Pregnancy and childbirth, compounded by gender inequalities, expose women and adolescent girls to sexual and reproductive health risks. A lack of autonomy to make decisions about one’s own reproductive health care, limited control over financial resources, restricted mobility to access services and power differentials between health care providers and recipients are all factors which may preclude women and adolescent girls from being empowered to exercise their reproductive rights and make decisions about their bodies and their futures.
Adolescent girls are particularly at risk. Pregnancy during adolescence, especially early adolescence, can have a number of negative consequences for the health and well-being of girls, their newborns and communities as a whole. In 2019, maternal health conditions such as haemorrhage, sepsis or obstructed labour were the second leading cause of death among girls aged 15-19. The global adolescent birth rate has declined from 51 to 42 births per 1,000 adolescent girls aged 15-19 over the past decade. However, in sub-Saharan Africa, the region with the highest adolescent birth, 1 out of 10 adolescent girls aged 15-19 give birth.
Worldwide, only 1 in 2 adolescent girls and young women aged 15-19 have their demands for family planning satisfied by modern methods
Policies that encourage girls’ equal access to education, health-care services and socio-economic opportunities can contribute to lessening the prevalence of pregnancy during adolescence. Meeting the need of adolescent girls to prevent or delay childbearing also requires removing barriers to using contraception, including cost, stigma, lack of awareness, fear of side effects and limited decision-making autonomy. However, family planning services for adolescent girls in many regions are falling critically short. In West and Central Africa, for example, only 1 in 4 adolescent girls have their needs for family planning satisfied by modern methods.
In most countries with data, few adolescent girls make decisions about their own sexual and reproductive health
Women’s and adolescent girls’ autonomy to make decisions about their sexual and reproductive health is key to their empowerment and ability to chart their own life course. Common determinants of reproductive autonomy include knowledge of sexual and reproductive rights; communication between partners; gender norms which frame appropriate behaviour for women in heterosexual unions; access, affordability and acceptability of health services; and socioeconomic factors, such as household wealth, education levels and rural/urban location. For married adolescent girls in particular, these barriers may be even more difficult to surmount. In 31 of 36 countries with available data, less than 50% of married adolescent girls make informed decisions regarding sexual relations, contraceptive use and reproductive health. In Turkmenistan, Nigeria, Tajikistan, Mali and Senegal, 1 in 10 or fewer adolescent girls do.
Access the data and read more about maternal health and early childbearing.
1. World Health Organization- Global Health Estimates (GHE) 2019.
2.UNFPA and Hera (2019). Research on what determines women’s ability to decide on their SRHR and the relationship between this and other aspects of their lives. Volumes 1 and 2: Final report, October 2019.