This paper draws on a qualitative study (n = 52) and applies a political ecology of health framework to examine men’s perceptions of women’s reproductive health in South Sudan. The findings suggest that political practices of place making configure men’s views of women’s reproductive roles in this new nation state. In particular, masculinity intertwines with fears of losing traditional culture, and with lingering concerns about sovereignty to underpin men’s deep aversion to modern family planning methods. In addition, the use of tribal militia to control territory and leverage political power places women’s reproduction at the centre of South Sudan’s post-secession politics. Improving health in such a fragile environment may require more than rebuilding the health infrastructure and guaranteeing financial access to health care.