TEENAGE PREGNANCY

Many teenage girls between 15 and 19 get pregnant

About 16 million women 15–19 years old give birth each year, about 11% of all births worldwide.

Ninety-five per cent of these births occur in low- and middle-income countries. The average adolescent birth rate in middleincome countries is more than twice as high as that in high-income countries, with the rate in low-income countries being five times as high.

The proportion of births that take place during adolescence is about 2% in China, 18% in Latin America and the Caribbean and more than 50% in sub-Saharan Africa.

Half of all adolescent births occur in just seven countries: Bangladesh, Brazil, the Democratic Republic of the Congo, Ethiopia, India, Nigeria and the United States.

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Pregnancy among very young teenagers is a significant problem

In low- and middle-income countries, almost 10% of girls become mothers by age 16 years, with the highest rates in sub-Saharan Africa and south-central and south-eastern Asia.

The proportion of women who become pregnant before age 15 years varies enormously even within regions – in sub-Saharan Africa, for example, the rate in Rwanda is 0.3% versus 12.2% in Mozambique.

The contexts of teenage pregnancies are not always the same

Having a child outside marriage is not uncommon in many countries. Latin America, the Caribbean, parts of sub- Saharan Africa and high-income countries have higher rates of adolescent pregnancy outside marriage than does Asia.

Births to unmarried adolescent mothers are far more likely to be unintended and are more likely to end in induced abortion.

Coerced sex, reported by 10% of girls who first had sex before age 15 years, contributes to unwanted adolescent pregnancies.

Teenage pregnancy is dangerous for the mother

Although adolescents aged 10-19 years account for 11% of all births worldwide, they account for 23% of the overall burden of disease (disability- adjusted life years) due to pregnancy and childbirth.

Fourteen percent of all unsafe abortions in low- and middle-income countries are among women aged 15–19 years. About 2.5 million adolescents have unsafe abortions every year, and adolescents are more seriously affected by complications than are older women.

In Latin America, the risk of maternal death is four times higher among adolescents younger than 16 years than among women in their twenties.

Many health problems are particularly associated with negative outcomes of pregnancy during adolescence. These include anaemia, malaria, HIV and other sexually transmitted infections, postpartum haemorrhage and mental disorders, such as depression.

Up to 65% of women with obstetric fistula develop this as adolescents, with dire consequences for their lives, physically and socially.

Teenage pregnancy is dangerous for the child

Stillbirths and death in the first week of life are 50% higher among babies born to mothers younger than 20 years than among babies born to mothers 20–29 years old.

Deaths during the first month of life are 50–100% more frequent if the mother is an adolescent versus older, and the younger the mother, the higher the risk.

The rates of preterm birth, low birth weight and asphyxia are higher among the children of adolescents, all of which increase the chance of death and of future health problems for the baby.

Pregnant adolescents are more likely to smoke and use alcohol than are older women, which can cause many problems for the child and after birth.

Teenage pregnancy adversely affects communities

Many girls who become pregnant have to leave school. This has long-term implications for them as individuals, their families and communities.

Studies have shown that delaying adolescent births could significantly lower population growth rates, potentially generating broad economic and social benefits, in addition to improving the health of adolescents.

Progress to date

Rates of adolescent childbearing have dropped significantly in most countries and regions in the past two to three decades.

Age at first marriage is increasing in many countries, as are rates of contraceptive use among both married and unmarried adolescents.

Educational levels for girls have risen in most countries, and job opportunities have expanded. Low education levels are closely associated with early childbearing.