By: Katherina Lister
Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the KCL Latin American Society or El Cortao
There is an ongoing pandemic taking place in Latin America. This is not the pandemic that may currently pop to the forefront of one’s mind, but rather one that has persisted for decades: teen pregnancy, a common occurrence throughout the region. It can be the norm to see teenagers with one, if not several, children. While a young mother with children may not be a cause for concern in isolation, the societal impact of heightened teen pregnancies raises several issues.
Today, many Latinx families are the result of teen pregnancies. Even if it isn’t the case for a family’s latest generation, they can often look back only one or two generations to find a teen pregnancy. Of course, times have changed, and the prevalence is not as high as it once was. A few generations ago, not only were teen pregnancies more common, but it was very much a part of the societal structure of Latin America. This societal structure has transformed as a result of globalization, yet there are still many young mothers bearing children. With Latin America having been dealt a heavy dose of colonialism and the many societal injustices that come with it, the impact that teen pregnancies have on social mobility has been laid bare.
Teen pregnancies are strongly linked to poverty, social exclusion, gender-based violence, and early marriages. These associations facilitate a vicious cycle, in which teenage girls already suffering from societal injustices have these issues compounded if they become pregnant. This can then lead to ramifications throughout a girl’s life as she is at an increased risk of dropping out of school, resulting in decreased employment and financial security. Moreover, children born from a teen pregnancy are at an increased risk of having one themselves. The problem is therefore intergenerational.
By the Numbers
It is important to understand and quantify teen pregnancy. In Latin America and the Caribbean (LAC), the total fertility rate – the number of children per woman – has declined. However, adolescent fertility– in women aged 15 to 19 – colloquially “teen pregnancy”, is declining at a much slower rate. The adolescent fertility rate in LAC is estimated to be the second highest in the world with 60.7 births per 1,000 women, compared to the global average of 44 per 1,000. In addition, there has been a rising trend of pregnancies in females aged under 15 in LAC, the only region in the world where this increase is taking place.
The probability of having an adolescent pregnancy in the region is up to four times higher in girls who are illiterate, only have an elementary education, or are from rural areas. This rate is even higher in the indigenous population.
This trend has been an area of much investigation by the World Health Organisation, Pan-American Health Organisation (PAHO), among many others. Nonetheless, progress has been slow and unsteady throughout the decades.
There are identifiable factors that have contributed to this slow progress, namely: the healthcare system in Latin America, government policies regarding pregnancy, and access to contraception. These three areas not only contribute to the high rate of teen pregnancies but can also be used as vehicles for change in decreasing this trend.
Healthcare & Policy
Healthcare in Latin America varies by country of course. Despite these differences, there are systemic similarities in access to healthcare regardless of the specific country. Monetarily, rising healthcare costs due to technological advances, chronic diseases, and an ageing population have led to problems raising public funds for health coverage. In addition, investment in healthcare is heavily politicised, therefore factors such as economic stability and political ideals provide an uncertain and volatile funding landscape.
According to a study conducted by the London School of Economics, total health expenditure as a proportion of gross domestic product has increased in Latin American countries in the past 15 years. However, there is an inefficient delivery of care and a delayed uptake of healthcare reform. To exacerbate this, the provision of resources to rural areas, where the majority of teen pregnancies occur, also presents inequalities in access to medicine.
A policy affecting teen pregnancy rates that has garnered much attention in Latin America is abortion. Abortion is currently illegal in El Salvador, Nicaragua, Honduras, and the Dominican Republic. In countries where abortion is legal, specific requirements must be met in order to proceed. This can include a lengthy ordeal of doctor referrals and legal processes, further alienating at risk adolescent pregnant women. Thus, if a teenager becomes pregnant and wants to seek an abortion, she typically pursues illegal avenues to do so. The World Health Organisation estimates that over 4 million illegal abortions take place every year in Latin America and the Caribbean. Often these methods are unsafe and have contributed to the region’s high maternal mortality rate.
Maternal mortality is also increased by the many cases of sexual violence in Latin America. Instances of rape, sexually transmitted infections such as HIV, and domestic violence all contribute to the high number of maternal deaths. More recently, mortality has also been affected by the COVID-19 pandemic, where government responses have led to the suspension of many maternal services.
Contraception
According to PAHO, providing adequate contraceptive access to teens could avoid 2.1 million unplanned births, 3.2 million abortions, and 5,600 maternal deaths each year.Contraception can act as a source of empowerment for young girls to exert autonomy over their bodies and sexual decisions. Unfortunately, there are many barriers in accessing contraception in Latin America. Rural areas, social stigma, and a lack of sexual education are all factors preventing the widespread use of contraception.
A PAHO official, Sonja Caffe, stated that “reducing poverty and increasing access to education and development opportunities would undoubtedly be an important step on the path to reduce unplanned pregnancies in teenagers, but it wouldn’t be enough. It’s also necessary to give teenagers access to effective, high-quality information, and sexual and reproductive health services.” This highlights the importance of a multifactorial approach to preventing teen pregnancies of which sexual education, combined with contraceptive use, is critical.
Looking at the issue on a more individual level, teenage girls often do not want to become pregnant. Many are aware of the availability of contraceptives and have even been taught sexual education in school. Despite this, girls may still be reluctant to use contraception due to the associated social stigma and gossip. While some Latin American countries have set up sexual health clinics to access contraception, in smaller villages where girls can be seen in the waiting room of the clinics, gossip can carry on to families that their daughters are sexually active.
Looking Ahead
Moving forward, to decrease teen pregnancies in Latin America, it is crucial to improve access to healthcare. This would encompass increased expenditure to allow for a more universal coverage and for better access to healthcare in rural and poor income areas where teenage pregnancies are highest. In addition, government policies regarding sexual health, such as abortion laws and the impact of COVID-19 on maternal services, must be addressed to reduce maternal mortalities.
Provision of contraception and reducing the social stigma of its use are also vitally important. Additionally, widespread sexual education is necessary to reduce teen pregnancies. If these improvements are made, there will be fewer adolescent girls dropping out of school, lessening the gender gap in education and increasing social mobility. This would provide teenage girls with a platform to attain higher positions in employment and public life. While teen pregnancy is still rampant throughout Latin America, there have been several recent protests against sexual violence, abortion, and maternal mortality serving to galvanise support and recognition of the issue.
Katherina is a fourth-year Medical student at King’s College London. Half-Colombian, Half-American, she is passionate about access to medicine in Latin America and the Latinx community of the United States.
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