Managing sexual and reproductive health (SRH) needs remains a challenge for many women migrant workers in developing countries. Nonetheless, the extent to which they can be supported in meeting these needs remains underexplored, with implications for worker health and working life. Drawing on semi-structured interviews with 25 factory women migrant workers in Penang, Malaysia, this article applies a Foucauldian lens of governmentality to explore directly their agency in managing their SRH. The authors consider the self-surveillance practices the women adopt in response to a programme of SRH interventions. The findings reveal varied degrees of compliance with programme expectations. The article demonstrates empirically the importance of the perceived salience of SRH as a motivating force in self-surveillance practices, drawing out the disempowering effects of self-consciousness and shame in gendered subjectivity. The authors further consider the impact of universalist prescriptions for SRH within locales in the developing world, and the implications for SRH interventions with factory women migrant workers in such settings.