The past three decades are marked by substantial improvements in many Reproductive Health indicators across the countries of Central Asia. Increases in aggregate levels of knowledge, access, and practice of family planning are particularly impressive and represent substantial improvements in the health and well being of women. However, are these benefits shared equally across all women? Employing qualitative and quantitative data Cynthia traces the impact of cultural norms and structural factors on limiting the ability of rural, less educated, unmarried, and childless men and women to reap the benefits of reproductive health improvements.