important facts
- As of 2019, adolescents aged 15 to 19 in low- and middle-income countries (LMICs) had an estimated 21 million pregnancies each year, approximately 50% of which were unintended, resulting in an estimated 12 million live births. is bringing about. (1,2).
- According to 2019 data, 55% of unintended pregnancies among adolescent girls aged 15 to 19 end in abortion, which is often unsafe in LMICs. (1).
- Adolescent mothers (10 to 19 years) are at higher risk of eclampsia, puerperal endometritis, and systemic infections than women 20 to 24 years of age, and babies of adolescent mothers have lower birth weight and are born prematurely. , increased risk of severe neonatal conditions.
- Data on childbirth among girls aged 10 to 14 years are becoming more widely available. Globally, the adolescent birth rate for girls aged 10 to 14 in 2023 is estimated at 1.5 births per 1,000 women, with 4.4 births per 1,000 women in sub-Saharan Africa (4.4 births) and Latin America and the Caribbean. The rate is higher in the region (2.3 people). (3).
- Preventing pregnancy and pregnancy-related mortality and morbidity in adolescents is fundamental to achieving positive health outcomes across the life course and is part of the Sustainable Development Goals for Maternal and Newborn Health ( is essential to achieving the SDGs).
overview
Adolescent pregnancy is a global phenomenon with clear causes and serious health, social, and economic consequences. Adolescent birth rates (ABR) are declining globally, but the rate of change varies by region. There are also large differences in levels between and within countries. Adolescent pregnancy rates tend to be higher among those with lower education and economic status. Moreover, the decline in first births among adolescents has been slower among these and other vulnerable groups, leading to increased inequalities. Child marriage and child sexual abuse put girls at increased risk of unintended pregnancy. In many places, barriers to contraceptive access and use prevent adolescents from avoiding unwanted pregnancies. There is increasing focus on improving access to quality maternal care for pregnant and parenting adolescents. WHO is working with partners to call attention to adolescent pregnancy, build an evidence base for action, develop policy and program support tools, and build capacity to help countries address adolescent pregnancy. We help you deal with it effectively.
scope of problem
Every year, an estimated 21 million girls aged 15 to 19 become pregnant in developing regions, and approximately 12 million of them give birth. (1).
Globally, the ABR has decreased from 64.5 births per 1,000 women (ages 15-19) in 2000 to 41.3 births per 1,000 women in 2023. However, the rate of change has been uneven across world regions, with South Asia experiencing the sharpest decline (SA) and slower declines in Latin America and the Caribbean (LAC) and Sub-Saharan Africa (SSA). is. Although all regions experienced declines, SSA and LAC continued to have the highest fertility rates in the world, with 97.9 and 51.4 births per 1,000 women, respectively, in 2023 (3).
There are also large regional differences in ABR. The estimated ABR for the WHO Africa Region was 97 per 1000 adolescents and girls in 2023 compared to 13.1 per 1000 adolescents and girls for the European Region. (3). There is wide variation within countries; for example, in Zambia, the proportion of adolescent girls aged 15 to 19 who have started childbearing (women who have given birth or are pregnant at the time of the interview) ranges from 14.9% in Lusaka to 14.9% in Lusaka. and 14.9% in Lusaka, ranging from 14.9% to 19% in Lusaka. 42.5% in Southern Province in 2018 (Four). In the Philippines, this proportion ranged from 3.5% in the Cordillera Administrative Region to 17.9% in the Davao Peninsula region in 2017. (Five).
Although the estimated global ABR is decreasing, the actual number of births among adolescents remains high. SSA had the highest estimated number of births for 15-19 year olds in 2021 (6,114,000), while Central Asia (68,000) had far fewer births. The equivalent number was 332,000 for adolescents aged 10-14 in SSA, compared to 22,000 in South East Asia (SEA) in the same year. (3).
Background of adolescent pregnancy
Studies of risk and protective factors associated with adolescent pregnancy in LMICs show that levels tend to be higher in those with lower educational attainment and lower economic status. (6). Efforts to reduce first birth among adolescents have been particularly slow among these vulnerable groups, leading to increased inequalities.
Several factors are involved in adolescent pregnancy and childbirth. First, in many societies, girls are under pressure to get married and have children. As of 2021, the number of child brides worldwide is estimated at 650 million. Child marriage puts girls at increased risk of pregnancy. This is because girls who marry very early usually have limited autonomy to influence decisions to postpone childbearing or use contraception. Second, in many places, girls choose to become pregnant because their prospects for education and employment are limited and motherhood is valued.
In many places, contraceptives are not easily available to adolescents. Even if adolescents have access to contraceptives, they may lack the institutions and resources to pay for them, as well as knowledge about where to get them and how to use them correctly. You may face stigma when trying to obtain contraceptives. Additionally, side effects, changes in lifestyle, or reproductive intentions often increase the risk of discontinuation.. Restrictive laws and policies regarding contraceptive access based on age and marital status pose important barriers to contraceptive access and uptake among adolescents. This is often combined with healthcare professionals' biases and lack of willingness to recognize adolescents' sexual health needs.
Child sexual abuse increases the risk of unwanted pregnancy. A WHO report released in 2021 estimates that 120 million girls under the age of 20 have been sexually assaulted by someone other than their partner. This abuse is deeply rooted in gender inequality. It affects more girls than boys, but many boys are also affected. According to estimates, in 2020, at least one in eight of the world's children will have been sexually abused before they reach the age of 18, and in their 20s of girls between the ages of 15 and 19. One in every person has experienced forced sexual intercourse in their lifetime.
WHO report “Estimated prevalence of violence against women in 2018” “Adolescents aged 15–19 years (24%) are estimated to have already experienced physical and/or sexual violence by an intimate partner at least once in their lifetime; 16% of girls and young women have experienced this violence in the past 12 months.
Adolescent pregnancy and childbirth and child marriage prevention are on the SDG agenda with dedicated indicators, including indicator 3.7.2 “Adolescent birth rate per 1,000 women of their age group (10–14 years, 15–19 years)” is part of. ” and 5.3.1 “Percentage of women aged 20-24 who were married before the age of 18”.
Strategies and interventions related to adolescent pregnancy have focused on pregnancy prevention. However, increasing attention is focused on improving access to and quality of maternal care for pregnant and parenting adolescents. Available data on access paint a mixed picture. Access to quality care depends on geography and the social status of adolescents. Even when access is not restricted, adolescents appear to receive lower quality clinical care and interpersonal support than adult women.
WHO response
WHO is working with partners to call attention to youth, build the evidence and epidemiological base for action, develop and test program support tools, build capacity and the need to address youth sexual problems. The initiative is being piloted in a small but growing number of countries that recognize this. and reproductive health. As a result of these joint efforts, adolescent health has moved to the center of the global health and development agenda. In this evolving context, WHO is working to support countries to effectively address adolescent pregnancy, prevent child marriage, and provide care and support to married young people in line with their national plans. We continue to work beyond that.
Adolescent pregnancy is a global phenomenon with clear causes and significant health, social, and economic consequences for individuals, families, and communities. There is consensus on the evidence-based actions needed to prevent it. Efforts to prevent child marriage and adolescent pregnancy and childbirth are increasing globally, regionally and nationally. Nongovernmental organizations have led this effort in several countries. In an increasing number of countries, governments are taking the initiative to introduce large-scale programs. They challenge and inspire other countries to do what is doable and urgently needed to be done now.
References
- Sully EA, Biddlecom A, Daroch J, Riley T, Ashford L, Lince-Deroche N, et al. Total: Investing in sexual and reproductive health 2019. New York: Guttmacher Institute. 2020.
- Darroch J, Woog V, Bankole A, Ashford LS. Total: Costs and benefits of meeting adolescent contraceptive needs. New York: Guttmacher Institute. 2016.
- United Nations, Ministry of Economic and Social Affairs, Population Division. Fertility of young people aged 10 to 14 years. New York: UNDESA, P.D., 2020.
- United Nations Department of Economic and Social Affairs.World Population Prospects, 2019 revised edition: Age-specific fertility rates by region, subregion and country, 1950-2100 (births per 1,000 women) estimates. online version [cited 2021 Dec 10]. Available from: https://population.un.org/wpp/Download/Standard/Fertility/
- Zambia Statistics Authority, Zambia Ministry of Health (MOH), and ICF. 2018 Zambia Demographic and Health Survey. Lusaka, Zambia and Rockville, Maryland, USA: Zambia Bureau of Statistics, Ministry. 2018.
- Philippine Statistics Authority (PSA) and ICF. 2017 Philippine National Demographic and Health Survey. Quezon City, Philippines, and Rockville, Maryland, USA: PSA and CF. 2018.
- Chung, WH, Kim, ME., Lee, J. A comprehensive understanding of risks and protective factors associated with adolescent pregnancy in low- and middle-income countries: A systematic review. Journal of Adolescence. 2018; 69:180-188.