Today, one of the most serious health threats from which adolescent girls suffer from is Adolescent pregnancy. On average, 16 million adolescent girls give birth each year, which constitutes approximately 11% of all births globally. Due to the high prevalence of child marriage in India, most adolescent pregnancies occur within the sacrosanct bond of marriage. The age of 15-19 years is usually termed as ‘adolescence’. It is defined as a period of transition from childhood to adulthood.
Adolescence pregnancy can also be termed as ‘motherhood in childhood’. The significant factors causing pregnancy among young girls includes early marriage, illiteracy, lack of proper socio-economic conditions, lack of proper health facilities, poor awareness, lack of acceptability & use of contraceptive, and deficiency in prenatal care of the women. It is a multifaceted problem that exists in both developed & developing countries and affects society at large. Young girls involving in sexual acts at an early age are quite unlikely to use contraception for avoiding pregnancy. It may be due to a lack of knowledge and information about contraception and the restrictions behind it.
Health complications during pregnancy
The present adolescent mortality rates in the age groups of 15-19 years can be attributed to early marriages and health complications, especially during pregnancy and childbirth. Along with this, gender discrimination also prevents effective responses to the health needs of young girls. Today, adolescent fertility constitutes more than half of India’s total fertility, and many of them suffer from poverty.
As per the reports, the complications resulting from pregnancy and childbirth are among one the leading causes of death in adolescent girls. Thus, adolescent pregnancy is a serious health threat to women in India. It also leads to sexually transmitted diseases, mental disorders, pregnancy-induced hypertension, anemia, along a high rate of neonatal mortality. Most of them aren’t ready either physically or psychologically for pregnancy or childbirth, so this reproductive process often results in ruining their health. Adolescent fertility may lead to abortion which in turn can result in serious maternal complications, and may even lead to pelvic inflammatory disease and subsequent infertility to the women. It can also lead to subsequent birth injuries to the child, or abnormal childbirth.
Rights of Adolescent girls
There are several fundamental rights provided by the constitution of India that protects the integrity of young girls. Some of them are listed below:
- The Right to Equality
- The Right to freedom of speech and expression
- The Right to Life
- The Right to live a healthy childhood
- The Right to Freedom from all forms of discrimination
- The right to be protected from all sorts of violence and gender bias
- The Right to education. They are forced to leave school which deprives her educational right.
- The Right to health; they are prevented from using any contraception or reproductive health-related information, which violates their right to health.
- These are some of the rights that every girl is entitled to, but surprisingly many of these rights are violated. They have to face discrimination and a lot of gender-based stereotypes.
The laws regulating Adolescent Fertility in India
Before 1971, abortion was an offense under Sections 312 to 316 of the Indian Penal Code except in the case when there is danger on the life of the pregnant woman, which led to increasing in cases of illegal abortion. Consequently, the Medical Termination of Pregnancy Act, 1971 was passed which made abortion legal in India. Although the reason for the introduction of abortion rights in India was to control the growing population rather than for the protection of the rights of the women. Section 3(4) of the MTP act, provides that, a minor girl can abort her pregnancy but with the consent of her legal guardian i.e., Father/husband (after marriage). According to this act, termination of pregnancy can be provided at the discretion of a medical practitioner up to 20 weeks of gestation period under certain conditions –
- When the continuation of pregnancy threatens the life of a pregnant woman or may cause injury to her physical or mental health;
- When there is a risk that the child would be seriously handicapped when it is born due to physical and mental abnormalities;
- When pregnancy is caused due to rape;
- When pregnancy is caused due to failure of any contraceptive methods used by a Married woman or her husband.
The MTP Act of 1971 is completely outdated today because medical science has made tremendous progress after which the Medical Termination of Pregnancy (Amendment) Act, 2021 was passed. It had brought some major changes including the increase of gestation limit from 20 weeks to 24 weeks. And in the provision or failure of contraceptive methods, the ‘married woman or her husband’ have been replaced by ‘women or her partner’, so that unmarried women and teenage girls can also have access to abortions in cases of unwanted pregnancy. This law provides women with their reproductive rights to some extent, but still, there is no provision for unconditional pregnancy.
In India, marriages between 15 and 18 years of age are voidable, which means when a woman attains majority, she has the right to nullify the marriage. Now, the female consenting age has been increased to 18, yet, there is no change in the consenting age of a married minor girl. The Prohibition of Child Marriage Act, 2006 provides the right to give consent to women above the age of 16 years, but in cases of unwanted pregnancy, she does not have the right to take an abortion without the consent of her legal guardian.
The adolescent fertility rate has fallen significantly in India since 2004. The North Eastern States have the highest Adolescent Fertility except Nagaland. While the states of West Bengal and Tripura record more than 80 births per 1000 women aged 15 to 19 and in Assam & Bihar with 60 to 80 births. Himachal Pradesh, Jammu & Kashmir, and Ladakh recorded less than 23 births per 1000 women aged 15-19 and in the Central States like Maharashtra and the South Indian States have 40-60 births per 1000 women aged 15-19 while in Kerala 18 births per 1000 have been recorded. The highest decline occurred in Nagaland and Telangana. In Nagaland, the adolescent fertility rate declined from 42 to 19 births per 1000 women aged 15 to 19, and in Telangana, it reached 48 from 67 births per 1000 women aged 15-19.
Moreover, in 16 countries including India, the contribution of the birth rate of adolescents aged 18-19 was more than 75 percent. Also, the proportion of adolescents among women in the reproductive age group (15-49 years) decreased between 1990-1995 and 2015-2020.
There are many reasons for this speedy rate of decline in adolescent fertility. Some of it includes the increasing modern contraceptive methods to prevent couples from having an unintended pregnancy, the introduction of abortion laws, poverty reduction, and improvement in income inequality. However, social norms such as early marriage, pro-fertility norms, and toxic masculine ideology still remain a problem.
Thus, the existence of adolescent fertility has become less as compared to the recent past, but still, there is a long way to go. Time and again, various rights which are made for the protection of women and girls are violated, and they are being deprived of their rights and even the necessities of life. One of the reasons for this may be the backward position of women in society. But, today, in the 21st century, a lot of those differences are torn off, and we are working for the development of women and their rights. Among these, the important aspect remains adolescents’ right to choose, to make their own decisions, to have the right to good health and education. Hence, the age of women is an extremely important factor that affects their fertility levels. After analyzing the data it can be surely said that today there has been a decline in the adolescent fertility rate from the past few years due to several reasons, but still, a lot is yet to be achieved.
If we want to eradicate the existing social stigmas from their root, it will require the cooperation of the country as well as its citizens. There are some of the things we could do to get a better world for women and girls. They are as follows; the awareness about women and child rights should be increased, there should be a focus on the study of young girls, rather than being pushed into household and marriage, awareness campaigns about the knowledge of contraceptives, their use, and benefits among young girls and their parents should be increased, the healthcare system should be more efficient in dealing with adolescents’ problems, etc. Most importantly all, sex education in schools and even in rural areas must be provided. Doctors and Researchers suggest that postponement in first pregnancy may be encouraged for adolescents. It may lead to long-term health benefits to them and may contribute to the economy of the country.
According to the reports of the United Nations, India is expected to have the biggest national rise of adolescent girls up to 95 million by 2030. At present, we don’t have any law specifically dealing with adolescent pregnancies. Therefore, we need to undertake imperative measures and more stringent laws should be made for regulating teenage pregnancies, in order to control the maternal and infant mortality rate.