March 2014
ADOLESCENT PREGNANCY IN LAC:
MAGNITUDE, CONSEQUENCES, RISK FACTORS
AND POLICY OPTIONS
BASED ON TEENAGE PREGNANC...
• Motivativation: magnitude of the phenomenon and
implications for social advancement
• Complex decision making process
• ...
 LAC countries have some of the highest teenage pregnancy
rates in the world
 In a context of adolescent fertility rates...
Teenage pregnancy is relevant from a development-policy
perspective mainly for two reasons:
1) Adolescent pregnancy is a m...
 Prior studies find significant correlation between early motherhood
and negative outcomes for the mother and the child
...
Teenage pregnancy might in addition:
 Increase the risk of maternal mortality, fetal death, and infant mortality, as
well...
COMPLEX DECISION MAKING PROCESS
Teenage pregnancy associated with:
Lack of opportunities (poverty, social exclusion)
Macro level:
- Adolescent fertility i...
1) Opportunities/endowments/assets
Macro level:
 reduction of inequality and the creation of more opportunities for women...
Thank you!
ANNEX
WHAT WE OBSERVE?
Adolescent fertility rate in LAC is
higher than in countries with similar
growth and poverty: 2000 – 2010
based on World D...
RISK FACTORS
RISK FACTORS
CONSEQUENCES
AFTER OBSERVATIONS – TO DISCUSS
FRAMEWORK?
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Situación Actual de la Salud y Bienestar de los Adolescentes en América Latina y el Caribe. Dra. Elizaveta Perova, Banco Mundial.

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  • Inequities in adolescentpregnancy – basedonTeenagePregnancy Regional Study
  • - adolescent mothers differ along a number of important unobserved dimensions from women who delay childbearing
  • -1)INFORMATIONmost interviewees had sexual education classes in schoolhuman anatomy versus sexual interaction, risks, behavior etc.Lack of space and comfort to raise questions- Families are not able to fill this gap – shame and avoidance – tabooization of sexuality2) CONTRACEPTIONAccess to contraception sometimes limited by shame and fear to purchase them“When you are 16 you don’t go to the drugstore and ask for a condom or a preservative; that is embarrassing. I wouldn’t do it. And then how would you ask to an older friend to buy it for you? He’ll ask why would you buy it? Just do it without protection, it feels better. Then you do it to avoid embarrassment and don’t realize the consequences and that you are entering a vicious circle.” (Partner of a pregnant girl, 27 years old, mestizo, incomplete secondary school, MB.)3)PEER effects-stigmatization costs are reduced4) Intended pregnancy Domestic spaces dominated by violence & controlpregnancy intended as an exit strategyForming a new family and one’s own home seems to be the only exit option to the girlsreflects limited set of opportunities available to them 5) Gender stereotypesGirls expected to behave passivelyOften difficult for them to negotiate their sexuality and have full autonomy over their bodies.Power asymmetries within couples: adolescent girls report they tried to convince their partner to use a condom, not always successfully6)Lack of control over life projectsMajority of girls do not mention an explicit and conscious motivation to their pregnancy. Lack of well-defined goals, aspirations and clearly-framed life projects that they are decided to stand up for and defend. Does not seem to interrupt careers Passivity - “Let it happen” Pregnancy “happened due to – life itself”“In my case, I think it was “whatdoesitmatterism” (quemimportismo)”A qualitative study in Ecuador, commissioned for the Regional report found that while most of the young mothers and fathers interviewed had participated in sexual education in school, the majority complained that knowledge received in this context was not meeting their demand as mainly focused on human anatomy instead of sexual interactions, risks, behaviors etc.. In addition, several teenage parents explained that shame and fear to purchase contraception oftentimes inhibited them from effectively accessing them. Only few of the interviewed adolescent mothers had intentionally planned to get pregnant – and if this was the case, pregnancy and the formation of an own family was their strategy to escape their family homes – where some of them were suffering from violence and/or exacerbated controlling behavior. Interestingly though, the formation of an own family was seen as the only strategy to them – which reflects the limited set of opportunities available to these girls. Finally, the vast majority of the interviewees did not mention an explicit and conscious motivation to their pregnancy. Rather they stated that pregnancy ‘ happened’ to them – but that it did not interrupt their life plans, that it was not contradictory to their aspirations and goals necessarily. Pregnancy “happened due to – life itself”. The qualitative work found a lack of clearly defined goals, aspirations and specified life projects that adolescent girls were decided to stand up for and defend
  • so that fertility decisions are made on the basis of life plans they have reasons to value and teenage pregnancy is not the only option at hand or an unintended consequence of behavioral inconsistencies
  • Situación Actual de la Salud y Bienestar de los Adolescentes en América Latina y el Caribe. Dra. Elizaveta Perova, Banco Mundial.

    1. 1. March 2014 ADOLESCENT PREGNANCY IN LAC: MAGNITUDE, CONSEQUENCES, RISK FACTORS AND POLICY OPTIONS BASED ON TEENAGE PREGNANCY REGIONAL STUDY
    2. 2. • Motivativation: magnitude of the phenomenon and implications for social advancement • Complex decision making process • Risk factors • Policy options OVERVIEW
    3. 3.  LAC countries have some of the highest teenage pregnancy rates in the world  In a context of adolescent fertility rates declining worldwide, adolescent fertility in Latin America declines at a record-slow pace.  The annualized rate of decline between 1997 and 2010 was 1.25% in LAC—the lowest after East Asia and the Pacific region. Indeed, the adolescent fertility rate curve in LAC is almost flat over time.  Adolescent pregnancy rates in LAC countries are higher compared to countries in other regions with similar characteristics, in particular those with the same GDP per capita. WHAT WE OBSERVE IN THE REGION
    4. 4. Teenage pregnancy is relevant from a development-policy perspective mainly for two reasons: 1) Adolescent pregnancy is a manifestation of the lack of (economic) opportunities. 2) Early childbearing may have important intra- and inter- generational implications that could trigger intergenerational poverty traps and high social costs. WHY SHOULD WE CARE? The Regional Report assumes the principle that fertility decisions should be the result of choice, rather than defined by constraints.
    5. 5.  Prior studies find significant correlation between early motherhood and negative outcomes for the mother and the child  Background papers for this report: teenage mothers are less likely to complete secondary education, teenage pregnancy decreases years of schooling, lowers school attendance and reduces work hours CAVEATS:  Negative effects attributed to teenage motherhood reduce significantly once one controls for co-founding factors.  this Report focuses on the cost of teen motherhood, and not of teen pregnancy ADOLESCENT PREGNANCY IS A MANIFESTATION OF THE LACK OF (ECONOMIC) OPPORTUNITIES
    6. 6. Teenage pregnancy might in addition:  Increase the risk of maternal mortality, fetal death, and infant mortality, as well as the probability of health problems and morbidity  Impact teen mothers’ opportunities in the marriage market – they are also more likely to live in a single-headed household, to divorce  Cause psychological consequences of being pregnant during adolescence  Increase the risk of serious complications from unsafe abortions  Trigger additional negative impacts on the mother: loss of free- time, friendships, childhood, control over how to spend their time  Trigger additional negative impacts on the fathers: increased responsibility and economic stress, less investment in education Effects on the child:  higher risk of presenting risky behaviors/behavioral problems when they become adolescents. Effects on other members of the household:  Negative effects on the well-being of the siblings of the teen mother  Costs on mothers of the teenage mothers who often take over the care work Coping strategies are unequally distributed INTERGENERATIONAL POVERTY TRAPS AND HIGH SOCIAL COSTS
    7. 7. COMPLEX DECISION MAKING PROCESS
    8. 8. Teenage pregnancy associated with: Lack of opportunities (poverty, social exclusion) Macro level: - Adolescent fertility in Latin American countries correlates positively with poverty, inequality, public health expenditure, female labor force participation rate and negatively with unemployment and the share of rural population. Micro level: - Adolescents who have more education, live in urban areas and come from wealthier families have a lower probability of getting pregnant. Local social and household context: Women may get pregnant due to a lack of agency:  by following existing norms or socially accepted behaviors by having low bargaining power in their relationship and thus being unable to get their partners agree on the use of contraceptives by a context marked by constraints: Girls lack control of their life plans and/or getting pregnant may be the seen as the only goal to be achieved and motherhood as the purpose in life (given the lack of educational and labor market opportunities) or as the main way out of parental homes RISK FACTORS
    9. 9. 1) Opportunities/endowments/assets Macro level:  reduction of inequality and the creation of more opportunities for women  Policies and programs that reduce poverty and gender inequalities Micro level:  affect fertility choices by increasing the opportunities and assets of teenage girls. (policy interventions that focus on increasing education, health, and employment prospects in communities) 2) Intangible assets/agency  Providing adolescents with positive role models;  using peer promoters to increase control over own decisions and shape life plans  Expanding access to youth-friendly reproductive health services;  Supporting comprehensive sexual and family life education Complexity of the phenomenon:  long-term and multi-sectoral approach more effective  complex and simultaneous efforts at different levels (addressing: society, community, family and the individual). POLICY OPTIONS Policy objective should be to widen the set of options for women, as well as their capacity to aspire and to be in effective control over their lives.
    10. 10. Thank you!
    11. 11. ANNEX
    12. 12. WHAT WE OBSERVE?
    13. 13. Adolescent fertility rate in LAC is higher than in countries with similar growth and poverty: 2000 – 2010 based on World Development Indicators
    14. 14. RISK FACTORS
    15. 15. RISK FACTORS
    16. 16. CONSEQUENCES
    17. 17. AFTER OBSERVATIONS – TO DISCUSS FRAMEWORK?

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