Objectives The study aimed to provide a deeper understanding of the gender-related determinants and organisational structure of primary health care that shape contraceptive use among disadvantaged women living in a developing Islamic country where family planning services are affected by health care reforms. Methods A qualitative study was conducted in three disadvantaged neighbourhoods in the metropolitan district of Bornova, Izmir. A purposive sampling method with maximum diversity was used to obtain a study sample of 43 women. Data were collected through in-depth interviews and analysed using a coding paradigm of grounded theory. Results Three themes emerged from the analysis, namely, factors affecting participants' number of children, experiences with using contraceptive methods, and use of family planning services at family health centres. Despite a desire to limit their number of children and a positive view of contraception, women in the study faced gender-related barriers to accessing family planning services. Their statements indicate significant deficiencies in terms of provision of contraception and family planning consultations at family health centres. Conclusion For disadvantaged women living in conservative areas, family planning is a fragile exercise. Gender-sensitive primary care services are essential to ensure access to everyone in the community.