Negotiating contraception: Joint decision-making and gendered power dynamics among Chinese migrant workers

This study examines how joint contraceptive decision-making unfolds among rural-to-urban Chinese migrant couples at elevated risk of unintended pregnancy. Based on 91 in-depth interviews, we trace how broad agreement to prevent pregnancy becomes contested in specific moments. Most couples agreed to use condoms in principle, yet discordance frequently emerged at the moment of sexual encounter: often women pressed for condoms as “safe,” while some men resisted due to comfort or preferred withdrawal or the “safe period.” A culturally grounded harm–safety framework shaped method valuation. Among most couples, partners commonly perceived hormonal methods and intrauterine devices as potentially harmful to women’s bodies, elevating condoms as the comparatively safer and more acceptable option. Yet this created a paradox. Because couples rejected hormone-based methods based on harm concerns, their dependence on condoms meant male resistance repeatedly arose, locking them in per-encounter negotiation. When persuasion failed, some women turned to emergency contraception—sometimes covertly—absorbing bodily costs. Education shaped how couples narrated choices but did not influence discordance. The analysis shows how gendered power, culturally specific harm beliefs, and education-linked repertoires interact to generate agreement in principle yet friction in practice.