'Having children is like rain, as they say in our region': exploring refugees' reproductive agency.

Migrants with refugee backgrounds in the Netherlands face significant reproductive health challenges, including higher rates of unintended pregnancies and limited access to contraception. This study explores how post-migration realities affect the reproductive agency of refugees from Afghanistan, Somalia, Eritrea and Syria. Utilising a participatory approach, eight peer researchers from these communities conducted eight focus-group discussions and 118 in-depth interviews, involving four migrant grassroots organisations and two Dutch non-governmental organisations. The findings reveal that refugees must navigate multiple tensions: (1) adapting to a new country, including securing housing, employment and adjusting to social norms and gender dynamics; (2) navigating cultural norms and family expectations; and (3) obtaining resources such as knowledge and contraception, within a healthcare system that may lack cultural sensitivity and reflect broader societal stigma. These challenges may require strategies that differ from Dutch notions of individualistic reproductive choices. Reproductive services must be sensitive to this complex navigation and adopt a culturally sensitive approach, focusing on refugees' strengths and agency rather than solely on issues like cultural taboos, lack of knowledge, low literacy or language barriers.