State of the World Population 2013 Launch: Facing the Challenge of Adolescent Pregnancy
Twenty thousand girls under the age of 18 give birth every day, and 90 percent of these births occur within the context of marriage, according to the UN Population Fund’s latest State of the World Population report. This year’s edition, launched at the Wilson Center on October 30, focuses on adolescent pregnancy and finding ways to better protect this vulnerable group of young women.
“Pregnancy harms the girl in many ways, but it can also harm her household, her community, her country, and even the economy,” said Dianne Stewart, director of information and external affairs at the UN Population Fund.
“Adolescent Pregnancy Equals Powerlessness”
“Adolescent pregnancies should not be seen only as a result of recklessness or a deliberate choice, but rather that of the absence of choices and of circumstances beyond a girl’s control,” said Stewart.
Robert Blum, chair of the Population, Family, and Reproductive Health Department at Johns Hopkins’ Bloomberg School of Public Health, agreed, urging scholars, practitioners, and policymakers to take a “broader lens than we have historically had” on the notion of adolescent pregnancy and agency.
For example, Fagbenle Oluwaseun Oyindamola, an African women’s leadership and advocacy fellow with Georgetown Law, explained how maternal mortality and early pregnancy rates are higher in the northern, rural parts of Nigeria, where girls have limited access to education and sexual and reproductive health services. “They do not know who to talk to, and the sad part of it is, they are not actually allowed to speak,” she said.
Panelists reported that even “youth-friendly” services often do not reach young girls, because girls are excluded once married or because they fear being stigmatized for being sexually active, both by other community members and service providers themselves.
Societal expectations can be very powerful. A popular Nepalese saying epitomizes the cultural norms that have to be overcome, said Blum: “Educating your daughter is like watering your neighbor’s garden.” Families do not invest in their daughters’ futures because they expect them to ultimately marry and leave.
“If one works on the assumption, ‘build it, and they will come,’ you’re wrong. They don’t come,” Blum said. “Youth-friendly health services have a number of barriers…that have a lot to do with the attitudes of adults.”
Actionable Steps With a Broader Lens
Heather Boonstra, senior public policy associate at the Guttmacher Institute, lauded this year’s State of the World Population report for “really challenging us…to think about this issue in a different way.”
Despite the societal barriers to reducing adolescent pregnancy, she pointed out there is clear demand for more information, services, and guidance from girls around the world, citing a study from the Guttmacher Institute on attitudes in sub-Sahara Africa.
“Policymakers really need to think about ways of promoting comprehensive sex [education],” said Boonstra. “These education programs will of course address biology and unplanned pregnancy and HIV, but it’s important that they also keep in mind what young people are interested in in terms of relationships and communication and love and negotiation.”
Blum advocated for programs that target societal norms rather than individual girls’ behavior. He cited aseven-year study from Stanford University showing the effects of a program in Kenya that provided free school uniforms to children in 6th, 7th, and 8th grades. School dropout rates fell by 18 percent, and with more girls in school adolescent pregnancy rates also fell by 17 percent.
For USAID’s part, Senior Policy Advisor Beverly Johnston said the Agency is working to develop a more holistic approach and addressing not just the problems but “expanding on the assets of youth.” The Global Health Bureau is currently waiting on an award for its YouthPower program, she said, which will focus on multi-sector approaches – including health, education, livelihoods, democracy, human rights, and governance – to empower young women and men in developing countries.
“Childhood Should Never Be Derailed by Motherhood”
According to the report, adolescent pregnancy rates in many developing countries are lower than they were in the 1980s, but population growth in some countries indicates that the total number of girls giving birth will likely rise. Presently, 7.3 million girls under the age of 18 give birth each year.
Reducing this number will require more comprehensive, coordinated efforts, said Johnston. “No government, donor, or organization can do it all…these issues are too complicated.”
But there is good reason for governments, NGOs, and the private sector to cooperate and make it a focus. Besides the humanitarian and moral motives for reducing adolescent pregnancy rates, Stewart noted that the opportunity cost of child mothers – in terms of foregone annual income over their lifetime – can equal almost 30 percent of GDP in a small economy like Uganda. “Girls and young women are often thought of as the forgotten drivers of development,” Boonstra said. “Investing in this area and in sexual and reproductive health is really essential to prosperity and opportunity, whether you’re talking about the young woman, or you’re talking about families and communities, or national governments worldwide.”
“UNFPA strives to uphold every girl’s right to grow up unhindered by gender inequality and discrimination, violence, child marriage, and pregnancy, so that they make a safe, healthy, and successful transition from adolescence into adulthood,” said Stewart. “We believe…that childhood should never be derailed by motherhood.”
Drafted by Laura Henson, edited by Schuyler Null.
Director of the Information and External Relations Division of the United Nations Population Fund
Leadership and Advocacy for Women in Africa Fellow, Georgetown University Law Center
Senior Policy Advisor, United States Agency for International Development