Twenty-nine focus groups were conducted among men and women in five regions of Zaire to identify motivations for and obstacles to voluntary surgical contraception (VSC) for women. Both male and female participants believe that VSC is justified only for medical reasons related to difficulties with pregnancy or childbirth, and not for economic hardship. Women feel great pressure, especially from the husband's family, to produce many children, and fear they might be abandoned after being sterilized, even if their husband had previously consented to VSC. Men also perceive the major consequence of VSC to be marital conflict and dissolution. However, women who had had the procedure--primarily for medical reasons--expressed high levels of satisfaction with the operation. At the same time, they stress the need for confidentiality, suggesting that VSC remains controversial. Also examined are reasons for introducing VSC programs in a country such as Zaire.