ADOLESCENT FERTILITY

In those developed countries where substantial numbers of young women give birth as teenagers, adolescent fertility has been a long-standing concern and is increasingly becoming a concern in the developing world.

To monitor adolescent childbearing, demographers commonly rely on two measures. The adolescent fertility rate is the number of births per 1,000 women aged 15 to 19 and is computed from vital statistics reports or birth history data from fertility surveys. The proportion of women aged 20 or older who have had a child by specified ages, usually 15, 18, and 20, is computed from fertility surveys.

Fertility Rates and Trends

Adolescent childbearing declined in the 1980s and 1990s in much of the world, although substantial numbers of women still gave birth in their teenage years. In sub-Saharan Africa, according to fertility surveys conducted in the 1990s, the percentage of women aged 20 to 24 who gave birth before age 20 ranged from a low of approximately 40 percent in Ghana to a high of around 70 percent in Chad, Mali, Niger, and Uganda with most francophone (French-speaking) countries having elevated rates by comparison to the anglophone (English-speaking) countries. In Latin America and the Caribbean, where data from fertility surveys were available for only nine countries, the percentage ranged from a low of 30 percent in Peru to over 50 percent in Nicaragua. In Asia, in the six countries for which fertility surveys were conducted in the 1990s, Bangladesh stood out: Just over 60 percent of young women in Bangladesh gave birth as teens. This is a considerable decline, however, from the previous generation, when over three-quarters of surveyed women aged 40 to 44 had had a child before age 20. In India and China, of women aged 20 to 24, 49 percent and 14 percent, respectively, reported giving birth as teenagers in surveys from the early 1990s. There were only five Middle Eastern/North African countries for which data were available for the 1990s; in Egypt, just under one-quarter of 20- to 24-year-olds were mothers by age 20, compared with 17 percent in Jordan and Morocco, 26 percent in Turkey, and 45 percent in Yemen.

Within the industrialized world in the 1990s, the percentage of women aged 20 to 24 who had had children as teenagers ranged from 3 percent in Japan to 22 percent in the United States. The latter figure was one of the highest levels in the developed world. The proportion of U.S. women who give birth as teenagers is unusually large in comparison to other wealthy countries–mostly a consequence of less use and less effective use of contraception. It is also worth noting that the U.S. adolescent fertility rate declined less than in Europe between the early 1980s and the late 1990s.

Adolescent fertility rates in the 1990s range from a low of 4 births per year per 1,000 women aged 15 to 19 in Japan to a high of over 200 in Niger and Uganda. Within the industrialized world, there is also considerable variation. In addition to Japan, low rates–under 10–are found in western (Belgium, Netherlands, and Switzerland), northern (Denmark, Finland, and Sweden), and southern Europe (Italy, Spain, and Slovenia). High rates–over 50–are found in some countries of eastern Europe (Armenia, Georgia, Moldova, and Ukraine) and in the United States. In 2000 the U.S. fertility rate for age 15 to 19 was 56.5 (50 among whites, 93 among blacks, and 99 among Hispanics). Within the developing world, adolescent fertility is highest in sub-Saharan Africa, but there are also countries in South Asia and Latin America with teen birth rates of over 100.

The late-twentieth-century decline in adolescent childbearing was especially pronounced in certain sub-Saharan African countries (namely Cameroon, Kenya, Senegal, and Tanzania), the Middle East/North Africa, Asia, and the industrialized countries. In Latin America, adolescent fertility declined in some countries–notably Bolivia, Guatemala, and Nicaragua–but rose in others, such as Brazil and Colombia. Moreover, where declines occurred in Latin America, they were less rapid than declines in the fertility of older women. This pattern was in contrast to many industrialized countries where the adolescent fertility rate fell faster than the overall fertility rate. In monitoring trends in adolescent childbearing, demographers observed that the reported age-specific fertility rate of women aged 15 to 19 declined more than the proportion giving birth before age 20, indicating that while women in many countries were still becoming mothers at a young age they apparently were having fewer births as teenagers. Indeed, there are countries–for example, Burkina FASO, Central African Republic, Ivory Coast, and Bolivia–where the proportion of women giving birth before age 20 has remained stable or even increased slightly since the 1970s but where the adolescent fertility rate has declined. Potential reasons for this include a rise in the age at first marriage and a delay in the age at first birth, and an increase in contraceptive use after the first birth.

Within Marriage Childbearing

There is a perception that most teenage childbearing takes place prior to marriage. In fact, throughout the developing world–and in contrast to the situation in developed countries–the majority of young women who give birth as teenagers do so within marriage. Indeed, one reason why adolescent childbearing has declined in many developing countries is that the proportion of women marrying during their teenage years has fallen. While substantial proportions of young women give birth out of wedlock in sub-Saharan Africa and Latin America, premarital childbearing has not changed or has increased only slightly in most countries in these two regions. (There are some noteworthy exceptions in sub-Saharan Africa, such as Ivory Coast, Kenya, Namibia, Tanzania, and Zambia.) What has increased in many sub-Saharan countries and in the United States, although not in Latin America, is the percentage of births to teenage girls that are premarital.

Consequences of Adolescent Childbearing

Many observers take it for granted that having a child during the teenage years is problematic. But the research on the health, social, and economic consequences of adolescent childbearing reveals a complex set of associations. Adolescent mothers are at much greater risk of poorer health outcomes than are somewhat older mothers, but this is largely a consequence of teen mothers on average being poorer, less well nourished, and less likely to get adequate obstetric care. Indeed cephalopelvic disproportion, a major cause of obstructed labor in developing countries and a condition that is much more prevalent among young mothers, is extremely un-common in developed countries even among teen mothers because nutrition is adequate, physical growth is almost completed by the mid-teenage years, and there is access to adequate delivery services, including cesarean section.

Research on the social and economic consequences of teenage childbearing has been conducted almost exclusively in the United States. The findings are still far from definitive, in large part because of the presence of selection bias–namely, that those who give birth as teens differ systematically in many respects from those who delay. Outcome measures that have been focused on by researchers in the United States include earnings, poverty status, completion of high school, employment, and subsequent fertility. There is a consensus that, although early childbearing has a significant effect on some social and economic outcomes, researchers in the past overstated the deleterious effects of teen childbearing.

The social environment in the developing world is quite different from that of the United States, where most teen childbearing is unplanned or unwanted and occurs outside of marriage and where the opportunity costs of teen motherhood are greater. In many poor countries, particularly in rural areas, early childbearing may benefit a young woman because it increases her status within the family. Nonetheless, there is some evidence from the developing world that as levels of schooling and the demand for skilled labor rise, adolescent mothers, who are often less well educated, may become increasingly disadvantaged.

See also: Fertility, Age Patterns of; Fertility, Non-marital.

bibliography

Alan Guttmacher Institute. 1998. Into a New World: Young Women's Sexual and Reproductive Lives. New York: Alan Guttmacher Institute.

Mensch, Barbara S., Judith Bruce, and Margaret E. Greene. 1998. The Uncharted Passage: Girls' Adolescence in the Developing World. New York: Population Council.

Ribar, David C. 1999. "The Socioeconomic Consequences of Young Women's Childbearing: Reconciling Disparate Evidence." Journal of Population Economics 12: 547–565.

Singh, Susheela. 1998. "Adolescent Childbearing." Studies in Family Planning 29(2): 117–136.

Singh, Susheela, and Jacqueline E. Darroch. 2000. "Adolescent Pregnancy and Childbearing: Levels and Trends in Developed Countries." Family Planning Perspectives 32(1): 14–23.

Zabin, Laurie Schwab, and Karungari Kiragu. 1998. "Health Consequences of Adolescent Sexuality and Fertility Behavior in Sub-Saharan Africa." Studies in Family Planning 29(2): 210–232.

Barbara S. Mensch

Susheela Singh