- 90% of adolescent births in low-income countries are to girls who are already married or in a union. [i]
- Every year, an estimated 21 million girls aged 15 to 19 years become pregnant in low-income regions and approximately 12 million of them give birth. [ii]
- At least 777,000 births occur each year to adolescent girls younger than 15 years in low-income countries. [iii]
- Adolescent pregnancy is most common in sub-Saharan Africa and Latin America and the Caribbean. [iv]
Links and health impacts
The criminalisation of consensual adolescent sexuality can drive child marriage underground. When an adolescent girl becomes pregnant in such conditions, she will not attend ante-natal health checks or register the birth of their baby.
When girls first marry, they often face intense social pressure to prove their fertility. It can be extremely difficult for them to assert their will, particularly when deciding whether to get pregnant, or negotiating safe sexual practices and the use of contraception.
Girls face barriers to accessing contraception and safe abortion. This reduces their options for limiting or spacing their pregnancies. Barriers include judgement by health care providers and physical barriers – like distance and restricted mobility – to accessing clinics.
In contexts where there are both high levels of unintended pregnancy and restrictive abortion laws, pregnant adolescent girls frequently turn to clandestine, unqualified abortion providers who put their health and lives at risk. An estimated 8-11% of all maternal deaths are due to unsafe abortion, and adolescent girls are more likely than older women to go to unsafe providers. In Central America, where abortion laws are among the most restrictive in the world, there is evidence of higher suicide rates among girls who are unable to access abortion.
Child brides are more likely to experience early pregnancies and go on to have more children than girls who marry later. This increases their risks of pregnancy- and childbirth-related complications, which can have long-term health impacts, or even cause death. The younger the girl is when she becomes pregnant, the greater the risk to her health.
When a girl marries as a child, the health of her children suffers too. The children of young married girls are at higher risk of low birth weight, preterm delivery and severe neonatal conditions, as well as being more likely to suffer from malnutrition and stunting throughout childhood.
Prioritising adolescent girls’ rights and maternal health
We must address child marriage and support married girls if we are to improve maternal health. Some key recommendations are:
- Focus on the social drivers of early pregnancy for married and unmarried girls in programming for maternal health.
- Increase access to contraception for married and unmarried adolescent girls, so they can delay and space pregnancies.
- Provide age-appropriate comprehensive sexuality education, including discussion of gender and empowerment.
- Create safe spaces for girls to learn about sexual and reproductive health and rights, and to reduce their social isolation.
- Tailor maternal health programmes to the unique needs of adolescent girls, including married girls and those that are pregnant outside of marriage.
- Make safe abortion services and post-abortion care available where possible.
- Use health services as an entry point to other services, including nutrition, child protection, education and income-generating opportunities.
- Take cross-sectoral action to prevent child marriage.
Find out more about girls’ agency and gender equality on our Gender learning page.
- [i] UNFPA, 2015, Girlhood, not motherhood: Preventing adolescent pregnancy, New York: UNFPA
- [ii] Darroch J, Woog V, Bankole A, Ashford L.S, 2016, Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents, New York: Guttmacher Institute
- [iii] UNFPA, 2015, Girlhood, not motherhood: Preventing adolescent pregnancy, New York: UNFPA
- [iv] UNFPA, 2021, State of the world’s population
- Neal S, Matthews Z, Frost M, et al, 2012, Childbearing in adolescents aged 12–15 years in low resource countries: a neglected issue. New estimates from demographic and household surveys in 42 countries, Acta Obstet Gynecol Scand 2012;91: 1114–18.
- Chandra-Mouli, V., et. al., 2014, Contraception for adolescents in low and middle income countries: needs, barriers, and access, Reproductive Health 2014 11:1
- Sarosh, T., 2018, Dissecting Bias, Pathfinder website: https://www.pathfinder.org/
- WHO Guidelines, 2011, Preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries
- Margaret E. Greene, Jill Gay, Gwendolyn Morgan, Regina Benevides, and Fariyal Fikree, 2014, Reaching Young First-Time Parents for the Healthy Spacing of Second and Subsequent Pregnancies (Washington, DC: Evidence to Action Project, July 2014).
- UNFPA, 2019, ¿Sin opciones? muertes maternas por suicidio, El Salvador
- Wodon. Q., N. Onagoruwa, and N. John, 2017, Economic Impacts of Child Marriage: Child Health and Nutrition, Washington, DC: The World Bank and International Center for Research on Women.
Child marriage and maternal health
This brief takes a look at child marriage and the detrimental impact it can have on maternal health.
Child marriage and SRHR
Developed by Girls Not Brides, this infographic and thematic brief outline the links between child marriage and SRHR.
Making the continuum of care work for mothers and infants: does gender equity matter? Findings from a quasi-experimental study in Bihar, India
This study shows how child marriage attenuated the impact of an health programme on reproductive, maternal and newborn health in Bihar, India.
Meeting the needs of young married women and first-time parents
Series of SRHR trainings from Pathfinder International aimed at health care providers, community workers, and small group facilitators.