Adolescent pregnancy

Early childbearing, high fertility rates and inadequate access to maternal health services are the main contributing factors in the high number of maternal deaths among young women in Africa. Girls aged 15-19 years are twice as likely to die during childbirth as women 20 years and above. Coupled with HIV, complications during pregnancy and childbirth are the leading cause of death for young women aged 15-19 years, with 26 per cent of all maternal deaths occurring among adolescents. In the ESA region, adolescent fertility rates are either declining slightly or stagnant. However, ten countries have rates of more than 100 per 1000 live births.

Early childbearing, high fertility rates and inadequate access to maternal health services are the main contributing factors in the high number of maternal deaths among young women in Africa. Girls aged 15-19 years are twice as likely to die during childbirth as women 20 years and above. Coupled with HIV, complications during pregnancy and childbirth are the leading cause of death for young women aged 15-19 years, with 26 per cent of all maternal deaths occurring among adolescents.

In the ESA region, adolescent fertility rates are either declining slightly or stagnant. However, ten countries have rates of more than 100 per 1000 live births.

Unsafe abortion because of unwanted pregnancy is also common among adolescents. It is an indicator of girls’ and women’s unmet need for contraception.  In sub-Saharan Africa, extreme poverty, inadequate access to reproductive health information and services, and restrictive abortion laws cause many women to resort to clandestine abortion providers to avoid unintended pregnancy, resulting in about 3 per cent obtaining unsafe abortions each year. Unsafe abortion is a major contributor to maternal deaths, with 14 unsafe abortions performed for every 100 births in Africa.

UNFPA’s 2013 State of World Population Report highlights the main challenges of teenage pregnancy and the substantial impact on girls’ education, health and long-term employment opportunities. The report discusses what can be done to protect girls’ human rights and well-being and in the long term, curb the trend.

High adolescent fertility rates will delay fertility transition and the emergence of the demographic window of opportunity for the region. The significant declines of unmet need for contraception among young women in a relatively short period in Rwanda and Ethiopia confirm the success of the expansion of family planning services for young women, especially through community-based distribution methods.

Scaling up youth-friendly health services that conform to international standards and addressing the negative attitudes of health providers to adolescents’ desire to access sexual and reproductive health services will be critical for accelerating a reduction in teen pregnancies, unwanted births, unsafe abortions, obstetric fistulas and overall maternal mortality in the region.

UNFPA advocates a human rights-based approach to tackling adolescent pregnancy. This includes the right to access affordable sexual and reproductive health information and services, including contraceptives; access to safe abortion where legal; providing comprehensive and age-appropriate sexuality education both in and out of school; and the ban of marriage under the age of 18.

UNFPA urges governments in the region to combat social and cultural beliefs that contribute to the lower status of women and girls, and to invest in developing girls’ human capital by keeping girls in school and ensuring quality education for all.

Comprehensive sexuality education and youth-friendly services

 
The Fund promotes comprehensive sexuality education for both in- and out-of-school adolescents by promoting supportive national policies, strengthening curricula, training teachers and developing tools to measure implementation in schools. Comprehensive sexuality education is complemented by the use of information communication technologies such as the Internet and social media, to improve young people’s access to reliable information.
 
UNFPA promotes the scaling up of youth-friendly sexual and reproductive health services that respect clients’ right to confidentiality, and advocates for the elimination of legal and policy barriers to accessing information and services.
 
UNFPA also supports and partners with youth-led organizations in the region and provides opportunities for young people to participate in high-level advocacy events. The Y-PEER, or youth peer education initiative, active throughout the region, trains thousands of young people to be advocates for and sources of factual information on sexual and reproductive health, and to act as mentors to their peers on these issues.