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Adolescent pregnancy
Key facts
Approximately 12 million girls aged 15–19 years and at least 777,000 girls under 15 years give birth each year in developing regions. (1) (2)
At least 10 million unintended pregnancies occur each year among adolescent girls aged 15–19 years in the developing world. (1)
Complications during pregnancy and childbirth are the leading cause of death for 15–19-year-old girls globally. (3)
Of the estimated 5.6 million abortions that occur each year among adolescent girls aged 15–19 years, 3.9 million are unsafe, contributing to maternal mortality, morbidity and lasting health problems.(1)
Adolescent mothers (ages 10–19 years) face higher risks of eclampsia, puerperal endometritis, and systemic infections than women aged 20 to 24 years, and babies of adolescent mothers face higher risks of low birth weight, preterm delivery and severe neonatal conditions. (4)
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Every year, an estimated 21 million girls aged 15–19 years in developing regions become pregnant and approximately 12 million of them give birth. 1 At least 777,000 births occur to adolescent girls younger than 15 years in developing
countries.
2
The estimated global adolescent-specific fertility rate has declined by 11.6% over the past 20 years. 5 There are, however, big differences in rates across the regions. The adolescent fertility rate in East Asia, for example, is 7.1 whereas
the corresponding rate in Central Africa is 129.5. 5
There are also enormous variations within regions. In 2018, the overall adolescent fertility rate in South-East Asia was 33. 6 Rates, however, ranged from 0.3 in Democratic People’s Republic of Korea to 83 in Bangladesh. 5
And even within countries there are enormous variations. In Ethiopia, for example the total fertility rate ranges from 1.8 in Addis Ababa to 7.2 in the Somali region with the percentage of women aged 15-19 who have begun childbearing ranging from
3% in Addis Ababa to 23% in the Affar region. 7
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. 8 The largest number of births occur in Eastern Asia (95,153) and Western Africa (70,423). 9
Adolescent pregnancies are a global problem occurring in high-, middle-, and low-income countries. Around the world, however, adolescent pregnancies are more likely to occur in marginalized communities, commonly driven by poverty and lack of education
and employment opportunities. 10
Several factors contribute to adolescent pregnancies and births. In many societies, girls are under pressure to marry and bear children early. 11,12,13 In least developed countries, at least 39% of girls marry before they are 18 years
of age and 12% before the age of 15. 14 In many places girls choose to become pregnant because they have limited educational and employment prospects. Often, in such societies, motherhood is valued and marriage or union and childbearing
may be the best of the limited options available. 12
Adolescents who may want to avoid pregnancies may not be able to do so due to knowledge gaps and misconceptions on where to obtain contraceptive methods and how to use them. 15 Adolescents face barriers to accessing contraception including
restrictive laws and policies regarding provision of contraceptive based on age or marital status, health worker bias and/or lack of willingness to acknowledge adolescents’ sexual health needs, and adolescents’ own inability to access
contraceptives because of knowledge, transportation, and financial constraints. Additionally, adolescents may lack the agency or autonomy to ensure the correct and consistent use of a contraceptive method. At least 10 million unintended
pregnancies occur each year among adolescent girls aged 15-19 years in developing regions. 1
An additional cause of unintended pregnancy is sexual violence, which is widespread with more than a third of girls in some countries reporting that their first sexual encounter was coerced. 16
Early pregnancies among adolescents have major health consequences for adolescent mothers and their babies. Pregnancy and childbirth complications are the leading cause of death among girls aged 15–19 years globally, with low- and middle-income
countries accounting for 99% of global maternal deaths of women aged 15–49 years. 3 Adolescent mothers aged 10–19 years face higher risks of eclampsia, puerperal endometritis and systemic infections than women aged 20–24
years.
4 Additionally, some 3.9 million unsafe abortions among girls aged 15–19 years occur each year, contributing to maternal mortality, morbidity and lasting health problems. 1
Early childbearing can increase risks for newborns as well as young mothers. Babies born to mothers under 20 years of age face higher risks of low birth weight, preterm delivery and severe neonatal conditions. 4 In some settings, rapid repeat
pregnancy is a concern for young mothers, as it presents further health risks for both the mother and the child. 17
Social consequences for unmarried pregnant adolescents may include stigma, rejection or violence by partners, parents and peers. Girls who become pregnant before the age of 18 years are more likely to experience violence within a marriage or partnership. 16 Adolescent
pregnancy and childbearing often leads girls to drop out of school, although efforts are underway is some place to enable them to return to school after child birth, this may well jeopardize girls’ future education and employment opportunities. 19
During the early part of the Millennium Development Goals era, 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. 20 During this period, WHO worked with partners to advocate for attention to adolescents, to build the evidence and epidemiologic base for action such as “WHO’s Guidelines for preventing
early pregnancy and poor reproductive outcomes in adolescents in developing countries", 21 to develop and test programme support tools, to build capacity, and to pilot initiatives in the small but growing number of countries that recognised
the need to address adolescent health. As the world has transitioned to the Sustainable Development Goals era, adolescents have moved to the centre of the global health and development agenda. 21
While WHO continues its work on advocacy, evidence generation, tool development and capacity building, the focus has shifted to strengthening country-level action. WHO works closely with partners within and outside the United Nations system to contribute
to the global effort to prevent children becoming wives and mothers. WHO works to strengthen the evidence base for action, and to support the application of the evidence through well-designed and well-executed national and subnational programmes.
For example, WHO works closely with the UNICEF, UNFPA and UNWomen on a global programme to accelerate action to end child marriage. 22 It also collaborates with Family Planning 2020 ─ a global partnership working to enable 120 million
more women and girls access contraceptives by 2020.
Nongovernmental organizations have been at forefront of efforts to prevent adolescent pregnancy in many countries through bold and innovative projects. There is now a small but growing number of successful government-led national programmes e.g. in
Chile, Ethiopia and the United Kingdom. 23 These countries show what can been achieved with the application of good science combined with strong leadership, management, and perseverance. They challenge and inspire other countries to
do what is doable and what urgently needs to be done – now.
(1) Darroch J, Woog V, Bankole A, Ashford LS. Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents. New York: Guttmacher Institute; 2016.
(2) UNFPA. Girlhood, not motherhood: Preventing adolescent pregnancy. New York: UNFPA; 2015.
(3) Neal S, Matthews Z, Frost M, et al. Childbearing in adolescents aged 12–15 years in low resource countries: a neglected issue. New estimates from demographic and household surveys in 42 countries. Acta Obstet Gynecol Scand 2012;91: 1114–18. Every Woman Every Child. The Global Strategy for Women`s, Children`s and Adolescents` Health (2016-2030). Geneva: Every Woman Every Child, 2015.
(4) WHO. Global health estimates 2015: deaths by cause, age, sex, by country and by region, 2000–2015. Geneva: WHO; 2016.
(5) Ganchimeg T, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. Bjog. 2014;121(S Suppl 1):40-8.
(6) UN DESA, Population Division. World Population Prospects: The 2017 Revision, DVD Edition. New York: UN DESA; 2017.UNDESA, Population Division. World Population Prospects, the 2015 Revision (DVD edition). New York: UNDESA, Population Division, 2015.
(7) UNFPA. Adolescent pregnancy: A review of the evidence. New York: UNFPA, 2013.
(8) UN DESA, Statistics Division. SDG Indicators: Global Database. New York: UN DESA: 2017.
(9) Every Woman Every Child. The Global Strategy for Women`s, Children`s and Adolescents` Health (2016-2030). Geneva: Every Woman Every Child; 2015.
(10) UNICEF. Ending child marriage: Progress and prospects. New York: UNICEF, 2013
(11) WHO. Global and regional estimates on violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO; 2013.
(12) WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Trends in maternal mortality: 1990 to 2015: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: WHO; 2015. Filippi V, Chou D, Ronsmans C, et al. Levels and Causes of Maternal Mortality and Morbidity. In: Black RE, Laxminarayan R, Temmerman M, et al., editors. Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2). Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016 Apr 5. Chapter 3.
(13) Kozuki N, Lee A, Silveira M, et al. The associations of birth intervals with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis. BMC Public Health 2013;13(Suppl. 3):S3.
(14) World Bank. Economic impacts of child marriage: Global synthesis report. Washington, DC: World Bank; 2017.
(15) WHO. Preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. Geneva: WHO; 2011.
(16) Raj A, Boehmer U. Girl child marriage and its association with national rates of HIV, maternal health, and infant mortality across 97 countries. Violence Against Women 2013;19(4).
(17) WHO. Making health services adolescent friendly: Developing national quality standards for adolescent friendly health services. Geneva: WHO; 2012.
(18) WHO. Global Accelerated Action for the Health of Adolescents (AA-HA!): Guidance to support country implementation. Geneva: WHO; 2017.
(19) WHO. Global standards for quality health care services for adolescents. Geneva: WHO; 2015.
(20) WHO. Core competencies in adolescent health and development for primary care providers: including a tool to assess the adolescent health and development component in pre-service education of health-care providers. Geneva: WHO; 2015.
(21) UNESCO. International Technical Guidance on Sexuality Education: An evidence-informed approach for schools, teachers and health educators. Paris: UNESCO; 2009.
(22) UNESCO. Early and Unintended Pregnancy & the Education Sector: Evidence Review and Recommendations. Paris: UNESCO; 2017.
(23) United Nations General Assembly. Resolution adopted by the General Assembly on 25 September 2015: Transforming our world: the 2030 Agenda for Sustainable Development. New York: United Nations; 2015.
ToR_Reducing gaps for quality PPFP services_Nepal
From Wikipedia, the free encyclopedia
^ Girls in India could customarily be married after reaching puberty.
^ Thai law allows for the marriage of minors arranged by their parents.
^ Rosa had been dubbed "the other Rosita" by the press in reference to the famous Rosa V. Reyes Fletes, another young Nicaraguan girl, born in late August 1993, who lived with her family in Costa Rica. In early 2003, she aborted her pregnancy at age 9 + 1 ⁄ 2 ; it was done illegally, as her country prohibited abortion. Her case was later the subject of a documentary by American filmmakers Barbara Attie and Jane Goldwater.
^ Jump up to: a b c "Little Mother" . Time . 16 December 1957 . Retrieved 1 January 2020 .
^ "El increíble caso de Lina Medina: Madre a los 5 años" [The incredible case of Lina Medina: Mother at age 5]. Los archivos de la Tierra (in Spanish). 4 June 2009. Archived from the original on 19 July 2011 . Retrieved 8 July 2012 .
^ Bogart, Rachel (20 June 2007). "The Story of Lina Medina, the World's Youngest Mother" . Yahoo Voices. Archived from the original on 28 July 2014.
^ Jump up to: a b Mikkelson, Barbara; Mikkelson, David P., eds. (July 21, 2004). "Youngest Mother" . Snopes.com . Retrieved 16 January 2009 .
^ "Six decades later, world's youngest mother awaits aid" . The Telegraph: Calcutta . 27 August 2002 . Retrieved 30 June 2011 .
^ Keane, Hilda L. (1933). "A Case of Maternity at Seven Years of Age" . British Medical Journal . 2 (3794): 567–569. doi : 10.1136/bmj.2.3794.567 . S2CID 220170101 . Retrieved 9 December 2011 .
^ Tkachuk, Tapac (2 April 2004). Самая молодая мама в истории человечества 6-летняя Лиза из Харькова, забеременела... от собственного деда-моряка [The youngest mother in history is 6-year-old Lisa from Kharkov, who's pregnant ... by her grandfather, a sailor]. Fakty i Kommentarii (in Russian) . Retrieved 16 November 2011 .
^ Medvei, V.C. (1993) The History of Clinical Endocrinology: A Comprehensive Account of Endocrinology from Earliest Times to the Present Day , CRC Press, New York, 576 pages.
^ Schmidt (1760). "Lettre écrite à Monsr. J. J. d'Annoni" [Letter written to Mr. J. J. d'Annoi]. Acta Helvetica (in French). 4 : 167–168 . Retrieved 11 December 2011 .
^ Jump up to: a b "Family Records" . Nealirc.org . Retrieved 13 August 2010 . [ self-published source ]
^ Jump up to: a b Lyall, Archibald (1936). The Future of Taboo in These Islands . K. Paul, Trench, Trubner. p. 114. ASIN B0006DAYAW .
^ Charles Zastrow; Karen K. Kirst-Ashman (10 February 2012). Brooks/Cole Empowerment Series: Understanding Human Behavior and the Social Environment . Cengage Learning. p. 281. ISBN 978-1-133-70889-6 .
^ Janet Shibley Hyde (January 1986). Understanding Human Sexuality . McGraw-Hill. ISBN 978-0-07-031581-5 .
^ Robert LeRoy Ripley (1957). Ripley's Believe it Or Not: Wonder Book of Strange Facts . Universal Guild.
^ Vaughn, Kathleen (1933). "Pregnancy in Childhood" . British Medical Journal . 2 (3798): 759. doi : 10.1136/bmj.2.3798.759-a . PMC 2369490 . Retrieved 12 December 2012 .
^ Restrepo, Alonso; Perez R., Hernal; Uribe Piedrahita, Cesar; Urueta F., Carlos Adolfo; Uribe Jaramillo, Eugenio; Grau, Luis Carlos (1 June 1937). "Maternidad precoz" [Precocious maternity]. Boletín Clínico [Clinical Bulletin] (in Spanish). 3 (9): 479–499 . Retrieved 28 December 2011 .
^ "8 years 7 months 28 days mother" . La Nación . 5 January 1958 . Retrieved 13 May 2012 .
^ "Bambina, violentata dallo zio, partorisce a 8 anni" [Girl, raped by her uncle, gives birth at 8-year]. Corriere della Sera (in Italian). 15 January 1993 . Retrieved 12 May 2012 .
^ "8-Year-Old Gives Birth in Mexico" . Deseret News . 15 January 1993 . Retrieved 16 November 2011 .
^ "Estupor por embarazo a los 8 años" [Astonished at being pregnant at age 8]. El Tiempo [The Time(s)] (in Spanish). 8 September 2004 . Retrieved 12 May 2012 .
^ Williams, Dawson; Taylor, Charles Louis (1904). "Early Pregnancy" . The British Medical Journal . 2 : 52. doi : 10.1136/bmj.2.5243.52-a . Retrieved 17 November 2020 .
^ Dodd, Henry (1881). "Remarkable Case of Early Maternity" . American Medical Journal . 97 : 264 . Retrieved 10 December 2011 .
^ "Remarkable Case of Early Maternity" . The Canadian Journal of Medical Sciences . 6 : 151. 1881 . Retrieved 10 December 2011 .
^ Pittman, V. I. (1908). "Pregnancy at Nine Years of Age" . Memphis Medical Monthly . University of Michigan. 28 (6): 315 . Retrieved 11 December 2011 .
^ "Embaraza a su hija de 9 años, El padre abusó sexualmente de la menor, En tres semanas dará a luz" [Father impregnates his 9-year-old daughter, sexually abused the minor, will give birth in three weeks] (in Spanish). 2007-04-16.
^ "9-Year-Old Mother Has 2.5 lb Boy" . Pittsburgh Post-Gazette . 31 (5). 30 August 1957.
https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
https://en.wikipedia.org/wiki/List_of_youngest_birth_mothers
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