Lack of reproductive rights and choices undermines a generation of young people in the Democratic Republic of the Congo

GOMA, Democratic Republic of the Congo – “I wanted three children,” Ombeni Mburano, 31, told UNFPA, the United Nations sexual and reproductive health agency. “I've already had five, and the sixth is coming soon. I never had a choice.” 

According to UNFPA’s recently released State of the World Population report, 44 per cent of women and girls worldwide don’t have decision-making power or bodily autonomy over sexual relations, contraception or reproductive healthcare. In the Democratic Republic of the Congo, this rises to a staggering 69 per cent.

“In our country, it's not always you who decides whether you want a child or not. Sometimes it's your family, your husband... or just life's circumstances,” Ombeni explained.

A survey conducted for the report also revealed that around one in three respondents had experienced an unintended pregnancy. These figures are particularly stark in the Democratic Republic of the Congo, a country with one of the highest total fertility rates in the world. Poverty, sexual violence, child marriage, conflict and displacement, and lack of access to sexual and reproductive healthcare all too often undermine true and free choice when planning whether and when to have children. 

In Goma, at a health centre supported by UNFPA, midwife Espérance explained, “Many young women say they want to wait before having a child. But they have neither the means to protect themselves nor the ability to say no.”

Insufficient information about, and access to, contraceptive services hampers people’s ability to plan the timing and size of the family they want. Data from 2023-2024 show that one in five women in the country wants to delay or avoid pregnancy, but can’t access the contraception they need. As a result, adolescent birth rates are extremely high – with 11 per cent of births being to mothers aged only 15 to 19 years old. 

Futures disrupted, families struggling

Esther, a young displaced woman from Rutshuru in the North Kivu Province, is barely 18 years old – and seven months pregnant. Neither she nor her partner Samuel, 25, had much knowledge about sexual and reproductive health or contraception. She became pregnant soon after they started dating.

Without any means of support, Esther moved in with Samuel's mother, Thérèse. But this won’t be Thérèse’s first grandchild. 

Years earlier, Samuel’s first girlfriend fell pregnant, but he was too ashamed and afraid to handle the situation. He fled, and never heard from the girlfriend again. His sister also had a baby meanwhile – but that father abandoned them too. 

Through a modest vegetable business, 62-year-old Thérèse is struggling to support her daughter and grandchild, as well as Samuel and Esther. And another baby is on the way. 

Samuel alternates between odd jobs, searching for a way to earn enough to survive each day. His situation is all too common: More than 60 per cent of young people under the age of 30 in the country do not have access to stable formal employment, according to the World Bank. Most work informally, often without contracts, social protection, or prospects for advancement – a troubling situation for young parents-to-be.

“When Esther got pregnant, I had no home, no job, no plans,” said Samuel. “My mother had to take her in, just as she had done for my sister. I feel stuck, forced to take responsibility without being ready.” 

Empowering young people to create the families they want 

Investing in young people and their well-being and autonomy is key to enabling them to create the families they desire.

“Having a child should be an informed and shared decision, never a consequence suffered by default,” said Dr. Solange N. Ngane, coordinator of UNFPA’s sexual and reproductive health programme in Goma.

In the eastern part of the country, where escalating conflict has led to mass displacement and extensive damage to health facilities, UNFPA is working to strengthen access to family planning and reproductive healthcare. 

UNFPA-supported mobile teams of community health workers and youth peer educators are reaching displaced populations with contraceptive supplies, information campaigns about sexual and reproductive health, and referrals to available facilities.

UNFPA is also supplying health facilities with reproductive health kits and has deployed 148 midwives to ensure that sexual and reproductive health services remain available for displaced women and girls, returnees and host communities. 

One of these facilities is the Buhimba health centre, where Esther and Samuel recently attended a prenatal consultation. Together with other couples, they benefited from an information session led by a midwife and a psychosocial assistant. These services are free for displaced women like Esther.

“We learned how to recognize the signs of danger in pregnant women, but also about the methods of contraception we can choose after giving birth. I didn't know we could be so well received, even without money. Now I feel safe, and Samuel also understands that we can decide together,” said Esther.

Support is needed for young people to choose their own futures

Programmes like the one at the Buhimba health centre are funded through support from the European Union, Japan, Norway, Sweden and the United Kingdom.

But towering needs are outstripping resources: In the first quarter of 2025, only 7 per cent of the people targeted for sexual and reproductive health services in the Humanitarian Needs Analysis and Response Plan for the Democratic Republic of the Congo were reached. This dire situation was exacerbated by the withdrawal of support from the United States, which led to sexual and reproductive health funding in the country being reduced by more than half. 

UNFPA analysis shows this has led to a surge in unintended pregnancies, unsafe abortions, sexually transmitted infections, and maternal and infant deaths; a reminder that the most affected are, as always, the most vulnerable.

“When a girl becomes pregnant without meaning to, her life is often turned upside down,” said Dr. Ngane. “Investing in young people means allowing them to freely decide if they want to become parents, when, and under what conditions. That is true reproductive justice.”