Son Preference and Maternal Health: A Cross-Cultural and Temporal Analysis

Neha Agarwal and Annamaria Milazzo

Economic Development and Cultural Change, 2026, vol. 74, issue 4, 1167 - 1203

Abstract: This paper examines how son preference and reproductive health-care conditions interact to influence maternal morbidity and mortality. Using data on 2.5 million women across 44 developing countries between 1990 and 2018, we exploit cross-country variation in son preference intensity and health-care conditions to document distinct patterns in maternal health. We show that in societies with strong son preference, women with first-born girls face higher incidence of moderate to severe anemia, a risk factor for maternal mortality. Moreover, these women exhibit lower survival into older ages where strong son preference coexists with poor maternal care. These patterns persist over time.

Date: 2026
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