Language and metaphors are central mechanisms of the human mind and thought processes, and allow us to draw on existing social or physical experiences to make sense of novel concepts. Metaphors are not simply linguistic tools; they are deeply rooted and structured in cultural backgrounds and can shape our understandings, perceptions and actions. Different cultures can have different views about the life-course, reproduction and preventing pregnancy,2 and these views are reflected in the use of language when talking about contraception. Our hypothesis is that the vernacular language used to refer to contraception in northern Malawi would not correspond to the English terms in content or tone, and that such mismatches in the language of public health initiatives could affect uptake. We propose that the discussion around English terms in reproductive health programming must understand and use the local vernacular in each setting, particularly when trying to promote family planning programmes, where cultural values will shape willingness to use contraception.