A new report from PAHO, UNFPA and UNICEF showcases recommendations for preventing teen pregnancy. In the region, 15% of pregnancies occur in women under the age of 20.
Panama City, 28 February 2018 (PAHO/WHO) - Latin America and the Caribbean continues to be the region with the second highest adolescent pregnancy rate in the world, according to a joint report launched today by the Pan American Health Organization/World Health Organization (PAHO/WHO), the United Nations Children´s Fund (UNICEF), and the United Nations Population Fund (UNFPA).
The report highlights recommendations to reduce teen pregnancy, which range from supporting multisectoral prevention programs geared toward those in the most vulnerable situations, to increasing access to contraception and sex education, among others.
The global adolescent pregnancy rate is estimated at 46 births per 1,000 girls, while adolescent pregnancy rates in Latin America and the Caribbean continue to be the second highest in the world, estimated at 66.5 births per 1,000 girls aged 15-19 years, second only to Sub-Saharan Africa, according to the report "Accelerating progress toward the reduction of adolescent pregnancy in Latin America and the Caribbean."
Although total fertility - the number of children per woman - in Latin America and the Caribbean has declined over the past 30 years, adolescent fertility rates have dropped minimally during that period, according to the report. Additionally, it is the only region where a rising trend has been observed in pregnancies among adolescents younger than 15 years, according to UNFPA. An estimated 15% of all pregnancies occur annually in girls younger than 20 years in the region, and 2 million children are born to mothers between the ages of 15 and 19 years.
"Adolescent fertility rates remain high in our region, affecting mostly population groups living under conditions of vulnerability and highlighting major inequities between and within countries. Teen pregnancy can have a profound effect on girls' health over their life course," said Carissa F. Etienne, PAHO Director. "It not only hinders their psychosocial development, but is also linked to poor health outcomes and higher risks of maternal death. In addition, their children are at higher risk for poor health and social outcomes."
Maternal mortality is one of the top causes of death among adolescents and youth aged 15-24 years in the region of the Americas. In 2014, approximately 1900 adolescents and youth died as a result of complications occurring during pregnancy, childbirth, and post-partum periods. At the global level, the risk of maternal death is doubled in mothers younger than 15 years in low- and middle-income countries. Perinatal deaths are 50% higher among infants born to mothers under 20 years when compared to those born to mothers 20-29 years old, according to the report.
"The lack of information and restricted access to comprehensive sex education and adequate sexual and reproductive health services are directly related to adolescent pregnancies. Many of these pregnancies are not a deliberate choice, but rather the result, for example, of an abusive relationship," said Esteban Caballero, Regional Director of UNFPA for Latin America and the Caribbean. "Reducing teenage pregnancy means ensuring access to effective contraceptive methods."
The report found that in the majority of countries adolescent girls with no education or only primary education are up to four times more likely to get pregnant than girls with secondary or higher education. Girls whose households are part of the lowest wealth quintile are also three-to-four times more likely to become mothers compared with those in the highest quintile in the same country. Indigenous girls, especially in rural areas, have a higher probability of becoming pregnant at a young age.
"Many girls and adolescents must abandon school because of pregnancy, which has a long-term impact on their opportunities to finish their education and join the workforce, as well as their ability to participate in public and political life," said Marita Perceval, Regional Director of UNICEF. "As a result, adolescent mothers are exposed to situations of greater vulnerability and the repetition of patterns of poverty and social exclusion."
Preventing adolescent pregnancy
The report outlines several recommendations to reduce adolescent pregnancy, focusing on actions from legislation to education at the individual, family, and community levels:
- Promote measures and norms that prohibit child marriage and early unions before the age of 18
- Support evidence-based pregnancy prevention programs that involve multiple sectors and target the most vulnerable groups
- Increase the use of contraception
- Prevent coerced sex
- Significantly reduce pregnancy interruption in unsafe conditions
- Increase the use of skilled prenatal, childbirth, and postpartum care
- Include youth in pregnancy prevention program design and implementation
- Create environments that enable gender equality and help adolescents exercise their sexual and reproductive rights
Adolescent pregnancy by the numbers:
- The majority of countries with the highest estimated adolescent fertility rates in LAC are in Central America, with the highest rates in Guatemala, Nicaragua, and Panama. In the Caribbean, the Dominican Republic and Guyana have the highest rates; and in South America, Bolivia and Venezuela have the highest rates.
- The adolescent fertility rate in Latin America and the Caribbean ranges from 15.8 per 1000 women to 100.6 per 1000 women during 2010-2015.
- The total fertility rate in Latin America and the Caribbean has declined from 3.95 births per woman s in 1980-1985 to 2.15 in 2010-2015.
- Although the age-specific fertility rate (the number of births per 1000 women) decreased significantly in most age groups of women over the age of 18 years to half or less than in 1980-1985, the adolescent fertility rate had the slowest decline during that period, from 88.2 to 66.5.
- The United States and Canada have adolescent fertility rates below the global average and have maintained this decrease over the past decade.
- In the United States, a record decrease in adolescent pregnancy was registered in all ethnic groups, with a decrease of 8% between 2014 and 2015 to a historic low of 22.3 births per 1000 adolescents' ages 15-19 years.
- Approximately 16 million girls aged 15-19 years and 2 million girls younger than 15 years become pregnant each year around the world.
- Of the 252 million adolescent girls aged 15-19 living in developing regions of the world, an estimated 38 million are sexually active and do not want a child in the next two years.
- About 15 million of these adolescents use a modern contraceptive method; the remaining 23 million have an unmet need for modern contraceptives and are at risk for unintended pregnancy.
- Providing the unmet need for modern contraceptives of women aged 15-19 would annually avert 2.1 million unplanned births, 3.2 million abortions, and 5,600 maternal deaths.