11 percent of the world’s teenage pregnancies happen in India.
This translates to 16 million women between the ages of 15-19 who become mothers each year.
Shocked?
In fact, India has one of the highest rates of early marriage in the world. The recent National Family Health Survey (NFHS) estimates that 27 percent of girls in India are married before their 18th birthday, that’s a third of all our young women.
Therefore, it is not surprising that we have one of the world’s highest numbers of teenage mothers, given that in India, pregnancies occur in the context of marriage.
The Reason Why So Many Minors Get Pregnant in India
Dr Niranjan Saggurti, from the Population Council India, who pioneered research on young people’s health and development, including sexual and reproductive health, says that the need for contraception among adolescents is almost twice the need in case of adult women.
Law enforcement hesitates to get involved, even though it is illegal for under 18 girls to marry. Largely because early marriage is sanctioned by culture and social norm. The worst affected state is Bihar where 70 percent of women in their early twenties are reportedly married by the age of 18.
When girls start their periods, their potential to be married and bear children takes primacy. They are married off early as families worry that they could engage in romantic relationships, bringing “dishonour”.
Financial considerations also play a role in early marriage. Dowry demands and “suitability issues” increase with age. In addition, when a family has more than one daughter, they find it economical to get both the younger and the older one married at the same time to reduce cost of multiple weddings.
In Indian culture, adolescents have little access to correct and comprehensive information on family planning and access to contraceptives, whether married or not. Wives too have little say in the number, timing and spacing of children. All these factors, taken together increase the likelihood of teen pregnancies.
The reality is that early marriage and consequently pregnancy is most often not the result of a deliberate choice, but the absence of choices, and of circumstances beyond a girl’s control. It is a consequence of little or no access to school, employment, reliable information about healthcare, and poor utilisation of health services and patriarchy.
Professor Sunil Khanna, Oregon State University, who has worked extensively on adolescent health in India, emphasises that childhood and youth – two of the most formative stage of life – must never be disrupted by parenthood.
The Impact of Early Pregnancies
Maternal malnutrition has a direct impact on the child, as it causes inter-generational malnutrition, especially irreversible stunting. That has a severe impact on the health and productivity of a nation.
Piyasree Mukherjee, from Foundation for Mother and Child Health, meets mothers as young as 18 already on their second pregnancy, weighing as low as 40 kilos, almost every other day.
The greatest threat of teenage pregnancy is higher rate of pregnancy-related complications like anaemia , hypertension, hemorrhage and unsafe abortions. In addition, malnutrition, sexually transmitted infections (STI) , cervical cancers and the psychological issues are highly prevalent. This makes adolescent pregnancies one of the most serious health and psychological threats to young women in India.
Dr Hema Divakar, Former President of Federation of Obstetric and Gynaecological Societies of India (FOGSI), stresses that adolescents pregnancies are one of the leading causes of the high burden of mother and neonatal deaths in India.
Multi-pronged approaches like comprehensive sexual education, change in social norms by involving village and community and religious leaders, through life skills education of both girls and boys, access to contraception, setting up of confidential and adolescent friendly clinics are helpful.
There are many ongoing efforts to tackle this issue, especially through path-breaking research, leading to adolescent friendly programs by various stakeholders.
Dr Atul Mittal, part of the Maternal and Child Survival Program (MCSP), says that it is essential to ensure youth-friendly sexual and reproductive health services with confidentiality and privacy as non-negotiables.
Children as mothers, do not just have consequences for the mothers and the newborns, but have a huge ranging implication for our society and our economy.
And though over past decade, India has successfully reduced the proportion of pregnancy between 15-19 years to half (16 percent during NFHS 3 in 2005-06 and 7.9 percent during NFHS 4 in 2015-16), we have miles to go before we sleep.
(Dr Angela Chaudhuri is a public health professional and freelance journalist working globally with Swasti Health Catalyst for the last 15 years on issues ranging from sexual reproductive health and rights, water sanitation and hygiene and health systems.)
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