Democratic Republic of Congo
Son preference pressure driving health risks for African mothers, study shows
Deep-rooted cultural pressure to have baby boys is putting many African women at risk of repeated pregnancies and serious health complications, according to a report highlighting maternal health challenges across sub-Saharan Africa.
In the Democratic Republic of Congo, one man, Prosper Mbumba, said he and his wife kept trying for a son after having four daughters, reflecting a widespread belief in some communities that male children are needed to continue family lineage.
“In my tribe, in my culture, that was like an insult, having only daughters,” said Mbumba, a human rights activist. He said he only felt “a little satisfied” after the birth of his first son.
His wife, Régine Ntumba, said she felt relief and happiness when they finally had a boy.
The issue is part of a broader maternal health crisis in sub-Saharan Africa, which records about 180,000 pregnancy-related deaths each year and accounts for around 70% of global maternal deaths, according to the World Health Organization.
Experts say high fertility rates, limited access to contraception, and weak health systems are major drivers of risk. In Congo, women have an average of 5.9 children, according to UN data, partly due to cultural expectations and limited family planning services.
Health workers say women are often blamed for not giving birth to boys, increasing pressure to continue having children even when pregnancies become risky.
“Mostly it is the woman who is blamed for giving birth to a girl,” said Patrick Djemo, who leads MSI Reproductive Choices in Congo. He said many women face pressure from partners and families to avoid contraception and continue childbearing.
Midwives and health workers describe repeated cases of women seeking sons even during high-risk pregnancies, sometimes under severe medical conditions. In one case recalled by a midwife, a woman in her ninth childbirth expressed distress upon learning she had another daughter.
The pressure continues even among educated families in urban areas, where women report threats of marital breakdown if they do not produce a male child.
Health experts warn that such social expectations contribute to unsafe pregnancies, limited use of family planning, and preventable maternal deaths across the region.
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