AIMS AND OBJECTIVES: To explore Somali Bantu refugee women's reproductive health decision-making, as influenced by their resettlement in the USA. BACKGROUND: Available literature on reproductive health of refugee women is mostly from the healthcare provider perspective, neglecting the lived experience of the population. DESIGN: Qualitative descriptive. METHODS: A purposive sample of 30 women was recruited for five focus groups. Data were collected via demographic survey and semi-structured focus group discussion. Content analysis was used to analyse the data. RESULTS: Our study revealed that Somali Bantu women considered children as wealth. Reproductive health decision-making was influenced by three main factors: family influence, cultural/religious ideas and experience with various hormonal birth control methods. CONCLUSIONS: Nurses and other healthcare providers would better serve refugee women if equipped with a more nuanced understanding of factors in their reproductive healthcare decision-making. This study can inform tailored and cultural relevant interventions to improve reproductive health among those at greatest need. RELEVANCE TO CLINICAL PRACTICE: Our findings can serve to guide nurses and other healthcare providers' clinical approach to a subset of the population whose cultural beliefs and practices regarding reproductive health may be unfamiliar. Incorporating the perspective of the Somali Bantu women will facilitate the provision of person-centred care and ensure women receive appropriate, efficient and quality care that meets their needs, which may potentially reduce financial costs to the healthcare system.