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Based on 16 months of ethnographic research in Salvador, Bahia, this paper points to the importance of an understanding and recognition of the aesthetic underpinnings of health and biomedical systems. Drawing on women’s reproductive experiences and navigations within a racialized gendered hierarchy, I draw attention to the role aesthetics play in the construction and perception of what constitutes healthy reproduction and reproductive practices. I point out how the processes and procedures related to the governance and measurements of reproduction and reproductive health shape the way Black women are navigating society and health systems. I focus in particular on Black women’s experiences of contraceptive use, attempts to acquire tubal ligations, and family construction. I analyze the way that values, sensibilities, and affect that have come to adhere to particular appearances and arrangements have also adhered to the perception and apprehension of reproductive decision-making (seen and un-seen), reproductive health, and family constructions. By demonstrating how aesthetic systems and their interactions with health and biomedical systems literally and figuratively color the movement and perception of movement of people through those systems, with implications for reproductive health, this paper highlights the “co-constitutive nature of medical science and popular perception, underscoring the need to engage them simultaneously” (Bailey 2016, 22).