Meeting the needs of married adolescent girls is critical to improving maternal health worldwide

At long last, we are seeing increasing global attention to a population that has long been neglected in global health, development and humanitarian programming – adolescent girls. Last month, the U.S. government released a Global Strategy to Empower Adolescent Girls, which followed significant commitments by U.S. global AIDS program (DREAMS) and USAID (Let Girls Learn) toward reducing HIV infections among adolescent girls and young women, and toward keeping girls in school.

The Sustainable Development Goals, via Agenda 2030, contained an impressive 17 references to adolescent girls, and over the past two years, countries as diverse as the UK, Nepal, Ethiopia and Zambia have hosted national and regionally-focused “Girl Summits” aimed at promoting girls’ empowerment and reducing child marriage.

Despite these impressive steps, we have a long way to go to improve the lives of adolescent girls worldwide, including most particularly 70 million child brides across the world. While it’s a key focus of ICRW to prevent and end child marriage, we simply cannot forget those who are already married, of which there are far too many.

The numbers are shocking. Some 15 million girls each year are forced into marriage before they turn 18. One in nine girls in developing countries is married before the age of 15. Despite what many well-meaning parents may believe when they marry off their daughters early, child marriage is neither a healthy nor a safe environment for girls.

Often unable to control if and how they have sex, married girls are at a disadvantage when negotiating contraceptive use and accessing information about family planning. Good sexuality education is rare in any context, and for the majority of married girls, any sex education they might have otherwise obtained in school is no longer available to them, because so many girls who marry early chose, or are forced, to drop out of school.

Around the world, more than 90 percent of births to adolescents each year take place within the context of marriage. Giving birth too young places girls at high risk of maternal morbidity and mortality. According to the World Health Organization, complications during pregnancy and childbirth, including obstetric fistula, are the second leading cause of death for 15-19 year-olds globally. But it is not only the health and futures of girls that are at risk, their children are also less likely to survive infancy and to live past the age of five, and often suffer disproportionately from malnutrition and low educational attainment over time.

A forthcoming study by ICRW demonstrates that very few health programs focus on or even seek to meet the needs of married adolescents, despite the known linkages between child marriage and poor health outcomes. Married girls need access to rights-based and youth-friendly health information and services that would enable them to plan their pregnancies and have safer births.

Mental health is another area for which married girls need support. Until recently, maternal mortality was the leading cause of death for adolescent girls aged 15 – 19 worldwide. The good news is that maternal mortality rates have been dropping globally, including for adolescents. This trend, however, has revealed a new leader in this unfortunate category – suicide. Among the key risk factors for suicide are social isolation, barriers to accessing health care, trauma, abuse, and relationship conflict – many of which married adolescents face on a daily basis. Research in India shows girls who married as children were twice as likely to experience physical abuse at the hands of their husbands, for example.

Married girls deserve attention and appropriate services to meet their full range of health needs. But even as we seek to meet the needs of married girls, we must continue to identify ways to end the harmful practice of child marriage. A new set of tools produced by ICRW and Girls Not Brides provides guidance for those working across a range of sectors, including health, economic growth, education and human rights, to help prevent and mitigate child marriage.

Join ICRW in signing this petition to the UN Secretary General, requesting that the UN officially recognize April 11th as the International Day for Maternal Health and Rights. Remind the global community that every woman and girl should have the right to choose if and when she becomes a mother, and that every girl should have the right to a childhood.