Motherhood in Childhood

ESTIMATING ADOLESCENT PREGNANCY AND BIRTH RATES
Precise data on adolescent pregnancies are scarce. Vital registration
systems collect information on births, not pregnancies.
Unlike births, pregnancies are generally not reported and
aggregated upward to national statistical institutions. Some
pregnancies fail very early, before a woman or girl is aware she
is pregnant. Pregnancies may go undocumented in developing
countries because adolescents often do not—or cannot—access
antenatal care and thus do not come to the attention of health
care providers. Pregnancies that end in miscarriage or abortion
(often performed illegally and clandestinely) are also absent
from most national databases.
Most countries, therefore, rely on information about births,
as a proxy for data on the prevalence of adolescent pregnancy.
Estimates of birth rates are invariably lower than pregnancy
rates. For example, according to a 2008 study, the pregnancy
rate among adolescents age 15 to age 19 in the United States
was 68/1,000 while the birth rate was 40/1,000 (Kost and
Henshaw, 2013). Pregnancy rates include miscarriages, abortions,
stillbirths, and pregnancies carried to term, while the birth
rate includes only live births.
The proxy data that demographers rely on is gathered in two ways:
• Through a retrospective approach, which asks women
between the ages of 20 and 24 if they had had a child
at an earlier age, usually before age 18. Data used in the
retrospective approach and cited in this report come from
demographic and health surveys, or DHS, and multiple indicator
cluster surveys, or MICS, which have been carried out
in 81 developing countries.
• By calculating the adolescent birth rate:
Adolescent
Birth Rate
=
Total number of live births
among girls between the
ages of 15 and 19
DIVIDED BY
x 1,000
Total number of adolescents between
the ages of 15 and 19
The retrospective approach yields insights into births to
girls before the age of 18, but can also provide insights into
births to girls younger than 15. The adolescent birth rate,
however, includes only live births to girls between the ages
of 15 and 19.
sphere of a pregnant girl. But just as important—and
just as limited—are data and
insights about the men and boys who father the
children of adolescent girls.
Adolescent pregnancies are not the sole
concern of developing countries. Hundreds
of thousands of them are reported each year
in high- and middle-income countries, too.
But some of the patterns found in developing
countries are also relevant in developed ones:
girls who live in low-income households, are
rural, have less education or have dropped out
of school, or who are ethnic minorities, immigrants,
or marginalized sub-populations are
more likely to become pregnant. In developing
countries, most adolescent pregnancies occur
within marriages, while in developed countries,
they increasingly occur outside of marriage.
THE STATE OF WORLD POPULATION 2013
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