Drawing on examples from iud users in China, Vietnam, Indonesia, Bangladesh, Tajikistan, Uzbekistan, and Nigeria, this article examines the variety of ways in which women in the global South have negotiated reproductive agency with the help of or by refusing the contraceptive device. Reproductive objectives and actions of women in the global South are shaped by competing pressures from family, economic reality, and gender roles as well as by pervasive patriarchal values and neo-Malthusian state population policy. As a long-acting, provider-controlled, easily-reversal, and inconspicuous contraceptive method, the iud has been appropriated by both feminist and anti-feminist actors. This article highlights individual cases in which the contraceptive device played an instrumental role in improving a woman’s ability to take control of her reproductive life in a place where female agency is severely constricted.