It has been widely documented in patrilocal and strongly patrilineal settings in India that the presence and influence of mothers-in-law in the household may affect fertility decisions made by young couples. However, not much is known about how intra-family relationships per se influence choice of contraceptive method and timing of use. To understand patterns of family planning decision-making, we carried out short, open-ended interviews in rural Madhya Pradesh in 2005 with 60 mothers-in-law, 60 sons and 60 daughters-in-law from the same families. Mothers-in-law were found to have an important influence on family decisions pertaining to activities within the household. They were also likely to influence the number of sons their daughters-in-law had and the timing of their daughters-in-law being sterilised, but they did not seem to have the same authority or influence with regard to decisions on the use of reversible contraceptive methods, which were mainly being made by young couples themselves. The findings show the flexibility and transformability of intra-family interactions, even within a hierarchically-ordered kinship system that is often considered an obstacle to improving reproductive health and gender equity. Given the right information, and availability of and access to reversible methods, young couples in rural Madhya Pradesh are increasingly making contraceptive choices for themselves.

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http://dx.doi.org/10.1016/S0968-8080(10)35497-8DOI Listing

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