Cultural beliefs impact fertility treatment with donors in Africa
The Divine in the Clinic: Assisted Reproduction and Religious Practice in Ghana and South Africa (Whittaker, 2025)
Whittaker, A., Gerrits, T., & Manderson, L. (2025). The divine in the clinic: Assisted reproduction and religious practice in Ghana and South Africa. Journal of Religion and Health. https://doi.org/10.1007/s10943-024-02222-1
Geographic Region: Ghana and South Africa
Research Question: How do spiritual and religious beliefs influence assisted reproductive technology practices, particularly donor conception, in Ghana and South Africa?
Design: Qualitative ethnographic study using observations and in-depth interviews conducted in 2012-2013 (Ghana) and 2022-2023 (South Africa) during site visits to two clinics in Ghana and seven clinics in South Africa.
Sample: 74 participants in South Africa (17 fertility specialists, 7 embryologists, 12 nurses/donor coordinators, 7 allied health staff, 18 other staff, 13 egg donors). 40 participants in Ghana (4 fertility specialists, 3 embryologists, 5 nurses/donor coordinators, 22 patients, 6 surrogates).
Key Findings: (Note: I focused on findings related to donor conception.)
In Zulu culture, when a child is born, they must be formally introduced to the ancestors through specific ceremonies. If a new child is born and the ancestors do not recognize the child as part of their lineage, people believe the child will be vulnerable to illness and misfortune due to witchcraft.
In South Africa, some Zulu egg donors declined to donate to Zulu recipients due to worries about ancestral ceremonies. They feared negative consequences if a child born from their donation was introduced to incorrect ancestors.
A Zulu intended parent expressed similar concerns about using an egg donor: "‘Obviously we are going to give our child back to the ancestors’—when the child is back they do a proper ceremony, a clan name, they speak clan names, so she was saying ‘what clan names am I going to speak to this child?’” Clinic staff advised focusing ceremonies on the father's clan names, as father's lineage is traditionally most important.
Limitations: Focus mainly on Christian and Zulu perspectives.
Applications: The study highlights the importance of understanding how different cultures integrate donor conception into existing traditions and rituals.
Funding Source: Australian Research Council Discovery Project Grant [DP 200101270]
Lead Author: Andrea Whittaker is based at the School of Social Sciences, Monash University, Melbourne, Australia.
Regulatory Context:
South Africa
The National Health Act 61 of 2003 provides the primary legal framework for assisted reproductive technologies procedures, including gamete (sperm and egg) donation.
Donor anonymity is mandated, prohibiting the disclosure of a gamete donor's identity.
Donors may be reimbursed for reasonable expenses incurred during the donation process, but commercial trading of gametes is prohibited.
A donor's gametes may not result in more than six live births, excluding the donor's own children. Fertility clinics maintain detailed records to monitor and enforce this limit.
Donors have no legal parental rights or obligations toward donor-conceived children.
Ghana
Ghana currently lacks specific legislation regulating donor conception and ART practices.
As a South African (Tswana) lady I agree. Though it should not stop people from having children with ART via donors. Some "biological" fathers are absent in any case to do the ancestral rituals for the child. So bite the bullet, introduce the child in your own family to be welcomed, accepted, loved valued and respected as their own.