Family Planning and Ethnic Heritage: Evidence from Sub-Saharan Africa

Family planning is a critical issue in countries, particularly those in sub-Saharan Africa, where high fertility rates coexist with low contraceptive use alongside ad- verse perinatal outcomes. Using a combination of ethnographic, ecological, and folklore data, we investigate the role played in this context by postpartum sex- ual abstinence, an extensively documented practice that, in preindustrial societies, finds its biological justification as a means to safeguard child survival. First, we show that the duration of contemporary postpartum abstinence increases with the duration of ancestral postpartum sex taboos within a woman's ethnic group. Sec- ond, postpartum abstinence is de facto pronatalist, as it increases the number of children ever born to a woman. At the same time, it increases the number of chil- dren of a woman who have died; lengthens birth intervals though not sufficiently to meet recommended guidelines; and increases neonatal death and child stunting. Exploring the underlying mechanisms reveals that postpartum abstinence is asso- ciated with patriarchal cultural norms and that the motivation for its adoption is that it serves as a purification ritual. Overall, our findings question the biologi- cal rationale for postpartum abstinence as a means to protect child health, while aligning with anthropological evidence documenting its adoption as a ritual.