Maternal Mortality Risk and Spousal Differences in the Demand for Children

Fertility decisions are often made by partners who may disagree. We develop a model in which an initial gender gap in ideal fertility prevents effective communication between spouses about the costs of childbearing incurred by women. This mechanism is likely to further widen the spousal disagreement over fertility in environments where maternal health risk is high and imperfectly observed. We design an intervention to experimentally vary exposure to information about maternal health costs to either the husband or the wife on a sample of approximately 500 couples in peri-urban Lusaka, in Zambia. At baseline, husbands display lower knowledge of maternal mortality and morbidity compared to their wives. At followup, about one year after the intervention, women whose husbands are treated experience a 43% reduction in the probability of being pregnant. Consistent with our hypothesis, men who are directly treated report lower desired fertility and have more accurate beliefs about their wife’s desired fertility than the husbands of treated women. Couples in which the husband is treated also increase communication about family planning, and experience greater marital satisfaction.