Social norms stop Ethiopian girls from making safe choices about pregnancy

Despite progress in reducing the rate of adolescent pregnancy, more than 16 million adolescent girls globally become parents each year. According to the World Health Organisation, 90% of these young mothers live in the global South.

Girls in countries with the highest adolescent fertility rates, many of which are in sub-Saharan Africa, are also the most likely to be malnourished without access to quality maternity care or safe abortions. This leads to complications and consequences that can last a lifetime.

Maternity is a leading cause of disability for girls aged 15-19, according to the World Health Organisation.

The maternal mortality rate for girls under 16 years is around four times that of women in their early 20s. In low and middle-income countries, the overwhelming majority of adolescent pregnancies occur in marriage.

In developing countries, an estimated babies born each day to girls under the age of 18 are born to those who are already married.

A report on Ethiopia released last year corroborates this. In Ethiopia 60% of girls are married by the age of 18. This is a significant factor in the high rate of pregnancy among 15 to 19 year olds.

However, many adolescent girls don’t get the care they need. Free contraceptives are available in most communities in Ethiopia, but many girls lack social access because of conservative cultural and religious norms. A dominant norm is that girls need to give birth as quickly as possible after marriage to prove their fertility.

Adolescent girls and community health workers also report that service providers — contrary to their official mandate — are also unwilling to provide advice on contraceptives because of these powerful norms.

What this means is that young, married girls too often don’t get the family planning information they need. They also don’t get support in negotiating with their husbands and families to take control of their own fertility.