PAHO Latin America, Caribbean 2nd-highest for adolescent pregnancies

LATIN America and Caribbean are the second in the world for adolescent pregnancy rates with 60.7 births per 1,000 girls between the age of 15 and 19 according to data gathered between 2015-2020 by the Pan American Health Organization (PAHO) and the United Nations Family Planning Association (UNFPA)..

October 18-24 is the inaugural Adolescent Pregnancy Prevention Week in the Caribbean, commemorated by PAHO and UNFPA.

Pregnancy during adolescence can have far-reaching negative and irreversible consequences for both the young girl and her child. Each year in the region, five out of every 100 pregnancies occur in girls under 20, and 2 million children are born to young mothers between 15 and 19 years.

With an estimated adolescent fertility rate of 60.2 per 1,000 girls 15-19 years, the Caribbean sub-region is below the overall rate. However, Dr Sonja Caffe, PAHO Regional Adolescent Health Advisor, said in a joint release from PAHO and UNFPA that there are wide variances between countries.

Caffe said, “The rates range from 100.6 in the Dominican Republic to 82.6 in French Guyana, 90.1 in Guyana, to 17.2 in Grenada. High demand for family planning among adolescent girls in the Caribbean and substantial differences among age groups and across countries is a concern.

"For instance, 61.9 per cent among 15-19 years versus 21.4 per cent among 35-39 years old in Guyana or 59.7 per cent among 15-19-year olds, versus 20.3 per cent among those 35-49-year-old in Suriname.”

Cafe noted adolescent pregnancy has been exacerbated by the interruption of sexual and reproductive health services due to the pandemic.

“We recognised that fear of going to the health facilities, lockdowns or restrictions to movement, health centres that are closed or operating with reduced services and health providers that may have been redirected to covid19 prevention and management, coupled with the shifting of financial resources for sexual and reproductive health programs for adolescents and young people have often resulted in a lack of timely access to health sexual and reproductive health services and more concretely to contraception.”

Projections from UNFPA, Avenir Health, Johns Hopkins University and Victoria University show that if the pandemic closures extend for another six months with high levels of disruption, the impact on girls and women would be disastrous with seven million unwanted pregnancies, 31 million cases of gender-based violence, and 13 million child marriages worldwide.

Adolescent pregnancy disproportionately affects girls who are already marginalised and further affects their educational and employment opportunities, thus contributing to the continuation of intergenerational cycles of poverty, exclusion, and marginalisation.

Regional leaders and stakeholders are being called to focus on adolescent pregnancy prevention as one of the social and economic consequences of this pandemic.

Countries have formulated strategies and plans and implemented actions to address adolescent pregnancy. However, too often, interventions are not evidence-based, not developed in a participatory approach with young people, and implemented at a limited scale.

Physical consequences and risks of early pregnancy include damage to the pelvic floor and increased risk of preeclampsia, eclampsia, premature delivery, unsafe abortions, maternal deaths, and sexually transmitted infections including HIV.

Early pregnancy has potential mental health implications, including anxiety, depression, suicidal thoughts and attempts, and posttraumatic stress, especially when the pregnancy is the result of sexual violence. Consequences for the child range from premature births, low birth weight, less likely to breastfeed, less likely to receive proper nutrition, health care and early childhood development, among others.

A recent UNFPA study in six Latin American countries estimated that the socio-economic costs associated with adolescent pregnancy in these countries were close to US$9 billion annually, related to lost education and labour gaps, preventable health care costs and lost taxes.