Facing the challenge of adolescent pregnancy

A pregnancy can have immediate consequences for a girl's health, education and income-earning potential. And it often alters the course of her entire life. How it alters her life depends in part on how old -- or young -- she is.
The risk of maternal death for mothers under 15 in low-and middle-income countries is double that of older females; and this younger group faces significantly higher rates of obstetrical fistulae than their older peers as well.
About 70,000 adolescents in developing countries die annually of causes related to pregnancy and childbirth. Pregnancy and childbirth are a leading cause of death for older adolescent females in developing countries. Adolescents who become pregnant tend to be from lower-income households and be nutritionally depleted. Health problems are more likely if a girl becomes pregnant too soon after reaching puberty.
Adolescent birth rates are highest where child marriage is most prevalent, and child marriages are generally more frequent where poverty is extreme. The prevalence of child marriage varies substantially across countries, ranging from 2% in Algeria to 75% in Niger, which has the world's fifth-lowest per capita gross national income (World Bank, 2013).
While child marriages are declining among girls under age 15, 50 million girls could still be at risk of being married before their 15th birthday in this decade.
Today, one out of nine girls in developing countries is forced into marriage before age 15. In Bangladesh, Chad and Niger, more than one in three girls is married before her 15th birthday. In Ethiopia, one in six girls is married by age 15.
Every day, 20,000 girls below age 18 give birth in developing countries. In Bangladesh, the median age of marriage for girls is 15.8 years, and 66% of Bangladeshi women haven given birth before age 18. Young mothers are twice as likely as their adult counterparts to have complications during pregnancy, and less likely to have access to or education about sexual and reproductive health.
Rekha, for example, is a young girl that the UNFPA has been providing maternal care to. She is already pregnant at 14 years old and lives in the Thakurgaon. Rekha is from a poor family and lost her father at a very early age. Her mother arranged a marriage for her at age 13 because she was unable to provide for her any longer. After the wedding, her in-laws insisted the couple have a baby as soon as possible so that people did not think Rekha was infertile. Rekha was able to get pregnant quickly after marriage, but is frequently sick with complications from the pregnancy.Rekha said: "My pregnancy has become a burden for me." She misses going to school and seeing her friends. "When I see my school friends still going to school, I become very upset and feel that I should also be with them and continue my studies. It is because I am from a poor family and because my father died that I had to marry so early." By giving birth to a child, Rekha will have her own childhood stolen away from her.
Child pregnancy is both the cause and result of rights violations. In Bangladesh, girls who are less educated come from rural areas, and those who are impoverished are more likely to be forced into early marriage and pregnancy. Children who get pregnant early on are at greater risk of being forced out of school, which in turn eliminates many job opportunities for them and ensures that their family will continue to be trapped in the cycle of poverty.
Adolescent pregnancy hinders Bangladesh's development as a nation. Because early pregnancy forces girls to relinquish career dreams, it severely debilitates Bangladesh's economy. Adolescents are the future of this country, and must be helped to flourish. Child pregnancy prevents girls and boys from taking advantage of opportunities to better both themselves and their country. We say that "children are the future of Bangladesh," but how can we expect them to contribute to Bangladesh's development when these children have children of their own?
The government of Bangladesh has made marriage to girls under age 18 illegal, but most adolescent pregnancies still occur within marriage. Various groups focus on eliminating child marriage, but many of these programmes focus solely on increasing girls' knowledge of sexual and reproductive health. Yet adolescent pregnancy is a result of social norms and powerlessness; many of the young girls in Bangladesh who become pregnant have no power to make decisions about their own bodies. Increasing girls' knowledge of sexual and reproductive health will not make a difference in rates of pregnancy unless these girls are given the opportunity to make use of this knowledge.
Programmes dedicated to eliminating child marriage must therefore take a broader perspective, increasing access to and knowledge of sexual and reproductive health but also abolishing the circumstances that make adolescent pregnancy more likely. Adolescent pregnancy is a symptom of poverty, gender inequality, discrimination, lack of access to services, and negative views about girls and women. By addressing the underlying causes of adolescent pregnancy, we can more effectively bring an end to this harmful practice.
No childhood should be cut short by motherhood.
Working together with the government, communities, families and schools, we can eliminate adolescent marriage in Bangladesh.
UNFPA strives to create a world where every pregnancy is wanted, every birth is safe, and every young person's potential is fulfilled.

The writer is Officer-in-Charge, UNFPA, Bangladesh.