This article examines socio-cultural conditions underpinning the so-called abortion culture in Soviet Ukraine. Unlike previous studies on abortion in the Soviet Union which primarily used country-level data, this study employs original sourcesin-depth biographical interviews and archival materialsto investigate local conditions and the manner in which decisions regarding abortion were made. The author studied couples whose reproductive years comprise the period from 1955 to 1970, when modern contraceptives were not readily available but abortion was legal. Two localities in Ukraine, the cities of Lviv and Kharkiv, are included in the investigation. The findings suggest that local patriarchal gender regimes and their associated spousal dynamics define when and how women exercise their agency in birth control and abortion decisions. In couples where spouses communicated about birth control and abortion decisions women sought abortions less. Those women did not feel a need to exercises their agency as the husband took over both responsibilities. When abortion was practiced as a routine family size limitation method, spouses did not communicate about birth control and abortion, and the two were practiced solely as a husband's and wife's responsibilities, respectively. Those women sought abortion to fulfill their own goals, and at the same time to maintain the dominant patriarchal order in marital relationships as they understood it. Additionally, peer networks seemed to be the crucial element reinforcing women's agency in these processes.