Preventing Early Pregnancy Brief
Preventing Early Pregnancy Brief
Preventing Early Pregnancy Brief
Joey OLoughlin
INTERVENTIONS MUST
AIM TO:
Prevent early pregnancy
1. Reduce marriage before age 18
2. Create understanding and support
to reduce pregnancy before age 20
3. Increase use of contraception by
adolescents at risk of unintended
pregnancy
4. Reduce coerced sex among
adolescents
WHO
Women and health: Todays evidence, tomorrows agenda. Geneva, World Health Organization, 2009.
State of the Worlds Children 2011: Adolescence an age of opportunity. New York, UNICEF, 2011.
Joey OLoughlin
The Millennium Development Goals Report 2011. New York, United Nations, 2011.
Women and health: Todays evidence, tomorrows agenda. Geneva, World Health Organization, 2009.
Sexually active adolescents are less likely to use them than adults,5 even in places
where contraceptives are widely available.
WHOs recommendations for increasing the use of contraception are informed by 7 graded and 26 ungraded
studies conducted in 17 countries, as well as the conclusions of a panel of experts. The studies were conducted in
Bahamas, Belize, Brazil, Cameroon, Chile, China, India, Kenya, Madagascar, Mali, Mexico, Nepal, Nicaragua, Sierra
Leone, South Africa, Tanzania and Thailand. Some focused exclusively on increasing condom use, while others
examined increasing the use of hormonal and emergency contraceptives. In some, increasing contraception
was a primary outcome whereas in others it was secondary. Some studies focused exclusively on health system
actions (such as over-the-counter or clinic provision of contraceptives) while others focused on community and
stakeholder engagement to increase contraceptive use. Collectively, these studies demonstrate that contraceptive use can be increased as a result of actions directed at multiple levels policies, individuals, families, communities and health systems.
How universal is access to reproductive health? A review of the evidence. New York, United Nations Population Fund, 2010.
* Conditional recommendation
Girls in many countries are pressured into having sex, often by family members. In some
countries, over a third of girls report that their first sexual encounter was coerced.6
WHOs recommendations for reducing coerced sex are informed by two graded studies, six ungraded studies or
reviews of laws, and the collective experience and judgment of an expert panel. The studies and reviews were
conducted in Botswana, India, Kenya, South Africa, Tanzania and Zimbabwe. Collectively, these studies suggest
that actions to influence community and gender norms can have positive effects on the ability of girls to resist
coerced sex and on the attitudes of men and boys towards coerced sex.
Multi-country study on womens health and domestic violence against women. Geneva, World Health Organization, 2005.
WHO
Policy-makers must support efforts to inform adolescents of the dangers of unsafe abortion and to improve their access to safe abortion services, where legal.
They must also improve adolescent access to appropriate post-abortion care,
regardless of whether the abortion itself was legal. Adolescents who have had
abortions must be offered post-abortion contraceptive information and services.
Ahman E. and I. Shah, New estimates and trends regarding unsafe abortion mortality, International Journal of Gynecology and Obstetrics
115 (2011) 121-126.
In some countries, adolescents are less likely than adults to obtain skilled care
before, during and after childbirth.8,9
WHOs recommendations for increasing the use of skilled antenatal, childbirth and postpartum care are informed
by one graded study, one ungraded study, existing WHO guidelines and the collective experience and judgment of a
panel of experts. The studies were conducted in Chile and India. One intervention was a home visit programme for
adolescent mothers. Another was a cash transfer scheme contingent upon health facility births. Collectively, these
studies suggest that interventions to increase the use of skilled antenatal, childbirth and postpartum care can result
in improved health outcomes for adolescent mothers and newborns.
Ensure that adolescents, their families and communities are well prepared for
birth and birth-related emergencies.
Pregnant adolescents must get the support they need to be well prepared for birth and birth-related emergencies,
including creating a birthing plan. Birth and emergency preparedness must be an integral part of antenatal care.
Reynolds, D, Wong, E, and Tucker, H. Adolescents use of maternal and child health services in developing countries. International Family
Planning Perspectives, 2006, 32(1): 6-16.
Magadi, M A, Agwanda, A O, and Obware, F A. A comparative analysis of the use of maternal health services between teenagers and older
mothers in sub-Saharan Africa: evidence from Demographic and Health Surveys (DHS). Social Science and Medicine, 2007 Mar, 64(6):1311-25.
UNFPA
Contact details
World Health Organization
Department of Maternal, Newborn, Child and Adolescent Health
20 Avenue Appia, 1211 Geneva 27, Switzerland
Tel +4122 791 3281 Fax +4122 791 4853 Email: [email protected]
Web site: http://www.who.int/maternal_child_adolescent/en/