Motherhood in Childhood

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prepares girls for jobs and livelihoods, raises their self-esteem and their status in their households and communities, and gives them more say in decisions that affect their lives. Education also reduces the likelihood of child marriage and delays childbearing, leading eventually to healthier birth outcomes. Leaving school—because of pregnancy or any other reason—can jeopardize a girl’s future economic prospects and exclude her from other opportunities in life. Many forces conspiring against adolescent girls 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 that will also help tear down the many barriers to girls’ empowerment so that pregnancy is no longer the likely outcome. One such ecological model, developed by Robert Blum at the Johns Hopkins Bloomberg School of Public Health, sheds light on the constellation of forces that conspire against the adolescent girl and increase the likelihood that she will become pregnant. While these forces are numerous and multi-layered, they all, in one way or another, interfere with a girl’s ability to enjoy or exercise rights and empower her to shape her own future. The model accounts for forces at the national level—such as policies regarding adolescents’ access to contraception or lack of enforcement of laws banning child marriage— all the way to the level of the individual, such as a girl’s socialization and the way it shapes her beliefs about pregnancy. Most of the determinants in this model operate at more than one level. For example, national-level policies may restrict adolescents’ PRESSURES FROM MANY DIRECTIONS AND LEVELS 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. Pressures from all levels conspire against girls and lead to pregnancies, intended or otherwise. National laws may prevent a girl from accessing contraception. Community norms and attitudes may block her access to sexual and reproductive health services or condone violence against her if she manages to access services anyway. Family members may force her into marriage where she has little or no power to say “no” to having children. Schools may not offer sexuality education, so she must rely on information (often inaccurate) from peers about sexuality, pregnancy and contraception. Her partner may refuse to use a condom or may forbid her from using contraception of any sort. vi INDIVIDUAL FAMILY SCHOOL/PEERS COMMUNITY
access to sexual and reproductive health services, including contraception, 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. For most adolescents below age 18, and especially for those younger than 15, pregnancies are not the result of a deliberate choice. To the contrary, pregnancies are generally the result of an absence of choices and of circumstances beyond a girl’s control. Early pregnancies reflect powerlessness, poverty and pressures—from partners, peers, families and communities. And in too many instances, they are the result of sexual violence or coercion. Girls who have little autonomy—particularly those in forced marriages—have little say about whether or when they become pregnant. Adolescent pregnancy is both a cause and consequence of rights violations. Pregnancy undermines a girl’s possibilities for exercising the rights to education, health and autonomy, as guaranteed in international treaties such as the Convention on the Rights of the Child. Conversely, when a girl is unable to enjoy basic rights, such as the right to education, she becomes more vulnerable to becoming pregnant. According to the Convention on the Rights of the Child, anyone under the age of 18 is considered a child. For nearly 200 adolescent girls every day, early pregnancy results in the ultimate rights violation—death. Girls’ rights are already protected—on paper— by an international, normative framework that requires governments to take steps that will make it possible for girls to enjoy their rights to an ADOLESCENT BIRTHS 95% 95 per cent of the world’s births to adolescents occur in developing countries NATIONAL vii
Page 1 and 2: Motherhood in Childhood Facing the
Page 3 and 4: state of world population 2013 Moth
Page 5 and 6: to health. Conversely, a girl who i
Page 7: “I was 14… My mom and her siste
Page 11 and 12: Research shows that addressing unin
Page 13 and 14: Additional efforts must be made to
Page 15 and 16: 1 A global challenge Every year in
Page 17 and 18: ights, or where access to health ca
Page 19 and 20: According to DHS and MICS surveys,
Page 21 and 22: “Efforts—and resources—to pre
Page 23 and 24: adolescents with no education and i
Page 25 and 26: A UNFPA review of four countries fo
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Page 29 and 30: ESTIMATING ADOLESCENT PREGNANCY AND
Page 31 and 32: 2 The impact on girls’ health, ed
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Page 35 and 36: In sub-Saharan Africa, an estimated
Page 37 and 38: ADOLESCENTS, AGES 10 TO 19, LIVING
Page 39 and 40: community environments, she may fee
Page 41 and 42: effect could have added $3.4 billio
Page 43 and 44: suggest that between 38 per cent an
Page 45 and 46: 3 Pressures from many directions Ad
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Page 49 and 50: social and economic exclusion from
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A study covering four African count
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esponsibilities of breadwinner and
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Child marriage does not always lead
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In much of Europe and North America
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Child, 2003; CEDAW, 1999; CRPD, Art
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Young people who are not living wit
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4 Taking action Multilevel interven
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actions have in some way contribute
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average household income. About 70
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(“Open Opportunities”), establi
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In India, Pathfinder International
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has learned a number of lessons abo
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change behaviour through the threat
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contraception, through its Competit
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and Nicaragua to strengthen the cap
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developing gender-equitable attitud
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eight outreach centres which offer,
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influence gender-related attitudes
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ehaviours of boys and girls, or inc
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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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