Counting the Invisible: Uncovering the childbearing trends of West Africa's youngest adolescents

Written by: Ann Garbett, University of Southampton, Professor Brienna Perelli-Harris, University of Southampton, Dr Sarah Neal, University of Southampton

Pregnancy in adolescence can pose severe health risks and long term social and economic disadvantage to young mothers and their babies, but childbearing patterns among the youngest remain essentially invisible. Common fertility measures exclude mothers aged 14 years and younger, and do not distinguish 15-year-old mothers from 19-year-olds even though the causes and consequences of motherhood at these ages differ considerably. Repeat births in adolescence, which carry additional serious health risks, are also obscured by traditional measures. Almost nothing is known about patterns of second and third (or more) births to adolescents.

Our innovative research, using nationally representative survey data, dives deep into West Africa’s adolescent childbearing trends to detail the patterns of the youngest vulnerable mothers. It reveals important and alarming trends.

The report outlines key findings from a comprehensive study of advanced demogrpahic techniques of the birth histories of nearly 400,000 women born from 1940 to 1994 from 51 Demographic and Health Surveys in twelve West African countries and their impacts on policy. 

• Early adolescent fertility is not a marginal issue. There is an intense need to acknowledge the very young age of first births in many contexts, as well as how the youngest mothers make disproportionately large contributions to overall adolescent fertility.

• The most common fertility measures are inadequate for capturing the intricacies of adolescent fertility. Without appropriate measures, policy and programming frameworks miss out on key targeting needed for differences in age, repeat birth and inter-birth spacing patterns.

• The number of adolescents giving birth at very young ages raises important issues around the rights of the girl-child in relation to protection from early, child and forced marriage and coerced or non-consensual sexual relationships. Legal frameworks need to be developed, adopted and effectively enforced to protect the rights and safety of adolescents, particularly those in the younger age groups.

• Efforts to reduce adolescent pregnancy need to specifically target girls starting childbearing very young, and may require distinct strategies that appropriately reflect the young adolescents’ level of cognitive development as well as their low autonomy and empowerment. Including men and boys in these efforts is vital.

• Comprehensive sexuality education (CSE) needs to reach adolescents before sexual activity commences and, when CSE is provided in school, before boys and girls leave school—both of which can happen at young ages. Within CSE, for both boys and girls, challenging negative gender norms and building skills to negotiate healthy relationships is key. Opportunities for delivering CSE to out-of-school youth need to be considered.

• Access to contraception through quality, youth-friendly sexual health services—to both prevent and space pregnancy—is key. This may well require different approaches and channels for service delivery depending on the adolescent’s age, and whether girls have already started childbearing.

Find out more