PIP: Variables which influence the decision among primarily lower-class J amaican women to use or not to use contraception are discussed. The material is based on interviews with 20 women, 14 of whom are clients at a family planning clinic. Additional data is derived from shorter interviews with 80 family planning clients. Case histories highlight the material. The following psychocultural variables were considered significant. 1) Poor communication between sexual partners. 2) Strictness in child rearing, shielding the child from any knowledge of sexual relations and its possible outcome in the hope of keeping her chaste but in fact often leading to early sexual relations. 3) High value attached to the status and role of mother. To many women, their mother is more important than their mate. 4) Negative perceptions of Ja maican men and of potential roles for women other than motherhood. 5) Socially permissible loose conjugal and household arrangements with little pressure on the men to assume responsibility for their children and much pressure on the woman to bear a child for each new mate. 6) Anxiety about contraception through ignorance and lack of communication with an informed, authoritative person. The force of these factors is apparent in the fact that fertility patterns have changed little in the 7 years since the government mounted a massive family planning campaign. However, the coming to a family planning clinic, especially early in a woman's reproductive period, represented a move in the direction of autonomy and self-determination for women.