Ndebele beaded fertility dolls are given to young girls when they attend initiation school. The doll is cared for and cherished until the woman's first pregnancy. According to custom, the child figure must be given away, sold or destroyed after the birth of the third child as it is considered unwise to keep the doll any longer.
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The dolls also play a significant role in courtship. A doll is placed outside the home of a prospective bride by her suitor, indicating his intentions of a marriage proposal.