes, and other institutions. This must be born in mind as we direct our attention to what may seem to be nonreligious factors within a culture as these factors affect human fertility rates and related population problems. Assuming this argument to he true, we focus our attention upon selected cultural traits' at play in an area characterized by the population "explosion." The area is Latin America where the population is increasing about three per cent annually, and where social scientists have identified typical factors contributing to the alarming population increases (Stycos, 1969).

Rapid population growth in Latin America is sur prising when it is known that most people in general seem to prefer small families. This general preference, however, is offset or defeated by cultural values which militate against married couples having small families. For example, soon after marriage the typical wife becomes pregnant because young husbands fear possible rumors of sterility or impotence, thus reflecting the great valise placed upon masculine virility. To the Latin American, the most convincing way to demonstrate masculinity is to father children. Sexual experience and adventures do not prove manliness, for while most Latin American men engage in pre-marital and extra-marital sexual activities, these are usually with prostitutes who, if they become pregnant and hear children, cannot enable a man to claim virility since the paternity of an illegitimate child is uncertain. When questioned about sexual and family matters, one informant gave this typical response: "This business of being married and having no children looks bad. One likes to have them to prove he is not barren" (Stycos, 1968:69). Hence when his wife, becomes pregnant soon after marriage and hears him a child, a young man confirms his adult status; and when the wife continues to hear children, the man demonstrates to his community his continuing virility.

The pronounced double standard of sexual behavior among Latin American societies is a second factor favoring human fertility. This double standard fosters intense jealousy among men toward their wives who in turn are deeply suspicious of their husbands. These marked jealousies frequently are rationalizations for desertion and extramarital sexual life, but their significance for this analysis is that they affect family size in that both men and women believe that Isaving many children reinforces the marital bond and reduces tendency toward unfaithfulness. In actual practice this belief is more effective in restricting the womansomething recognized by both men and women. One Puerto Rican wife put it this way: "He told me the more kids I have the more tied to him I was that with so many kids I could not abandon him to go with another man or return to my family" (Stvcos, 1968:70).

Male authority is a third reason contributing to the high birth rate among Latin Americans. Men usually object to their wives using contraceptives because they feel such use undermines their "rightful" male authority. In order to sustain his authoritarian position, the husband assumes that he has the right to determine the time, form, and frequency of coitus. He thus is the determining member in the family birth patterns. This dominating role, coupled with the desire to demonstrate his masculinity has its fulfillment in repeated pregnancies, each following quickly the previous childbirth.

Another cultural feature at play in keeping high birth rates is the man's fear of his wife's infidelity. Massy Latin American husbands believe that if their wives were allowed to control conception by contraceptive methods the wives would not hesitate to engage in extramarital sexuality. This conclusion rests upon the widespread notion that men are much more clever and wise in seducing women; therefore to grant the wife prerogatives with respect to becoming pregnant raises the threat that some adroit male may captivate and conquer her. Related to this is Oscar Lewis' observation that "Some husbands deliberately refrain from arousing their wives sexually, as it is assumed that a passive or frigid wife will be more faithful. In general, sexual play is a technique men reserve for the seduction of other women" (1960:58). Jealousy also motivates men to forbid their wives to submit to physical examination by a male physician; this in turn prevents many wives from learning about effective contraceptive methods and birth control.

Factors favoring human fertility: masculine virility . double standard of sexual behavior male authority .... fear of the wife's infidelity fear that birth control may impair one's health • • • . psychological reactions in
coitus • • • • lack of information cultural distinctives.

Both men and women, in ignorance, fear that birth control may impair one's health. We need not be onduly surprised that such apprehension exists for it may be remembered that serious charges have been made against oral contraceptives by medical authorities in our so-called enlightend United States. Many Puerto Rican husbands and their wives believe that birth control methods cause cancer or other serious maladies in women. Common views include the notion that diaphragms get trapped in the vagina and can he removed only by major surgery. Sterilization, it is assumed, can cause a woman to he chronically ill and helpless. One husband offered a typical feeling in these words: "I have never used prophylactics with my wife nor will I. That is dangerous because if it breaks the woman may die if that stays inside her womb" (Stycns, 1968:74).

Another cultural attitude rests largely upon psychological reactions in coitus. Many men are convinced that condoms destroy pleasurable sensation in the sexual act. We may challenge this stated reason for evidence seems to suggest that it is a rationalization for a more basic premise. In their double standard system, Latin men think women should be classed as "good" or "bad." Bad women are the prostitutes with whom the man can enjoy themselves sexually, hot good women are those desired for wives. The good woman is to be treated with respect and reserve an attitude that influences many husbands in their sexual life with their wives with the result that marital sex tends to he mechanical with little affection and eroticism. This persists as a culture pattern because the husband ascribes purity to his wife, while she has inculcated from her parents, especially her mother, the conviction that sex is ugly and unladylike. Small wonder that these false postulates tend to develop passivity and frigidity in many wives. Consequently men, who seek to demonstrate their virility in impregnating their wives, resort to prostitutes for erotic and sensual sex experiences. Since in so doing, they are threatened by venereal disease from prostitutes, they are willing to use condoms, which in turn become associated with the world of evil and which are inappropriate for conjugal intimacies with wives who are related with sacred bonds. As one husband confessed, "Those things I don't use with my wife, because it debases my wife to use something that is used with prostitutes" (Stycos, 1968:75).

Lack of Information

Unquestionably absence of accurate information and lack of communication between spouses about sex and child birth are unfortunate characteristics in many sociocultural groups. Even where literacy and education are cultural foci, facts about sex and reproduction may be shrouded in prudish ignorance, or worse, information about birth control may be erroneous because it is derived from questionable sources. Unfortunately in some cases distorted ideas are propagated by zealous religionists holding views contradictory to fact. Cultural premises may include puritanical attitudes by husbands and wives who consequently are ashamed to discuss sexual matters between themselves or consult competent authorities. An exaggerated sense of modesty is often a cultural principle to the degree that couples, especially wives, are reluctant to seek birth control information. So pronounced is this modesty concept in some cultures that wives refuse to submit to physical examination by a male physician and some are even ashamed to he seen by their own husbands.

Examples about misinformation and restricted communication forming part of cultural value systems may he cited for Latin America, Islamic countries, India, and elsewhere where population growth rates remain high. Obviously the decision to effectively employ birth control methods is a mutual one between spouses. Husband and wife may have knowledge about contraception but if cultural beliefs hamper freedom to discuss intimate matters between themselves, it is not likely that effective action can he implemented. Contraception and limited human fertility depend upon couples aware that their wishes are shared. Intensive and extensive educational schemes must not only be introduced in many countries but these programs must be directed by those cognizant with acculturatiooal processes and cultural factors already cited as well as the following selected at random from various societies.

Other Cultural Factors

Barnett provides an absorbing description of the role played by children in transferring and redistributing wealth among the Palauans in Micronesia (1960). In this cultural system, couples desire many children because the children are considered potential sources of services for the mother's kinsmen. The father is required to pay what Hoebel calls the "progeny price" which is compensation to the wife's kin for its loss of a legal claim to the children that she will bear

If it is difficult to inform people in the Western cultures where education is valued and the need for birth controls is appreciated, it is infinitely more difficult to instill necessary ideas in peoples who link many children with cultural ideals.

(1966:345). The father in turn realizes reimbursement by an adoption system whereby wealthy people adopt by payment as many children as possible for prestige and services. Children are thus viewed as a significant commodity in the economic patterns of Palauao culture. To suggest that a man limit his procreative activity is to threaten his right to economic security. Birth control measures meet stern opposition here.

In his study of a south Indian village, Beals singles out a cultural ideal bearing upon India's massive population problem (1962). While conducting a census in Copalpur, he discovered a household containing fifteen people which in analysis led him to observe that "This is a large household, the symbol of one old man's success in life. Few other men live to see a household full of children and children's children. Out of one hundred thirteen households, only six have more than nine members." In the succeeding paragraph Beals conveys something of the pathos expressed by a woman who informed him that nine of her children died before reaching adulthood (1962:13). But Western medical and health methods are reducing the terrible infant mortality rates while efforts to introduce birth controls lag due to this cultural equation that links family size to the successful life. The result is staggering population increases among those who must choose between the burgeoning numbers and an adequate standard of living. Through lack of information about the impending crisis, the villagers retain cultural views leading them to conclude that it is possible to have both.

African birth rates are high because in most cultures, many children symbolize prestige and insure old age security. It is a truism for Africa that parents, especially fathers, love children. Both polygyny and the levirate persist amidst changing cultures because these culture traits aid a man to father many children. In fact the desire to enlarge the family with many children explains why sociological paternity is more important to African men that biological paternity, a value quite foreign to Western husbands who in all likelihood will divorce a wife who bears a child not fathered by her husband. When Hoebel argues that the payment by the groom and his family to the bride's family to legally establish marriage should be labeled "progeny price," he reflects insight into African attitudes. The critical factor in most African marriages is that the wife produce offspring greatly desired by the man but which can he his legally only if an agreed upon amount has been paid to the bride's family. Hoebel puts it in these words: "Progeny price may be in part compensation for the loss of the girl by her kinship's group, but is much more an act of compensation to that group for its loss of a legal claim to the children that she will bear" (1966:345). Commonly the cause for divorce in Africa (as well as in many non-Western cultures) is a wife's barrenness, and polygyny is fostered for the same reason-to provide progeny to the man.

The culturally-induced desire for many children is illustrated by Gulliver's study of Jie marriage in Uganda (1960). Jie marriage is primarily for procreation as clearly revealed in fertility rites, and, equally significant, the view that marriage must be confirmed by the birth and survival of children. Radcliffe-Brown succinctly underscores this cultural principle in his assertion that "The most important part of the 'value' of a woman is her child-bearing capacity. Therefore, if the woman proves to he barren, in many tribes her kin either return the marriage payment or provide another woman to bear children" (1950). High infant mortality rates in Africa formerly limited population growth rates to offset the high birth rates stemming from these cultural incentives, but now medication and health improvements are lowering the mortality rate while birth rates remain at high levels to aggravate growing population pressures.


The practice of abortion needs some comment in any summary of cultural factors affecting human fertility. Abortion is practiced by practically all peoples despite its illegality in many cultures. A striking example of how this custom affects population dynamics is provided by Schneider in his study of abortion among the Yapese in the Pacific (1955). Prior to European contact, Yap's estimated population exceeded 50,000 people, but by 1945 when occupied by American troops, the island's population had declined to about 2,500, The Yapese express concern in their admission that something should be done "to have more babies." Evidence indicates that self-abortion is widespread among Yapese women during their years of maximum fecundity. The result is that 34 per cent of those interviewed between twenty-six and fifty years of age admitted that they have never borne children. Schneider's study revealed that Yapese culture encouraged non-responsibility in early adulthood with extended and multiple love affairs as a primary quest for erotic pleasure. Pregnancy and childbirth are considered threats to the culturally-favored amorous adventures. Despite male objection, women may accomplish abortion in secrecy easily because tradition requires the menstruating woman to retire to isolated areas. Here in seclusion, a pregnant woman (the pregnancy undetected by the man) induces abortion without her lover or husband being the wiser. Customarily pregnancy is kept secret by the woman for the first three months, a time when the expectant mother and her unborn child are highly vulnerable to sorcery. The pregnant woman has ample opportunity to accomplish abortion while visiting the isolated menstrual areas without detection because of this threemonth secrecy practice. Thus the cultural milieu favors a practice among the Yapese threatening their survival.

It is not likely that abortion will become the dominant means for limiting human fertility even though it may be effective as among the Yapese. Western ideas of medical practice and health measures will undoubtedly advocate inexpensive contraceptives as the preferable method rather than the more costly, and in some cases much more dangerous, abortive method. It is possible that increased emancipation of women and access to higher standards of living will favor that most extreme method, sterilization, especially by couples who have had several children.

Difficulty of Education

Unquestionably education is critical for disseminating safe and effective birth control methods to retard population increases. But from the viewpoint of cultural anthropology, we must caution those seeking to implement educational programs in cross-cultural situations. If it is difficult to inform people in the Western cultures where education is valued and the need for birth control is appreciated, it is infinitely more difficult to instill necessary ideas in peoples who link many children with cultural ideals. Education will be effective only to the degree that cultural values and customs are understood and the principles of acculturation are applied. Among those who have explored the multi-faceted problems in transcultural communication, Barrett has provided what should be required reading by every one seeking to promote birth control programs in other cultures (1953).

Short of ruthless dictatorship and coercion, governmental policies for restricting human fertility can be implemented only by appreciating that the citizenry have value-laden ideas about the "rightness" or the "wrongness", the "desirability" or "undesirability", and similar judgments about procreating many or few children. Perhaps there is occasion for optimism in Meier's conclusion that advances in science coupled with developed technology of communication will effectively disseminate birth control information throughout the world (1968). But cognizance of cultures is imperative in order to identify those subtle factors affecting human fertility so that programs may be realized and thus cope with the world's ominous population increases.

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