Motherhood in Childhood

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One hundred seventy-nine governments agreed in 1994 at the International Conference on Population and Development (ICPD) on the need to “promote the rights of adolescents to reproductive health education, information and care and greatly reduce the number of adolescent pregnancies.” (ICPD Programme of Action, paragraph 7.46). Yet many of the actions—before and since 1994—to achieve the objectives of reducing the number of adolescent pregnancies have been narrowly focused, targeting girls as the problem and aiming to change their behaviour as the solution. Such actions generally fail to reduce adolescent pregnancies because they neglect the underlying economic, social, legal and other circumstances, structures, systems, norms and rights violations that drive adolescent pregnancy around the world. Another shortcoming of these approaches is their failure to take into account the role of men and boys in perpetuating and preventing adolescent pregnancy. An “ecological” approach to adolescent pregnancy is one that takes into account the full range of complex drivers of adolescent pregnancy and the interplay of these forces. It can help governments, policymakers and stakeholders understand the challenges, and craft more effective interventions that will not only reduce the number of pregnancies but will also take steps that can tear down the many barriers to girls’ empowerment so that pregnancy is no longer the likely outcome. One such ecological model sheds light on the constellation of forces that conspire against the adolescent girl and increase the likelihood that she will become pregnant (Blum and Johns Hopkins, 2013). While these forces are numerous and multi-layered, they are all in one way or another about a girl’s inability to enjoy or exercise rights and about the lack of power to shape her own future. Most of the determinants in this model operate at more than one level. For example, nationallevel policies may restrict adolescents’ access to sexual and reproductive health services, including family planning, while the community or family may oppose girls’ accessing comprehensive sexuality education or other information about how to prevent a pregnancy. This model shows that adolescent pregnancies do not occur in a vacuum but are the consequence of an interlocking set of factors such as widespread poverty, communities’ and families’ acceptance of child marriage, and inadequate efforts to keep girls in school. In technical guidance on applying rights-based approaches to reduce maternal mortality in 2012, the Office of the High Commissioner for Human Rights called on States to address the diverse, multidimensional drivers of adolescent pregnancy by eliminating “immediate and underlying causes.” (Human Rights Council, 2012). Gender norms that reinforce early pregnancy, child marriage, sexual violence and other such underlying causes cited by the Office of the High Commissioner for Human Rights also feature in this ecological model. National-level determinants National laws and policies, the level of government commitment to meeting obligations under human rights instruments and treaties, the extent of poverty or deprivation, and political stability can all influence whether a girl becomes pregnant. These determinants are beyond an adolescent’s—or any individual’s—control, 32 CHAPTER 3: PRESSURES FROM MANY DIRECTIONS
DETERMINANTS OF ADOLESCENT PREGNANCY: AN ECOLOGICAL MODEL • Laws limiting access to contraception • Unenforced laws against child marriage • Economic decline, poverty • Underinvestment in girls’ human capital • Political instability, humanitarian crises and disasters NATIONAL • Negative attitudes about girls’ autonomy • Negative attitudes about adolescent sexuality and access to contraception • Limited availability of youth-friendly services • Absence of antenatal and postnatal care for young mothers • Climate of sexual coercion and violence COMMUNITY SCHOOL/PEERS • Obstacles to girls’ attending or staying enrolled in school • Lack of information or no access to quality comprehensive sexuality education • Pressure from peers • Partners’ negative gender attitudes and risk-taking behaviours FAMILY INDIVIDUAL • Negative expectations for daughters • Little value on education, especially for girls • Favourable attitudes to child marriage • Age of puberty and sexual debut • Socialization of girls to pursue motherhood as only option in life • Internalized gender-inequitable values • Lack of recognition of evolving capacities THE STATE OF WORLD POPULATION 2013 33
Page 1 and 2: Motherhood in Childhood Facing the
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Page 5 and 6: to health. Conversely, a girl who i
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5 Charting the way forward Adolesce
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overlooked by policymakers and deve
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and providing a safe environment fo
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©Mark Tuschman/Packard Foundation
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great risk of injury, illness and m
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• Registering all births and marr
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not address social norms risk treat
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Towards empowered adolescent girls
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Indicators Monitoring ICPD goals: s
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Monitoring Monitoring ICPD ICPD Goa
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Monitoring ICPD Goals Demographic -
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Monitoring ICPD Goals - Selected In
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Bibliography Abdella A. et al. 2013
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Delivering a world where every preg
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