Key Social Norms Take-aways Social norms related to female sexuality, discretion, and male authority continue to heavily influence whether and how young women use FP. Secrecy is often a survival strategy to avoid stigma or conflict. Interventions must go beyond providing FP information and instead engage entire social networks—particularly mothers, partners, and healthcare workers—to shift norms and build safe, supportive environments for reproductive decision-making.

Objectives This study explores how key influencers—including partners, parents, aunts, friends, and healthcare providers—shape young women’s decisions about using family planning (FP) in peri-urban Nairobi. It investigates how social and gender norms affect these interactions, and how women manage trust, secrecy, and stigma when making reproductive health choices.

Methods Researchers conducted 40 phone-based qualitative interviews in November 2020 with 16 young women aged 20–25, 10 male partners, and 14 key influencers, all living in informal settlements across seven peri-urban wards in Nairobi. The study used semi-structured interviews and vignettes to explore who women consult about FP, what advice they receive, and how social norms influence those decisions. Thematic analysis was used to identify key patterns.

Results Women’s FP decision-making was shaped by a network of influences. Mothers were seen as supportive and discreet, often drawing from their own experiences to advise daughters. Aunts were valued for their openness and impartiality. Partners were identified as central decision-makers, but many women anticipated opposition from them due to concerns about fertility, side effects, and suspicions of infidelity. Friends provided emotional support and shared lived experiences, though trust was not always guaranteed. Healthcare providers were viewed as knowledgeable and discreet, but some women feared judgment based on age or marital status. Many women described using FP in secret or consulting trusted confidants selectively to avoid social sanctions.

Conclusions FP decisions among young women in Nairobi are embedded in complex social environments where norms around gender, secrecy, and sexuality play a significant role. While women seek out multiple perspectives, they often do so cautiously—balancing the need for accurate information with the risk of judgment or conflict. Even when empowered to make decisions, women must navigate power dynamics and stigma within their networks, particularly from male partners and conservative healthcare providers.