Adolescent pregnancy is a hidden issue that very few want to talk about in public. A significant number of adolescents in the East Asia and Pacific region are sexually active. Every year, many adolescent girls become pregnant without intending to, changing the course of their lives in unforeseen ways.
In some cultures, these issues are uncomfortable for families and public figures to confront and address openly. This results in the problem being ignored or poorly addressed.
Most adolescents do not have the knowledge, skills or access to services required to prevent unplanned pregnancies, or to deal with early parenthood and the associated challenges of social stigma, interrupted education and other long term consequences.
In countries in East Asia and the Pacific, maternal health data is not disaggregated or analysed by age. There are no reliable data on pregnancy and abortion rates among adolescent girls. We do not know what proportion of adolescent pregnancies are a result of sexual abuse.
Shame instead of support
Adolescent mothers and their babies face higher risk of health complications. But adolescent pregnancy is not just a health concern. When an adolescent girl, who is technically a child herself, becomes pregnant, this endangers both her and her baby’s rights: their right to a childhood, to health, and to an education.
Adolescent girls who become pregnant often face shame, social isolation and depression. We don’t know how many of them attempt or commit suicide as a result of the social and self-stigmatisation. Adolescent pregnancy and childbearing have a long term effect on the family. Once pregnant, adolescent girls tend to drop out of school, which leads them to take low-skilled, low-paid jobs. If not supported, adolescents and their babies are put at a serious social and economic disadvantage that can persist throughout their lives.
Each instance of a child becoming pregnant is a failure of our systems to protect the rights of multiple children: an adolescent girl, often an adolescent boy, and their baby. Refusing to acknowledge the issue, or to address it effectively, makes us all complicit.
We need to consider the cultural and religious sensitivities involved, but at the same time we need to use evidence to demonstrate the social, developmental and economic costs – especially for girls and women – that are brought on by continued silence and denial of the issue.
|Adolescent boys sit on the waterfront at Dili, capital of Timor-Leste
© UNICEF EAPRO/2012/Andy Brown
Last year, while visiting the UNICEF office in Timor-Leste, I met with groups of adolescent boys and girls to listen to their concerns. Though socially disapproved, teenage pregnancy seemed to be common. Pregnant girls tended to drop out of school and hide in shame. Some move to relatives’ houses in other provinces until they give birth.
One particularly poignant story I heard was about a young girl who gave birth in the bushes of a coffee plantation, after which, in her shock and isolation, she abandoned the baby. Some babies born to adolescent mothers are said to be adopted by other families through informal arrangements. However, the number of babies adopted, the quality of the adoption services, and the overall survival, growth and development of babies born to adolescent mothers, is unclear.
Although girls are more likely to be stigmatized, stop school and forced to play motherhood roles that they are unprepared for, I feel we do not understand the effects of this on teenage fathers. An unknown proportion of these choose to get married or cohabit, some with limited or no support from their families. We need to pay more attention to the needs of adolescent parents and families, as much as the need to address effective ways to prevent unplanned pregnancies among children.
UNICEF has conducted a regional study on adolescent pregnancy and used the findings to plan concrete actions together with the governments of China, Thailand, Philippines and Vietnam, which came together to discuss and plan actions to address adolescent pregnancy a few months ago. To make sure that we develop culturally appropriate approaches, we are also conducting country-specific analyses, as is currently being done in Thailand.
But we can do much more. We need to provide adolescents with education and skills on sexuality and reproductive health, and make sure they can access contraceptive services before they are sexually active. In middle income countries, where governments have the capacity to ensure young child survival and where school enrollment rates are rising, schools offer the best setting and opportunity to impart the necessary knowledge and skills to adolescents.
This should not be seen as a job for health departments and health care systems alone. Education systems must also be held accountable for increasing knowledge and skills, while health systems should deliver results in increasing access to reproductive health services and contraception. We need to find ways to engage with adolescents when planning and implementing these processes, rather than treat them as passive recipients of services and information.
UNICEF, governments, development agencies and civil society must together, make a priority of working with and listening to the accounts of adolescent girls and boys, and invest in preventing and responding to adolescent pregnancies. Our region’s teenagers deserve nothing less.
Devashish Dutta is Youth and Adolescent Specialist for UNICEF East Asia and the Pacific.