This article is based on four months of fieldwork and data collection in rural Burkina Faso. It explores the dynamics of gender relations centered on the negotiation of fertility in the face of differential desires for offspring between men and women. These negotiations between partners is facilitated by women using a specific biomedical discourse in order to convince their husbands or by the possibility of using contraceptives surreptitiously. The article focuses on the advantages of hormonal contraceptives for women and on the types of power they acquire in the household and the marital space. The article also casts light on the limits of leeway available for negotiations between spouses, and further highlights the dynamics of masculine and social control of feminine fertility and sexuality in rural settings.