Marital status and fertility among adolescents under 15 years of age

Abstract

Pregnancy at an early age is risky. On the one hand, adolescent mothers are more likely to have miscarriages, stillbirths, preterm deliveries, and to seek induced abortion. Also, adolescent childbearing can also increase health risks of newborns, such as low birthweight and poor neonatal conditions. On the other hand, early pregnancy can lead to early marriage. Since out-of-wedlock pregnancies are often socially disapproved in less developed countries, pregnant adolescents may not have other choice than marriage. Early marriage reinforces gender inequality and exclusion from the decision on when and whom to marry. A rising age at marriage could be the most critical factor in postponing early adolescent childbearing and in meeting sexual and reproductive health rights. Most studies have focused on adolescents between 15 and 19 years of age mainly due to the paucity of data for adolescentes under 15 years of age. However, in recent years there is increasing information on young adolescents. Thus, we focus on births to adolescent mothers between 10 and 14 years of age. To our knowledge, there is no research that analyzes the effect becoming pregnant before the age of 15 to early marriage. We examine the characteristics of adolescents under 15 who become pregnant, and whether an early pregnancy precipitates early marriage or whether pregnancies occur within marriage. We compare our results with adolescents aged 15-19 to examine whether patterns are similar or different. We expect that births in early adolescence are more likely to occur within marriage among poorer adolescents and that births in early adolescence are more likely to precipitate a change in marital status among wealthier adolescents. Patterns are similar between adolescents under 15 and 15-19; however, the proportion of births within marriage is higher among older adolescents. We use all available DHS from 70 countries located in Latin America, North Africa & West Asia, South & Southeast Asia, and sub-Saharan Africa. We use birth histories to identify all births to adolescents under 15 and adolescents aged 15-19. We first compute age-specific fertility rates for the age groups 10-14 and 15-19. Second, we assign the marital status at the time of birth. Then, from the date of birth and date of first union we infer whether the pregnancy occurred in or out of wedlock and whether there was a change in marital status after the pregnancy. To do this, we calculate the date of the pregnancy by going back the number of months the pregnancy lasted. We also examine differences by place of residence and wealth quintile to see if there are specific patterns between richer and poorer adolescents, or between adolescents living in urban and rural areas. Where possible, we will use contraceptive calendar data to explore whether there was a change in marital status following pregnancies that did not go to term. Also, we use logistic regressions to model the effect of early pregnancy on the odds of changing marital status. Approximately 4 out of every 5 births in adolescents under 15 years of age occur within marriage, however, one of them was conceived when the adolescent was still unmarried. In other words, 20% of adolescent mothers under 15 who marry do so because they became pregnant. Regional averages show that more than half of the pregnancies in Latin America and sub-Saharan Africa occur when adolescents under 15 are still unmarried. In addition, there are differences according to the level of household wealth. Overall, pregnancies in adolescents under 15 years of age are more frequent in poorer households. In Latin America and sub-Saharan Africa, it is more likely that a pregnancy occurs within marriage in poorer households. Conversely, the wealthier the households, the more likely it is that a pregnancy will precipitate a change in marital status in adolescents under 15. Interestingly, the proportion of births to not-in union adolescent mothers under 15 also increases with wealth quintile. Differences by quintile are less evident in North Africa & West Asia and in South & Southeast Asia. Births to adolescents under 15 are considerably more frequent in rural areas than in urban areas, except in Latin America where the differences between areas are not as clear. It is more common for adolescents under 15 years of age to be single mothers in urban areas of Latin America and sub-Saharan Africa than in urban areas of the other geographic regions. We present an analysis of the relationship between marital status and fertility in adolescents under 15, which has been little explored so far. Our findings show that a significant proportion of young adolescent mothers rushed into marriage because they became pregnant. In the particular case of sub-Saharan Africa, which is also the region with the highest fertility in the world, the age-specific fertility rate of adolescents aged 10-14 is mostly explained by births that were conceived before marriage. Adequate access to contraceptives would have prevented both early pregnancy and early marriage. In contrast, in all geographic regions, the age-specific fertility rate of adolescents aged 15-19 is explained by the fertility of married adolescents. Adolescent girls, especially those under 15 years of age, face a double burden following an unintended pregnancy. On the one hand, an unintended birth, which leads to negative outcomes for both mother and child, and on the other hand, an unplanned marriage that conditions the adolescent's life. The fertility of adolescents under 15 years of age is positively correlated with the fertility of adolescents between 15 and 19 years of age. Begining childbearing earlier implies higher fertility later. A considerable proportion of births in adolescents between 15 and 19 years of age correspond to mothers who gave birth before the age of 15. We find that social conceptions that disapprove of out-of-wedlock pregnancies have a greater impact on adolescents under 15 years of age who come from wealthier households