With 90% of adolescent births taking place within the context of marriage, adolescent pregnancy and child marriage are closely linked. Married adolescent girls and girls who are already mothers have unique needs, which health care, education and social services systems are often not set up well to meet. Responses to adolescent pregnancy to date have been heavily focused on prevention and maternal health, ignoring broader sexual and reproductive rights, the psychological and socio-economic consequences of adolescent pregnancy, and the complex needs of married girls, pregnant adolescents and adolescent mothers.
Despite prevention efforts, adolescent pregnancy remains high: an estimated 12 million girls aged 15 to 19 – and 770, 000 girls under 15 – give birth every year in low- and middle-income countries. Prevention efforts therefore need to be implemented alongside initiatives to address the needs and rights of girls who are already pregnant or mothers.
This Thematic brief (and longer paper) explores these needs, shares examples of successful approaches from around the world, and calls for holistic responses to deliver on the rights and needs of married girls, pregnant adolescents and adolescent mothers to be integrated into existing strategies to address education, child marriage, adolescent pregnancy and adolescent health more broadly.
Specifically, we call for:
- Implementation of clear referral and tracking mechanisms between the health and education systems to identify pregnant adolescents in school, support them to access appropriate maternal health and support services, and return to school after birth.
- Establishment of mechanisms for identifying cases of pregnancy arising from sexual violence or coercion and referral to child protection services and legal authorities where appropriate.
- Implementation of flexible return-to-school policies that accommodate the specific needs and rights of adolescent mothers, including the provision of affordable or free childcare.
- Financial support; provision of scholarships or cash transfers for adolescent mothers to support their return to school and/or support them to enter the workforce or generate income.
- Implementation of social support programmes to help adolescent mothers overcome stigma and navigate becoming a mother for the first time, including building support networks, agency, and life skills, and engagement with the wider community.
- Training of sexual and reproductive health care staff on the rights of adolescent mothers to access health services – regardless of age or marital status – and on the risks faced by pregnant adolescents.
- Access to contraception for married girls and adolescent mothers who wish to delay or space their pregnancies.
- Access to safe abortion and post-abortion care for adolescents who do not wish to continue with their pregnancies.