In the developing world, infertility is a serious problem. It leads to both psychological and social hardship, in part because childless marriages often result in divorce, men taking another wife or extramarital relationships. Such responses have been attributed to cultural norms that mandate procreation. However, there are theoretical, methodological and moral issues with treating cultural norms as behavioural determinants. They have been insuffi ciently acknowledged in health research. Therefore, I demonstrate an alternative discursive approach, which examines how people actively mobilize ‘culture’ or ‘norms’ in interactions, and the interpersonal functions thereby fulfi lled (e.g. blaming or justifying). Analysis is presented of interviews on (responses to) infertility in Malawi. I show how respondents construct polygamy and extramarital affairs as culturally and normatively required, ‘automatic’ and normal solutions for fertility problems and play down people’s accountability for these practices. These accounts and constructions appear to facilitate engagement in affairs and polygamy when people face fertility problems, which seems problematic from a health and gender perspective. Thus, detailed analysis of how people use ‘culture’ and ‘norms’ in situ is important because it provides insights into its potentially undesirable consequences. Moreover, such analysis provides a starting point for culturally and gender sensitive interventions, since it highlights people’s agency, and creates a space to re-construct and change practices.
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