Key Social Norms Take-aways The study demonstrates that social norms—particularly those surrounding marriage, childbearing, masculinity, and female obedience—are central to shaping contraceptive use in Senegal. Norms that prioritize early and continuous childbearing, equate fertility with social value, and position men as primary decision-makers constrain women’s reproductive autonomy. The discussion highlights that these norms are enforced through social sanctions, including gossip, verbal abuse, and threats of divorce or violence, which often compel women to either conform or use contraception covertly. Importantly, norms are upheld not only by male partners but also by influential female family members (e.g., mothers-in-law), reinforcing a broader system of control. Shifting these norms requires addressing power dynamics within households and engaging both men and extended family networks.

Objectives The study aimed to explore how social norms, relationships, and belief systems shape women’s contraceptive decision-making and access to family planning services in Senegal.

Methods This qualitative study involved 256 participants (130 men and 126 women) across four regions of Senegal. Data were collected through 116 semi-structured interviews and 16 focus group discussions using purposive sampling. Thematic analysis was conducted using NVivo, guided by social norms theory. Social norms were not measured quantitatively but explored qualitatively through participants’ narratives, focusing on societal expectations, influential actors (partners, family, community), and sanctions associated with norm deviation.

Results Findings show that social norms related to marriage and childbearing strongly influence contraceptive use. Women face pressure to have children soon after marriage and are often blamed for infertility, while men’s masculinity is tied to fatherhood. Contraceptive use is frequently stigmatized, with women labeled as disloyal, promiscuous, or unloving if they use it—especially without partner consent. As a result, many women resort to covert use of contraception despite fear of repercussions such as conflict, divorce, or violence. Male partners and in-laws play a critical role in enforcing norms, while misconceptions about contraception, religious beliefs, and distrust in healthcare providers further shape decisions.

Conclusions The study concludes that contraceptive use is deeply embedded within a broader system of social norms and power relations. Improving access alone is insufficient; effective interventions must address normative barriers, including gender inequality, social sanctions, and misinformation. Integrating social norms change, engaging men and influential family members, and addressing links to gender-based violence are essential to support women’s reproductive autonomy and improve family planning outcomes.