This is a study of women’s capabilities and constraints in accessing contraceptive services in Guatemala. The thesis aims to draw attention to the importance expressed by the women themselves to have access to contraceptive services in order to be able to take care of their families and cope with the poverty. Throughout the thesis, one woman is used as a the main example to explore the usefulness of concepts such as agency, capability and choice in relation to reproductive health. The main issue stressed is the freedom to choose. The thesis aims to contextualize women’s capabilities and constraints on a local level in relation to health system and socio-cultural conditions. Further, it aims to understand the state’s role in providing women access to contraceptive services, and how different actors, the Catholic Church in particular, influence the situation. Toward the end, the global ideology of reproductive rights and what this might imply for the individual woman is discussed. In exploring reproductive health on all these levels this thesis aims to get a better understanding of the capabilities and constraints women face in having access to contraceptives.