An examination of reasons why oral contraceptives represent less than 5% of modern method use in Vietnam, based on structured discussions with program implementers and on interviews with women who are actual or potential pill users, indicates that promotion of the pill has been minimal and that demand is low. Many program implementers perceive the IUD to be a better method under most circumstances, and they lack accurate knowledge about the pill. For example, a large proportion believe that it is necessary for pill users to skip one or two cycles every year to restore their hormonal balance. In addition, most do not believe that rural women can remember to take the pill daily. In contrast, most current or former pill users report that they have not had serious difficulty in remembering to take the pill on a daily basis. The inadequate knowledge and negative attitudes toward the pill among program implementers can be traced to the structure of the family planning program and to the assumptions underlying population policy in Vietnam.