cephalopelvic disproportion and fetal distress. Adverse fetal outcomes include premature births, low birth weight infants, Still Births, birth asphyxia, Respiratory Distress Syndrome and birth trauma or injury. 10 1.5 Socio-economic Consequences There are many economic and social consequences of adolescent pregnancy that affect the adolescents themselves, their children, families and communities and reverberate throughout their lives and for generations after. Numerous studies have indicated that pregnant adolescents and young mothers face stigma or rejection by parents, peers and community at large and are more likely to experience violence within marriage or a partnership. Isolation, stigma and discrimination can then lead to stress and depression and other related problems at home and in school. Pregnant and parenting adolescents face stigma, lack of emotional support, poor health access and stresses around new life adjustments. 11According to (Black et al), Adolescent girls who become pregnant are significantly poorer than their peers, with poorer nutrition and general health. This in turn increases the likelihood of fetal, perinatal and maternal death and disability by as much as 50 per cent. 12About 5% to 33% of girls’ ages 15 to 24 years drop out of school in some countries as a result of early pregnancy or marriage. This
WHO. Global health estimates 2015: deaths by cause, age, sex, by country and by region, 2000–2015. Geneva: WHO; 2016. 11 Kumar, M., Huang, K., Othieno, C. et al. Adolescent Pregnancy and Challenges in Kenyan Context: Perspectives from Multiple Community Stakeholders. Glob Soc Welf 5, 11–27 (2018). 10
jeopardizes their future education employment opportunities. 13
and
1.6 The Adolescent Pregnancy context in Kenya Kenya has a relatively youthful population where about 78% of the population is under 34 years of age. Adolescents constitute about 36% of the total population yet they experience some of the worst reproductive health outcomes such as: adolescent pregnancies, abortions, high unmet need for contraceptives. Mortality rate is also high in women aged between 15 and 19 years compared to other segments of the population. 14 KDHS (2014) indicates that 18% of young women age 15-19 have begun childbearing: 15% have already had a live birth and an additional 3% are pregnant with their first child. Adolescent childbearing varies widely by county, from a low of 6% in Murang’a to a high of 40% in Narok. Young women with no education are much more likely to have begun childbearing (33%) compared to those with secondary or higher education (12%). The median age of first intercourse is 18 for women and 17 for men. 15% of women and 21% of men had their first sexual encounter by age 15. Age at marriage varies widely by county of residence with women marrying the earliest in Migori, Tana River and Homa Bay at just over 17 years. Women living in Nyeri marry the latest, at a median age of 21.8 years. Overall, more than one-quarter of women are married by Adolescent Pregnancy - Its Impact on Maternal and Fetal Outcome .Gazala Yasmin1, Aruna Kumar2, Bharti Parihar3. InternatiŽŶĂů :ŽƵƌŶĂů ŽĨ ^ĐŝĞŶƚŝ Į Đ ^ƚƵĚLJ ͮ DĂƌĐŚ ϮϬϭϰ ͮ sŽů ϭ ͮ /ƐƐƵĞ ϲ 13 Economic Impacts of Child Marriage: Global Synthesis BrieF world bank 2017 14 KNBS 2009 census 12
