KINSHASA, Congo (AP) — When Prosper Mbumba got married, he had planned on having just two children — but at least one of them needed to be a boy. After four daughters, he and his wife were still trying to conceive a son.
Mbumba felt the weight of tradition from his Luba community in Congo, where producing a male heir is a deeply held expectation.
“In my tribe, in my culture, that was like an insult, having only daughters,” said Mbumba, who works as a human rights activist. “I should do my best to get more children, expecting to have a boy.”
He and his wife, Régine Ntumba, said a sense of relief washed over them when their first son arrived — one of two boys they would eventually have. Sitting together at an open-air bar in the Congolese capital of Kinshasa, Mbumba described finally feeling a “little satisfied.”
Ntumba, a housewife, said she was “very happy to learn that finally I have a boy.”
—
This report is part of an ongoing series examining maternal mortality in sub-Saharan Africa — a region with the world’s fastest-growing population that accounts for 70% of all pregnancy-related deaths globally. Approximately 180,000 women die from pregnancy-related causes across the continent every year.
—
Africa’s population is expanding faster than anywhere else on earth, but countless births take place under extremely difficult circumstances — from shortages of trained medical staff to a lack of resources for handling complicated deliveries, particularly in rural communities. The World Health Organization reports that Africa is responsible for 70% of maternal deaths worldwide, even as those numbers have been slowly declining.
The Associated Press has been investigating why so many African women continue to lose their lives during childbirth. Contributing factors emerge even before pregnancy begins, including barriers to obtaining contraception. The situation is being further strained as major international donors — particularly the United States under the Trump administration — have significantly scaled back the aid that helps protect mothers and newborns.
Adding to these dangers in many parts of sub-Saharan Africa is a cultural pressure placed largely on women to give birth to sons who will carry on family bloodlines.
Because daughters typically marry into different clans or tribes, sons are considered essential for preserving ancestral legacies. This belief runs so deep that many women have come to accept it as valid — even when repeated pregnancies put their own health at serious risk.
Congo’s fertility rate stands at 5.9 children per woman, placing it among the highest in the world, according to United Nations data. That figure is driven largely by cultural norms favoring early marriage and large families, compounded by limited access to contraception.
Patrick Djemo, a physician who leads MSI Reproductive Choices in Congo, said the pursuit of male heirs is deeply embedded in society and exposes many women to pregnancies they do not want.
His organization offers counseling, contraceptive services, and safe, legally permitted abortions to women across seven of the country’s 26 provinces. Clients include both married women and younger women who wish to delay having children.
“A lot of pressure is exerted on couples, and, as you know, mostly it is the woman who is blamed for giving birth to a girl,” Djemo said. He added that men frequently try to prevent their partners from using family planning by claiming the authority to make those decisions.
According to the U.N. Population Fund, around 29% of Congolese women of reproductive age report an “unmet need” for family planning — whether they want to space out pregnancies or stop having children altogether.
Congolese officials have tried to address this through a five-year strategic plan designed to give all women of childbearing age access to “affordable, quality family planning services” by 2026. However, carrying that out remains a massive challenge in a nation the size of Western Europe, where infrastructure is poor and armed conflict continues in the eastern regions.
Annie Tshiamala, who heads an association of Congolese midwives, said she has seen far too many women consumed by the desire to have a son.
She recalls a moment more than 30 years ago when a woman in her 40s — bloodied and exhausted from a difficult labor delivering her ninth child — immediately asked whether the baby was a boy or a girl. The woman already had eight daughters and was desperate for a son.
Not wanting to deliver more bad news, Tshiamala stayed silent, but a colleague spoke up and told the mother it was another girl.
“And she was disappointed. She said, ‘Oh, my Lord. Why?’”
The woman later told Tshiamala that her marriage was on the verge of falling apart because she had never given birth to a son.
Tshiamala herself was not immune to such pressure — her mother-in-law pushed her to have more children beyond the four sons she already had. With her husband’s support, she refused.
Even in Congo’s capital city today, women with education and professional careers are not spared from this kind of scrutiny.
“When you don’t have boys, you are not worth respect,” said Gloria Masanka, a radio presenter with Congo’s national broadcaster, describing the attitude within her in-laws’ family. She said daughters are seen as a threat to the continuation of the family name.
Masanka, who has been married for ten years and is the mother of two young daughters, said the couple would feel more fulfilled if they had a son — even though she has suffered two miscarriages and her blood pressure climbs to dangerous levels during pregnancy.
The issue has caused tension and family conflict. She said her husband has even gone so far as to suggest he might seek a girlfriend in order to father a male heir.
