“Too often, society blames only the girl for getting pregnant,” said United Nations Population Fund (UNFPA) Executive Director Babatunde Osotimehin about a UN report released in 2013. “The reality is that adolescent pregnancy is most often not the result of deliberate choice, but rather the absence of choices, and of circumstances beyond a girl’s control. It is a consequence of little or no access to school, employment, quality information and healthcare.” Blaming young girls for the shocking number of adolescent pregnancies is misplaced and rooted in a culture that historically frees men of blame at the expense of women. However, we now know that adolescent pregnancies are the result of factors that can be mitigated by policy interventions. Therefore, the UN report not only sheds light on the high rates of teenage pregnancies but also calls on governments globally to help young girls achieve their dreams by ensuring adequate education and health services for all. It is paramount for governments to heed the UN’s call for action, for the report notes that 7.3 million teenage pregnancies occur in developing countries annually. The State of World Population in 2013, which was produced by UNFPA, records that out of the 7.3 million births, 2 million are to girls who are 14 and younger. Pregnancy and birth at that age is known to result in serious long-term health and social consequences. Many may suffer from obstetric fistulas for years, while others may die during birth. In fact, an estimated 70,000 adolescents in developing countries die each year from complications that occur in pregnancy and childbirth.

The report follows the growing trend that focuses on factors caused by families, communities and governments as opposed to solely looking at a girl’s behavior as a cause for early pregnancy. Looking at these factors are important because early pregnancy adversely impacts a girl’s health, education and even rights. Also, having a child at an early age results in girls not realizing their dreams and newborns growing up in the care of immature, inexperienced mothers. Governments are likely to pay special attention to this aspect, for a country’s economy is affected by teenage pregnancies as it stops a sizable portion of the population from entering the workforce. The report mentions Kenya as an example, stating that “if 200,000 teenage mothers had been employed instead of becoming pregnant, $3.4 billion could have been added to the economy.” Two other examples are Brazil and India, which could have added $3.5 billion and $7.7 billion to their economies respectively only if girls had been able to wait until their 20s to give birth. For countries to gain those benefits of the employment of girls, the report emphasizes that they need to invest in adolescent girls. Not only do governments need to spend money on preventing early pregnancies but also on the education and health of girls. Currently, the global community spends less than two cents of every dollar spent on international development on adolescent girls. (Source: UN)

In a more recent article by the World Health Organization (WHO), adolescent-specific fertility rates seemed to decrease but there was a huge variety across regions. The numbers from 2020 state that an estimated 21 million girls aged 15-19 years in developing countries become pregnant, 12 million of which end up giving birth. At least 777,000 births occur in girls that are younger than 15. The encouraging news is that the estimated global adolescent-specific fertility has declined by 11.6% over the last 20 years. However, huge differences between regional rates persist. For example, the adolescent fertility rate in East Asia is 7.1, while the adolescent fertility rate in Central Africa is 129.5. Not only are there differences between regions but also a wide variation within those regions. For example, in 2018, the overall adolescent fertility rate in South-East Asia was 33. However, the rates in that region varied from 0.3 from the Democratic People’s Republic of Korea to 83 in Bangladesh. To delve in even deeper, there are notable differences happening within countries. To take one example, in Ethiopia, the total fertility rate ranges from 1.8 in Addis Ababa to 7.2 in the Somali region. Specifically, the percentage of women aged 15-19 who have started childbearing range from only 3% in Addis Ababa to a worrying 23% in the Affar region. Also, the article notes an important fact, “While the estimated global adolescent fertility rate has declined, the actual number of child births to adolescents has not, due to the large- and in some parts of the world, growing- population of young women in the 15-19 age group. The largest number of births occur in Eastern Asia (95, 153) and Western Africa (70,423).” (Source: WHO)

Although these numbers may make it seem that adolescent pregnancies may only affect developing countries, the article emphasizes the fact that early pregnancies are a global problem that impact people living in high-, middle- and low-income countries. With that being said, marginalized communities are more likely to have high rates of adolescent pregnancies globally, due to the numbers being exacerbated by poverty and lack of education and employment. However, there is no one reason that leads to adolescent pregnancies. There are several factors that lead to high rates of early pregnancies and births. For example, in many societies, girls are forced by cultural pressures to marry and have children at a young age. In the least developed countries, at least 39% of girls marry before their 18th birthday and 12% marry before the age of 15. In more than a few cases, girls choose to become pregnant and give birth at a young age due to a lack of education and employment opportunities. In such societies, girls are led to believe that their value lies in motherhood and rearing children. Due to limited options, girls often find that becoming mothers is their only way of gaining value in society. Adolescents who do not want to go down this route and would not want to become pregnant may not be able to avoid pregnancies due to a lack of knowledge and many misconceptions on where to access contraceptive methods and how to use them. Often, adolescents face challenges to accessing contraception, including a number of restrictive laws that ban the use or the purchase of contraceptives based on age or marital status, bias coming from the health worker or simply a lack of willingness to acknowledge adolescents’ sexual health. Many adolescents also have a hard time obtaining contraceptives due to knowledge, transportation or financial barriers. If adolescents go through all that and succeed in accessing contraceptives, many still lack the agency to ensure the correct, consistent use of a contraceptive method. Because of that, 10 million unintended pregnancies occur annually among girls aged 15-19 in developing regions. One disturbing reason for unintended pregnancies is sexual violence, which is more widespread than many think, with more than a third of girls reporting that their first sexual encounter was coerced in some countries. (Source: UN)

Due to so many factors being in play, the report by the UN does not stop at stating that funding is important to stop teenage pregnancies but goes on to urge countries to adopt a holistic approach that seeks to change cultural attitudes in a society that encourages girls to stay in school, ban child marriage, support young mothers and provide access to sexual and reproductive healthcare. “We must reflect on and urge changes to the policies and norms of families, communities, and governments that often leave a girl with no other choice but a path to early pregnancy,” said Mr. Osotimehin, “This is what we are doing at UNFPA and what we will continue to do and recommend until every girl is able to choose the direction of her life, own her future and achieve her greatest potential.” Shifting people’s long-held assumptions about the role girls and women should play in society will undoubtedly result in changes in how girls are treated by communities and governments, paving the way to increasing girls’ education and participation in the workplace and decreasing early pregnancy rates. (Source: UN)

Instating changes is paramount, for girls continue to face the dangerous health and socioeconomic consequences of adolescent pregnancies. A sobering fact is that pregnancy and childbirth complications are the leading cause of death globally among girls that are aged 15-19. 99% of global maternal deaths for mothers aged 15-49 occur in low- and middle-income countries. Therefore, if you’re a girl living in a low-income country not only are you more likely to get pregnant due to factors outside your control but also more likely to die as a result of that pregnancy. Childbirth is also riskier for girls who are aged 10-19 than for ones aged 20-24, with reports showing a higher risk of eclampsia, puerperal endometritis and systemic infections. Another health risk are unsafe abortions, with reports showing some 3.9 million unsafe abortions among girls aged 15-19 that occur annually. It is important to note that health risks not only affect the mother but the newborn as well. Numbers show that babies born to mothers under the age of 20 face higher risks of low birth weight, preterm delivery and severe neonatal diseases. Pregnant adolescents also have to deal with social and economic consequences, which may include stigma, rejection by the family and domestic violence. Numbers show that pregnant girls under the age of 18 are more likely to experience violence within a marriage or partnership. Early pregnancies are likely to cause the girl to drop out of school, which negatively impacts girls’ education and their employment outlook. (Source: UN)

The WHO article provides solutions by looking at past efforts and the current efforts spearheaded by the organization. Unfortunately, the international community did not pay attention to the seriousness of the issue until recently. “During the early part of the Millennium Development Goals (MDGS) era,” read the article, “prevention of adolescent pregnancy and related mortality and morbidity and prevention of HIV and HIV related mortality in adolescents and young people were not given sufficient attention due to competing priorities.” In other words, countries in the UN did not see early pregnancies as posing much of a problem, and that made the suffering of millions of girls simply not a priority. The WHO states that during the creation of the MDGs, the organization had worked with partners to advocate and bring attention to adolescents’ suffering. The interventions recommended by WHO included the “WHO’s Guidelines for preventing early pregnancy and poor reproductive outcomes in adolescents in developing countries,” developing and testing program support tools, building capacity, and piloting initiatives in the small but growing number of countries that recognize the need to address adolescent health. As the world has moved past the MDGs and into the Sustainable Development Goals era, adolescents have moved into the spotlight of global health and the sustainable development agenda.

Organizations like WHO continue their advocacy work, with much of the focus now being on country-level action. Partnerships between international organizations are increasing with a focus on contributing to global efforts to end child marriage and increasing adolescents’ access to contraceptives. An example of such efforts can be found in the Family Planning 2020 mission, a global partnership which will enable 120 million more women and girls access to contraceptives. Nongovernmental organizations are also ramping up their efforts by sponsoring innovative and sustainable projects. As a result, there is a growing number of successful government-led national programs in Chile, Ethiopia and the United Kingdom (Source: WHO). Such examples should serve as both an inspiration to make a substantive, positive change for the lives of millions of girls and as a reminder that such changes are not far-fetched but are doable with enough work and funding. For years, the challenges that adolescent girls faced daily went largely unnoticed as many countries found other areas more worthwhile to focus on. However, now that we are aware of the dangers that adolescent girls go through in their communities and how impactful these struggles are in the long-term, we must take action. Here, at World Forgotten Children Foundation, we aim to empower such young voices through partnering with promising sustainable projects with the hope that our contribution will positively impact the lives of many. With the help of our donors and volunteers, we can continue to change the lives of many children, and we can give them hope for a better future. Donate to WFCF today and help us forward our mission of aiding children in need around the world.

Sources:

United Nations. (n.d.). 'motherhood in childhood,' new UN report, spotlights adolescent pregnancy | | UN news. United Nations. Retrieved June 18, 2022, fromhttps://news.un.org/en/story/2013/10/454182-motherhood-childhood-new-un-report-spotlights-adolescent-pregnancy

World Health Organization. (n.d.). Adolescent pregnancy. World Health Organization. Retrieved June 18, 2022, from https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy