‘I don’t want more children…’: risk, trust, agency, and the negotiation of family planning in Nigeria

Modern contraceptive uptake remains uneven in Nigeria despite increasing awareness and continuing investments in family planning services. This study explored how women, their families, community actors, and healthcare providers understood and negotiated modern contraceptive use in Lagos State, Nigeria. A qualitative descriptive design was employed, involving 56 in-depth and key informant interviews with women, men, healthcare providers, religious leaders, and traditional leaders across urban and rural settings. Data were analysed using reflexive thematic analysis. The findings show that contraceptive decision-making was shaped by socially constructed perceptions of risk, family and community relationships, structural barriers to service access, provider-client trust, and locally embedded moral frameworks. Participants negotiated competing sources of information, authority, and social expectations when making reproductive decisions. Family planning was understood through ideas of responsible parenthood, family wellbeing, and social responsibility, although participants also drew upon competing expectations regarding fertility, lineage continuity, and future family security. These findings highlight the importance of culturally situated, relational, and context-sensitive approaches to family planning policy, counselling, and service delivery.