Reproductive health has become a priority public health concern in recent years, although less attention has been paid to women's own reproductive health priorities. Qualitative research in this area is important in elucidating an understanding of women's roles in both social and biological reproduction, and in gaining access to women's perceptions of their own reproductive health. In this study, we examined rural Zulu women's perspectives on reproductive health and fertility as part of their life histories, and assessed knowledge of reproductive health and related practices. Findings indicate that, in spite of recent declines in fertility in South Africa, child bearing remains the principal form of self-expression among older Zulu women, with fertility a necessary step toward achieving social status as a woman. This status, however, does not confer autonomy or power on women, but rather serves as a means of meeting social expectations.