Women play an essential role in Asante society; the family line is passed on exclusively through the woman (matrilineal). Therefore, the importance of a successful pregnancy and having a female child can hardly be overstated. The fear of infertility, pregnancy failure, miscarriages and the death of young children must be viewed in this light. A woman who had many healthy children was held in high esteem.
The origin and use of the akua'mma is said to be based on the following origin myth: there was once a woman named Akua (Wednesday) who could not have children. She asked a god for help and was told by a priest to have an effigy of a child crafted from wood that met specific external characteristics. Then she was to care for the statue as if it were her own child, providing it with jewelry, feeding and drinking it, and carrying it with her. After she complied, she gave birth to many children. From then on, such an image was known as 'the child(ba) of Akua', or 'Akua'ba'.