Written by Maryam Ibrahim
Growing up as a woman in Nigeria, you quickly learn that many things are seen as your fault. From a young age, we watched movies about childless couples where the blame always fell on the wife. In real life, the same narrative plays out—women carry the weight of fertility, of pregnancy, of childbirth. And when a woman finally gets pregnant, the burden only deepens. Her body changes; she makes sacrifices; she shifts her entire life. And where is the man in all of this?
Today, I want to take you on a journey—one that challenges the idea that pregnancy is solely a woman’s responsibility. Through real-life stories of African women, scientific insights, and hard truths, we’ll explore how men play a bigger role in pregnancy than society acknowledges—and why it’s time to start holding them accountable.
It’s no doubt that historically, women have been defined by their ability to reproduce. For a long time, it was even assumed that the word “woman” was coined from a combination of “womb-man.” Women bore the children, raised them, and ensured they were well-fed and groomed. That was their role—at least, that’s how society saw it. But beyond the biological reality of pregnancy, the weight of conception, childbirth, and reproductive health as a whole has always been disproportionately placed on women.
From the moment a woman realises she’s pregnant, the burden is hers to carry. She adjusts her lifestyle, changes her diet, and becomes the sole focus of prenatal care. And where is the man in all of this? In most cases, he remains on the sidelines, barely acknowledged by the healthcare system, never feeling the same pressure or responsibility.
The Cultural and Social Influence: How Society Dictates Responsibility
The traditional approaches to maternal healthcare in many developing countries reflect deeply-rooted gender beliefs. Healthcare services are designed with only women in mind, further reinforcing the idea that pregnancy is a woman’s duty alone. This discourages male involvement at every stage.
Even as children, girls are prepared for the weight of reproduction. They are taught what to avoid, what to endure, and what to expect. Meanwhile, boys grow up with little to no education on reproductive health, let alone any sense of responsibility. And it’s not just about pregnancy—look at the horrific practices like breast ironing and female genital mutilation (FGM) still happening in parts of Sub-Saharan Africa. These practices exist as a constant reminder that a woman’s body is not her own but something that must be managed, controlled, and altered to fit societal expectations.
A paper I once read explained that, historically, pregnancy and childbirth in Sub-Saharan Africa were not seen as conditions requiring urgent medical attention, the way an illness might be. This perception, combined with the fact that the physical burden of pregnancy falls on women, meant there was never any cultural push for men to be actively involved. Over time, this attitude spilt over into healthcare systems, education, and even the information we share about pregnancy.
In many communities, a man accompanying his wife to a hospital visit is almost unheard of. He might be seen as “too soft” or even mocked for being overly involved in “women’s issues.” As a result, women go through pregnancy alone, making major decisions, attending hospital visits by themselves, and ultimately, enduring childbirth without the full support of their partners.
Scientifically, A Man might have more Roles to Play and here’s why
For generations, women have been blamed for “failing” to give birth to male children. In some cultures, this has even led to domestic violence, divorce, or men taking additional wives in the pursuit of a son. But here’s the truth—men determine the sex of the baby, not women.
A woman’s egg always carries an X chromosome, while a man’s sperm carries either an X or a Y chromosome. If the sperm that fertilises the egg carries an X, the baby will be female (XX). If it carries a Y, the baby will be male (XY). The science is that simple. Yet, when a woman gives birth to only girls, she’s the one who faces ridicule—while the real biological determinant is ignored.
Now, here’s where it gets even more interesting. We hear a lot about what women should and shouldn’t do for a healthy pregnancy—eat this, don’t stress, exercise, take your supplements. But a study published on PubMed (Rubino et al., 2019) found that sperm quality plays a major role in whether a pregnancy even lasts.
The study shows that DNA fragmentation in sperm increases the risk of miscarriage, meaning that if a man’s sperm carries damaged genetic material, the pregnancy could fail—even if the woman is perfectly healthy, and to maintain sperm health, a man has to stick to strict lifestyle changes pre-conception. I’m talking eating healthy, no drinking or smoking, proper and regular checkups, but there’s absolutely no one clamouring for African men to do this.
And if you think a man’s role in pregnancy ends after conception, think again. A Cornell University study (Antczak et al., 2013) found that paternal genes are directly responsible for placenta development—which means the baby’s ability to grow and thrive in the womb depends partly on the father’s genetic contribution.
So, if a pregnancy has complications like poor foetal growth or placental insufficiency, maybe, just maybe, we should also be asking about the father’s health and not just focusing on what the mother ate that week.
Paternal Health Conditions Can Lead to Birth Defects
A National Science Museum study (Fertility & Sterility, 2019) revealed that men with conditions like obesity, diabetes, and high blood pressure pass on risks that can affect the baby’s health.
- Diabetes in fathers has been linked to low birth weight and neonatal seizures.
- Obesity in men is associated with an increased risk of stillbirth and congenital heart defects.
- Older paternal age has been connected to conditions like autism and schizophrenia.
What this basically means is that the father’s social and medical history is just as important, and he should as well be put under strict antenatal appointments, changes, tests, and checkups.
Science Aside,
Let’s talk about the reality in most African homes. Even with all this evidence, paternal involvement in pregnancy care is still shockingly low.
- Few men accompany their wives to antenatal visits—either because they don’t see it as necessary or because health facilities aren’t designed to include them.
- Many don’t adjust their lifestyles even when their partner is making major sacrifices for the baby’s health.
- They often have the final say on medical decisions, despite not being directly affected. In some hospitals in Nigeria, a Caesarean section will not be performed on a woman unless the consent form is signed by her husband!
Why should we be talking about this more?
For too long, conversations about pregnancy and reproductive health have placed the burden squarely on women. But as we’ve seen, men’s health, lifestyle, and involvement play just as critical a role in pregnancy outcomes. If we truly care about reducing maternal mortality, preventing birth complications, and improving overall reproductive health, we need to start talking about paternal responsibility—and acting on it.
Paternal Antenatal Education is Crucial
One of the biggest gaps in our healthcare system is the lack of paternal antenatal education. In most African countries, antenatal classes are designed for women, reinforcing the idea that pregnancy is a mother’s responsibility. Men are rarely encouraged—let alone required—to learn about their role in pregnancy, from sperm health to postnatal care.
Yet, studies consistently show that when men are educated about pregnancy and actively involved in antenatal care, outcomes improve significantly. Educated fathers:
- Provide better emotional and financial support.
- Are more likely to encourage healthy habits in their partners.
- Make informed decisions about medical care instead of leaving it all to the mother.
- Understand that their own health and habits impact foetal development and adjust accordingly.
Sensitization and Policy Changes Can Drive Cultural Shifts
Beyond individual awareness, we need systemic changes in how antenatal and natal care are structured.
- Hospitals and clinics should actively encourage male participation by offering sessions tailored to fathers and emphasising their role in reproductive health.
- Public health campaigns should include men in discussions on pregnancy, childbirth, and infant care.
- Traditional beliefs that exclude men from reproductive conversations must be challenged through community-based sensitisation efforts.
Incorporating Paternal Responsibility into Medical Care
Medical practitioners also have a role to play. Instead of framing pregnancy care solely around the mother, hospitals should begin incorporating paternal health screenings and education into antenatal visits. This means:
- Screening men for conditions that could affect pregnancy outcomes, such as diabetes, high blood pressure, and genetic disorders.
- Educating them on how their diet, lifestyle, and stress levels impact foetal development.
- Encouraging them to attend and participate in prenatal appointments alongside their partners.
