More than 12 million adolescent girls between ages 15 and 19 gave birth in 2019. Girls who give birth before adulthood are likely to bear increased health risks, social stigma, and adverse economic impacts for the rest of their lives.

Pregnancy and childbirth are the leading cause of death among adolescent girls aged 15-19. More than half of the abortions that occur among adolescent girls are unsafe. They also face higher health risks than adult mothers aged 20-24, including complications from childbirth contributing to maternal mortality, low baby birthweight, and severe neonatal conditions.

Teenage mothers are less likely to continue going to school, which prevents them from realizing their full potential and finding better economic opportunities, and often results in reduced lifetime earnings. Adolescent pregnancy can also affect future generations, for example daughters of teenage mothers are at a greater risk of teenage pregnancy themselves, perpetuating intergenerational cycles of poverty.

Adolescent pregnancy is generally not a result of deliberate choice, but rather stems from the lack of choices when it comes to marriage and contraceptive use. The level of early childbearing is typically measured by the adolescent fertility rate, defined as the annual number of births per 1,000 adolescent girls aged 15-19.

Global and regional trends in adolescent fertility

Whether school dropout for teenage mothers is a contributing factor for pregnancy or is the result of being pregnant is hard to discern. A qualitative assessment in Ecuador was conducted to understand the behavioral patterns of teenage mothers, and it showed that a lack of agency, limited aspirations for the future and a lack of concrete life goals among adolescents appeared to be one of the key determinants for teenage pregnancy among adolescent girls.

The measure for the share of youth not in education, employment, or training (NEET) furthers our understanding. NEET includes discouraged worker youth and youth outside the labor force for various reasons including engagement in household responsibilities. In a study from 2010, authors estimated that of all the female youth aged 15 to 24 in Latin America & the Caribbean, 7 in every 10 girls were NEET girls, of which 20 percent of them had started their own household with children, in comparison to only 30 percent NEET boys of which only 1 percent had started their own family with children.

From more recent data (2019), we see that the share of female NEET youth has fallen but is still almost double (27 percent) that of male youth (15 percent). Even though we don’t know the share of NEET youth who started their own families with children from 2019, engagement in household care work is a close approximation. 70 percent of NEET girls were responsible for household care work, but only 10 percent of the NEET boys were engaged in unpaid domestic work or caregiving.

Efforts to combat adolescent fertility in Latin America & the Caribbean

To reduce adolescent pregnancy, programs to enhance future aspirations and life plans have been implemented in the region. Juventud y Empleo in the Dominican Republic is one such program which provided soft skills training to adolescents. Interventions included improvements in self-esteem, self-efficacy, and enhancement of life plans. The program successfully reduced teenage pregnancy by 20 percent by improving adolescents’ soft skills as well as their aspirations and expectations from life.

Subsidio Educativo was a conditional cash transfer (CCT) program in Colombia where adolescent girls received a subsidy if they attended school, completed their school year, and enrolled in the following year. This program was also effective in reducing pregnancy among adolescents across all grades included in the program.

The success of these programs highlights that ensuring adolescents stay in school, providing them with life skills’ training, and generating awareness about the impact of unintended early childbearing can be effective strategies in preventing teenage pregnancies.

The COVID-19 pandemic brings new challenges

The Sustainable Development Goals (SDGs) recognize the severe consequences of adolescent fertility for individual girls and society and aim to achieve universal access to sexual and reproductive healthcare services. Many economies have made continued efforts and improvements in adolescent girls’ health, social, and economic status. However, with adolescent girls outside the protective environment of schools and therefore at greater risk of early pregnancy, the COVID-19 crisis threatens to reverse this progress.

While the evidence on these impacts is still emerging, media reports suggest more teenage girls have become pregnant. For example, in Gauteng, the most heavily populated province in South Africa, the number of births to adolescent mothers increased by 60 percent since the pandemic started. As outlined in the World Bank's Gender Dimensions of the COVID-19 Pandemic brief, recovery efforts and policies need to ensure continued and expanded investments in the human development of adolescent girls for more inclusive and sustainable growth.