Children having children — and dying — a ‘global scandal’

Pregnancy is the biggest killer of teenage girls worldwide, with one million of them dying or suffering serious injury, infection or disease every year, Save the Children said on Thursday.

In a new report, “Every Woman’s Right: How family planning saves children’s lives,” the non-governmental organisation has highlighted that girls under 15 are five times more likely to die during pregnancy than women in their 20s.

Infant mortality risk

Babies born to adolescent mothers are also at far greater risk, says the NGO, pointing out that around one million children die every year. In India, infant mortality rate for teenage mothers is 77 per 1,000 livebirths, while the total infant mortality rate is 47 per 1,000. The country has a high maternal mortality ratio of 254 per 1,00,000 births ((National Family and Health Survey 3).

“This is a tragedy not just for those girls but also for their children: babies are 60 per cent more likely to die if their mother is under 18,” said Save the Children India CEO Thomas Chandy.

In many countries, it is normal for young girls to be married off and they become pregnant before their bodies have developed sufficiently, says the report. An estimated 10 million girls under 18 are married off every year, or more than 25,000 every day.

For many women and girls, contraception is not accessible or affordable, and others are prevented from resorting to it or they put it off, thanks to social or cultural barriers or myths about side-effects.

Around the world, now some 222 million women who don’t want to get pregnant do not have access to contraception. It is estimated that this year 80 million unintended or mistimed pregnancies will occur in developing countries.

A Population Council study in India of 58,000 young people found that one-fifth of the women were married off before the age of 15, half of them before they turned 18 and two-thirds before 20. Not only did marriage occur at a young age but also it was often arranged without the participation of young people themselves, particularly the girls, says the study.

“The issue of children having children — and dying because their bodies are too immature to be delivered of the baby — is a global scandal,” said Save the Children’s chief executive Justin Forsyth.

In this context, the NGO is urging world leaders — who are congregating in London next month for a family planning summit hosted by the U.K. government and the Bill & Melinda Gates Foundation — to increase global availability of contraceptives and empower girls and women to decide whether and when they will have children and how many. It is also calling for equal access to family planning for all women, for women’s rights to be guaranteed and enshrined in law, and for investment in education and health workers.

According to the NGO’s report, globally one among five girls will have had a child by the age of 18, with the young mothers likely to be poor, less educated and living in rural areas. The probability of a 15 year-old-girl dying during or after childbirth is one in 3,800 in developed countries and one in 150 in developing countries.

Healthier spacing, by which women delay conceiving by up to 36 months after the previous delivery, could prevent 1.8 million deaths of children under five a year — 25 per cent of annual child deaths, says the report.