 Adolescent pregnancy is alarmingly common in many countries. Every year, adolescents* give birth to 15 million infants.1 These young girls face considerable health risks during pregnancy and childbirth. Girls aged 15-19 are twice as likely to die from childbirth as women in their twenties; those under age 15 are five times as likely to die.2 Because early childbearing is so frequent, and carries so many health risks, pregnancy-related complications are the main cause of death for 15–19 year old girls worldwide.3
* The World Health Organization defines adolescence as the period of life between ages 10 and 19.
Sexual Behaviour and Childbearing
Globally, most people become sexually active during adolescence. Rates are highest in sub-Saharan Africa, where more than half of girls aged 15–19 in seven countries are sexually experienced.4
Millions of adolescents are bearing children. In sub-Saharan Africa, more than half of women give birth before age 20. In Latin America and the Caribbean, this figure drops to one third.5
Why Is Adolescent Pregnancy So Common?
A lack of information and services: Adolescents often have poor information about reproduction and sexuality, and little access to family planning and reproductive health services.
In Sri Lanka, one-third of young adults age 16–24 did not know the duration of a normal pregnancy. Fewer than 5% had discussed reproductive health with their parents.3
Cultural values: In many developing countries, female status is equated with marriage and motherhood. Adolescents often marry early; more than 50 countries allow marriage at age 16 or below, and seven allow marriage as early as age 12. 6 Even the youngest brides face immediate pressure to prove that they are fertile.7
Health Risks
Reproductive health problems and deaths are more common among sexually active adolescents than among women in their 20’s and early 30’s.4 Physiologically and socially, adolescents are more vulnerable to:
Maternal death: Girls age 15–19 are up to twice as likely to die during pregnancy or delivery as women age 20–34.4
Infant and child mortality: Children born to adolescents are more likely to die during their first five years of life than those born to women age 20–29.9
Sexually transmitted diseases (STDs): Each year, 1 in 20 adolescents worldwide contracts an STD (including HIV/AIDS).3
At Kenyatta Hospital in Nairobi, one-quarter of girls age 15-19 seeking antenatal care had an STD (gonorrhoea, chlamydia or herpes).10
Violence/sexual abuse: Adolescent girls may lack the confidence and decision-making skills to refuse unwanted sex. Girls who are subject to sexual abuse and rape can suffer serious, life-long physical and emotional consequences.
In interviews with adolescents in Peru and Colombia, 60% said they had been sexually abused within the previous year.11
Unsafe abortion: Each year, girls age 15-19 undergo at least five million induced abortions.12 Because abortion is legally restricted in many countries, adolescents often resort to unsafe procedures by unskilled providers. Adolescent girls therefore suffer a significant – and disproportionate – share of death and disability from unsafe abortion.13
Social and Economic Problems
A young mother’s ability to meet her own needs and those of her children can be jeopardised by:
A lack of education. Young women are often expelled from school if they become pregnant, and few ever return.
In Kenya, 10,000 girls leave school each year due to pregnancy.12
A lack of income. It can be difficult for young mothers, especially those without education or market able skills, to support themselves and their families financially.
Giving Girls Other Opportunities
Age at marriage: Delaying marriage often delays first birth, and can also reduce the total number of children a woman has, since she will spend fewer years in childbearing.6
Education: Women who have some secondary schooling are less likely to give birth during adolescence.4 On average, women with seven or more years of education marry four years later and have 2.2 fewer children than those with no education.14
What Can Be Done
Long-term policies and programmes must address the underlying social, cultural and economic factors that contribute to adolescent sexual activity and childbearing. They must improve the status of women and girls and expand their opportunities by:
Encouraging family and community support for delayed marriage and childbearing.
Expanding girls’ access to higher quality education and training, and helping them build market able skills.
Increasing income-earning abilities, opportunities to earn income and access to other resources for adolescent girls and women.
More immediately, programmes must make it possible for all adolescents to take responsibility for, and protect, their sexual and reproductive health by*:
Removing legal, regulatory and cultural barriers to sexual and reproductive health information and services for adolescents.
Providing appropriate, accurate sexual and reproductive health education for young people, both in- and out-of-school.
Designing and providing sensitive and confidential reproductive health services that respond to young peoples’ particular needs; help them make informed decisions about sexuality and negotiate safer sex; and emphasise the prevention of unwanted pregnancy, unsafe abortion and STDs..
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