This study has two main objectives. First, it aims at explaining variation in health perception and health seeking strategies within the working classes in Flanders during the 19th century. The second goal is to study the impact of these perceptions and strategies on reproduction. This study starts from the observation that changes in perceptions are important in explaining the fertility decline, which is a major transition from high to low fertility that occurred in Europe in the late 19th century. It has been demonstrated that preservation of maternal health was a major motivation to limit family size during the first decades of the 20th century. I will analyze how this outlook on maternal health developed during the pre-transitional and transitional period, using the life course paradigm as the conceptual framework. Within this framework factors that influence individual life courses are analyzed on three levels: historical context, social networks and personal life experiences. The practical implementation consists of narrative and statistical analyses. The contribution of this research to the literature is twofold: on the one hand, it aims at bridging the gap between structural and behavioral approaches of health. On the other hand, it contributes to the connection of the disciplines of medical history and historical demography.