In Latin America and the Caribbean
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Adolescent fertility in Latin America and the Caribbean declined over the past 15 years. Births to teen mothers are expected to decrease noticeably in the more developed countries in the region from 1995-2020.1 However, unintended pregnancy and too-early childbearing remain common, particularly in poorer countries. Impact on parents, children and society can be grave and long lasting.
Early childbearing is deeply ingrained in Latin American and Caribbean cultures, as it is in many other parts of the world. Marriage and childbearing are often perceived as the premiere events of a young woman's life. But the medical, economic and psychological impact of early childbearing can be significant, particularly for those who are unmarried.1,2
Adolescent Fertility Remains High in Latin America.
- Improvements in general health conditions and nutrition contribute to a lower age at menarche and to higher levels of adolescent fecundity than existed 25 years ago. About thirty-five percent of young women in Latin America have a first child before age 20.3 Women who begin childbearing as teenagers are estimated to have two to three more children than women who delay their first birth until their twenties or later.4
- Twenty-eight percent of women in Guatemala give birth before age 18.5 Approximately one in five young women under 18 in Mexico and Bolivia have given birth.5 In Colombia, Guatemala and Paraguay, young women are now more likely to have a child during adolescence than were teens during the 1970s.3
- Birth rates are higher for adolescents living in rural settings. A study of nine countries in Latin America and the Caribbean found that 40 to 60 percent of rural women had a child before age 20, compared to 25 to 36 percent of urban women.6
Many Teen Pregnancies Are Unplanned or Unwanted.
- Fifty percent of births to women aged 15 to 19 in Brazil are reported to be unplanned.3
- A 1993 study in Jamaica found that nearly 45 percent of young women aged 15 to 24 had ever been pregnant. Seventy-seven percent of those pregnancies were mistimed or unwanted.7
Too-Early Childbearing Often Harms the Health of Both Mother and Child.
- Early childbearing may be life-threatening to both the mother and the child. Mothers younger than 17 face an increased risk of maternal mortality because their bodies are not yet mature enough to bear children.2,3,8 These young women may not recognize the symptoms of pregnancy or may not wish to acknowledge a conception, delaying prenatal care and endangering the health of the child and mother.2
Maternal Mortality Rates Are High.
- In Paraguay, a pregnant adolescent's risk of dying is 52 times higher than in the United States. Nearly 20 percent of adolescent female deaths in Paraguay are attributable to complications of pregnancy or childbirth. In Ecuador, the Dominican Republic and El Salvador, the percentages are 13, 8.2 and 7.2, respectively.9
- Poor women, especially adolescents, tend to seek inexpensive, later, unsafe abortions. In Bolivia, Peru, Colombia and Venezuela—countries where abortion is illegal or severely restricted—a study of younger women seeking abortion found that they were at significant risk of abortion complications.10,4
- In Chile and Argentina, where abortion is similarly restricted, more than one-third of maternal deaths among adolescents are a direct result of unsafe abortions.8
- Teen mothers' deliveries are more often complicated by obstructed labor or other problems, which may lead to death of the mother and/or child, or to maternal infertility. Children born to teenage mothers are more likely to be premature, be of low birth weight, and suffer from retarded fetal growth.1,8
Early Pregnancy Can Endanger the Life and Health of the Child.
- In Paraguay, infants born to mothers 15 to 19 years old are nearly 80 percent more likely to die during the first year of life than infants born to mothers 20 to 29 years old.1
- In the Dominican Republic, El Salvador, Peru, and Colombia the increased likelihood of mortality is 77, 69, 36, and 29 percent, respectively, for infants born to younger mothers.1
- In Honduras, the infant mortality rate is 77.4 deaths per 1000 live births for women under age 20, compared with 48 for births to women aged 20 to 34.11
- Delaying a woman's first birth until she is at least 18 years old could reduce the infant mortality of first born children in Mexico, Peru and Dominican Republic by up to 30 percent.12
High Adolescent Fertility Rates Are Linked to Low Educational Attainment and Poverty.
- Young women with low levels of educational and economic attainment often experience restricted ability and motivation to regulate their fertility, resulting in higher rates of early pregnancy. The cycle is further perpetuated as young women who are in school are forced to discontinue their education when they become pregnant, greatly restricting their economic opportunities. Young women with higher levels of education are more likely to postpone marriage and childbearing.3 Education is positively associated with contraceptive use by increasing awareness, acceptability, and utilization of family planning services.13 Children of adolescent parents not only face an elevated risk of illness or death; they are also more likely to be abandoned, left to live on the street, and caught in a cycle of poverty.4,2
- Fertility levels among the least educated and the most educated women in Peru differ by five children. The fertility level of unschooled women is twice their stated ideal family sized.14
- Teenagers with some secondary education are roughly one-third as likely to have had a child as those who have less education.2 In Colombia, 46 percent of young women with less than seven years of schooling have their first child by age 20, compared to 19 percent of women with seven or more years of education.3
- In Guatemala, teen birth rates are highest among those with no schooling. Teenagers who postpone childbirth are five times more likely to finish their secondary education than are those who do not delay their first birth until at least age 20.6 The percentage of teens who had a child or were pregnant was highest among those who never attended school (37 percent) and higher among indigenous people than among Ladinos (26 percent vs. 19 percent).15
- In Latin America, teen mothers are seven times more likely than older mothers to be poor.4 The poorer the country, the higher the level of early childbearing.5
- Young women generally are expelled from school if they become pregnant, and they rarely return.3 A 1993 study in Jamaica found that 32 percent of young women who had ever been pregnant became pregnant for the first time while still in school and that almost 60 percent of these pregnancies occurred before the fourth year of secondary school. Of these young women, only 16 percent returned to school after the birth of their first child. Eighty-six percent of those who became pregnant while in primary school never advanced to secondary school.7
- McDevitt TM, Adlakha A, FowlerTB et al. Trends in Adolescent Fertility and Contraceptive Use in the Developing World. [IPC/95-1]. Washington, DC: U.S. Bureau of the Census, 1996.
- Yinger N. de Sherbinin A, Ochoa L, et al. Adolescent Sexual Activity and Childbearing in Latin America and the Caribbean: Risks & Consequences. Washington, DC: Population Reference Bureau, 1992.
- Alan Guttmacher Institute. Risks and Realities of Early Childbearing Worldwide. [Issues in Brief]. New York, NY: The Institute, 1996.
- Koontz SL, Conly SR. Youth at Risk: Meeting the Sexual Health Needs of Adolescents. Washington, DC: Population Action Intemational, 1994.
- Alan Gunmacher Institute. Women and Reproductive Health in Latin America and the Caribbean. [Women, Families and the Future]. New York, NY: The Institute, 1994.
- Wulf D, Singh S. Sexual activity, union and childbearing among adolescent women in the Americas. International Fam Plann Perspect 1991;17:137-144.
- Morris L, Sedivy V, Friedman JS, et al. Contraceptive Prevalence Survey, Jamaica 1993. Vol. 4. Sexual Behaviour and Contraceptive Use Among Young Adults. Atlanta, GA: U.S. Dept Health & Human Services, Centers for Disease Control and Prevention, 1995.
- Noble J. Cover J. Yanagishita M. The World's Youth 1996. Washington, DC: Population Reference Bureau, 1996.
- Maddaleno M, Silber T. An epidemiological view of adolescent health in Latin America. J Adolesc Health 1993;14:595-604.
- Singh S. Wulf D. The likelihood of induced abortion among women hospitalized for abortion complications in four Latin American countries. International Fam Plann Perspect 1993;19:134-141.
- Martin R. Buttari J, Macias H. et al. A.I.D. 's Family Planning Program in Honduras. [A.l.D. Technical Report; no. 9]. Washington, DC:Agency for International Development, 1993.
- United Nations. The Health Rationale for Family Planning: Timing of Births and Child Survival. New York, NY: The UN, 1994.
- Castro Martin T. Njogu W. A decade of change in contraceptive behaviour in Latin America: a multivanate decomposition analysis. Popul Bulletin UN, 1994;36:BI-109.
- Castro Martin T. worsens education and fertility: results from 26 demographic and health surveys. Stud Fam Plann 1995;26: 187-202.
- _____. Guatemala: Encuesta Nacional de Salud Materno Infantil, 1995. [Demographic and Health survey]. Guatemala city, Guatemala Instituto Nacional de Estadistica; Calverton, MD: Macro lntemational, 1996.
Compiled by Cristina Herdman
July 1997 © Advocates for Youth