This paper focuses on marital birth control practices c. 1955–1970, i.e. before the era of widespread uniform adoption of modern contraceptives, in two nearby Swiss cities characterized by different religious cultures. It asks how responsibility for contraceptive practices was shared within the marital couple, whether it was the object of discussion between spouses, how the choice of a method of contraception was made and how religious culture affected these elements. This paper uses written sources reflecting medical authorities’ views about birth control and 48 semi-structured interviews with elderly persons from the lower middle and working classes. The results point to three key conclusions. Firstly, the findings show a joint responsibility of both spouses for contraceptive practices. Secondly, the paper shows that religious culture plays a key role in the access to means of birth control. Specifically, Fribourg gynecologists were reluctant to prescribe modern methods. Thirdly, the results underline that a combination of methods are used throughout reproductive life, depending on the spouses’ desire to have additional children and on men and women’s individual attitudes toward birth control methods.