China's family planning policy has historically silenced the voices of women, especially unwed single mothers at the expense of their reproductive health and overall wellbeing. Further, reproductive decisions in China are closely intertwined with marriage decisions and intergenerational dynamics, highlighting the relevance of gender in women's reproductive health experiences. Chinese unwed single mothers are in particular penalized for violating the gendered social norms supported by the national reproductive policies. Drawing on previous work that calls on the need to explore gender system and its influence on health, this manuscript explores the ways in which gender norms are played out for the unwed single mothers within romantic and intergenerational relations, with impacts on their reproductive health and decision-making. The findings show that reproductive decisions are interwoven with the fulfilment of other gendered identities, such as daughter, daughter-in-law and wife. Although the decision to go through unwed motherhood is reflective of their agency, the tie between childbirth and marriage does not allow the women to entirely break free from the social system. The findings also highlight the importance of considering the role of gender system that is played out within social relations, which in turn impacts the health of the women.