Does Climate Change Increase the Risk of Child Marriage? A Look at What We Know--And What We Don't--With Lessons from Bangladesh & Mozambique

While child marriages are almost always the result of multiple interconnected factors, this Article will examine the existing evidence of a connection between the impacts of climate change and child marriage and analyze some of the research and monitoring gaps. Are existing climate change policies, as well as measures taken to reduce and eliminate child marriage, addressing this link? What are the human rights obligations of governments to protect girls from child marriage, including in times of disaster? Part I of the Article summarizes the current state of research about the causes and consequences of child marriage, followed by a review of the available research on connections between child marriage and climate change. It will examine the extent to which evidence has been gathered on this topic and assess the different ways in which impacts of climate change have been found to influence decisions regarding child marriage. It will argue that, while there are significant gaps in the research, there is growing evidence that climate change may exacerbate the rate of child marriage. Part II presents two country-specific case studies of the potential connection between climate change and child marriage in Bangladesh and Mozambique, two countries that are highly vulnerable to climate change and have rates of child marriage among the highest in the world. It also reviews laws and policies adopted by Bangladesh and Mozambique to cope with climate change and to reduce child marriage, and what lessons these efforts provide for other countries facing similar challenges. Part III reviews relevant obligations of governments under international human rights law and within the international climate change regime. In Part IV, the Article proposes measures to ensure that climate change mitigation efforts are grounded in an understanding of the gendered ways in which climate change affects women and girls, including through increased child marriage, and that anti-child marriage efforts take into account the impacts of climate change

Magnetic resonance imaging of vaginal support structure before and after Vecchietti procedure in women with Mayer–Rokitansky–Küster–Hauser syndrome

IntroductionIt is unclear how pelvic floor supporting structures might be affected by the absence of the vagina. It was the aim of this prospective study to analyze the magnetic resonance imaging morphology of pelvic support prior and after a Vecchietti procedure in women suffering Mullerian agenesis (Mayer–Rokitansky–Küster–Hauser syndrome).Material and methods26 women with a diagnosis of Mayer–Rokitansky–Küster–Hauser syndrome associated vaginal agenesis were recruited prospectively prior to the laparoscopic creation of a neovagina according to the Vecchietti procedure. The primary outcome measure was the magnetic resonance imaging morphology of supporting structures. Secondary outcome measures were anatomical and functional vaginal length. Follow up was conducted six months after surgery.ResultsTwenty‐six women were analyzed. Mean age was 19.8 ± 4.4 years (±SD) and mean body mass index was 23.7 ± 4.3 kg/m2 (±SD). All were Caucasian. Supporting structures consistent with cardinal and uterosacral ligaments were visible on magnetic resonance imaging in all cases (100%). There were no levator ani defects. The vaginal apex could be visualized postoperatively in 12 women (46.2%) reaching up to Level I. The vagina was visible in both Level II and III with normal relations to the pelvic walls in all cases. On gynecological examination, vaginal length was 8.8 ± 2.1 cm (mean ± SD) anatomically and 10.2 ± 2.2 cm (mean ± SD) functionally.ConclusionsThe preoperative presence of pelvic support structures into which the vagina is lengthened by the surgery likely explains the uncommon occurrence of vaginal prolapse in women who had the Vecchietti procedure.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144648/1/aogs13350_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144648/2/aogs13350.pd