Globally, an estimated 15 per cent of young women give birth before age 18. Early childbearing, or pregnancy and delivery during adolescence, can derail girls’ otherwise healthy development into adulthood and have negative impacts on their education, livelihoods and health. Many girls who are pregnant are pressured or forced to drop out of school, which can impact their educational and employment prospects and opportunities. Early pregnancy and childbearing can also have social consequences for girls, including reduced status in the home and community, stigmatization, rejection and violence by family members, peers and partners, and early and forced marriage.
Adolescent girls, especially those in early adolescence, are particularly vulnerable to the health consequences of pregnancy and delivery as their bodies may not be physically ready. Obstetric fistula, eclampsia, puerperal endometritis and systemic infections are just some of the serious conditions that they may face in the short- and long-term. Globally, maternal conditions are among the top causes of disability-adjusted life years (DALYs) and death among girls aged 15-19.
Globally, almost one in six young women give birth before age 18
Approximately 15 percent of young women globally reported giving birth before age 18 from 2015-2020. This per cent, however, has been found to vary by a number of factors including the region, the country, the location within the country (rural vs. urban), and the young woman’s levels of income and education.
While about 10 per cent of young women in South Asia gave birth before age 18 from 2015-2020, this percentage more than doubles when considering the regions of sub-Saharan Africa. In both Western and Central Africa and Eastern and Southern Africa, over 25 per cent of young women during this same period gave birth before age 18. In these regions, this amounts to an estimated 13 million young women.
The adolescent birth rate, or the annual number of births to women aged 15-19 years per 1,000 women in that age group, is another critical measure of early childbearing. While the global adolescent birth rate from 2015-2020 was about 44 births per 1,000 girls aged 15 to 19, this figure peaked in regions in sub-Saharan Africa. West and Central Africa, for example, had the highest regional adolescent birth rate at 115 births per 1,000 girls aged 15 to 19. Conversely, Western Europe, Eastern Europe and Central Asia and North America had some of the lowest regional adolescent birth rates at 8, 17 and 21 births per 1,000 girls aged 15 to 19.
Despite recent advances in most regions towards reducing the burden of early childbearing, more progress is needed in those that are high burden
Since 2000-2005, the global adolescent birth rate has declined by almost 20 per cent, from 53 to 44 births per 1,000 girls aged 15 to 19. This reduction in the global burden of early childbearing can be tied to improvements in almost all regional rates over this same period. South Asia, North America and Western Europe, for example, have reduced their adolescent birth rates by over 60 per cent since 2000-2005.
More progress towards reducing the burden of early childbearing is needed in the sub-Saharan African regions, however, where reduction rates during this same period are around 15 percent. West and Central Africa and Eastern and Southern Africa, for example, continue to hold adolescent birth rates well above the global rate at 115 and 92 births per 1,000 girls aged 15 to 19, respectively.
It is important to note that despite the observed declines in adolescent birth rates in sub-Saharan Africa, the number of births to adolescent girls has not actually decreased as the population size of adolescent girls has grown substantially in sub-Saharan Africa since 2000-2005.
Generally fewer adolescent girls receive antenatal, skilled delivery or postnatal care for themselves or their newborns as compared to older women.
As most adolescents who are pregnant are experiencing pregnancy for the first time, the need for careful monitoring and quality care during the antenatal, delivery and postnatal periods is generally more acute. Paradoxically, coverage of maternal health indicators, including contact with health system and quality of care, appear lower among adolescent girls than among older women.
Globally, 82 per cent of pregnant adolescents aged 15-19 attended at least one antenatal care visit as compared to 87 per cent of all women and girls aged 15-49. Fewer adolescent girls globally received skilled delivery care as compared to all women and girls (75 to 81 per cent). While the per centage who received postnatal care for themselves was comparable among adolescent girls and among all women and girls at about 65 per cent, there were relative differences in terms of postnatal care for newborns in some regions. In South Asia, for example, 31 per cent of newborns to adolescent mothers had a postnatal contact as compared to 37 per cent of newborns to all mothers. Together, these findings again highlight that greater investment is needed in supporting adolescent girls to realize their sexual and reproductive health rights and advance into safe and healthy adulthoods.
References
World Health Organization, 2017, Global Accelerated Action for the Health of Adolescents (AA-HA!): guidance to support country implementation. Geneva, 2017
WHO. Global health estimates 2019: deaths by cause, age, sex, by country and by region, 2000–2019. Geneva; 2019.
United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects. Geneva, 2021.
Azzopardi P, et al. 2019. Progress in adolescent health and wellbeing: tracking 12 headline indicators for 195 countries and territories, 1990–2016. The Lancet, VOLUME 393, ISSUE 10176, P1101-1118, March 16, 2019. DOI: https://doi.org/10.1016/S0140-6736(18)32427-9
