Adolescents’ access to sexual and reproductive health and rights

July 20, 2017

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A new publication of the Centre for Reproductive Rights analyses young people’s access to sexual and reproductive health from a human rights perspective. It concludes that significant gaps remain in adolescents’ knowledge about their sexual and reproductive health and rights and ability to access essential sexual and reproductive health services.

The report Capacity and consent. Empowering Adolescents to Exercise their Reproductive Rights examines the barriers adolescents face in realizing their sexual and reproductive health and rights, discusses recent critical developments in the human rights framework underpinning these rights, and proposes a way forward for guaranteeing all adolescents the full exercise of their sexual and reproductive health and rights, including their right to make informed decisions about their sexuality and reproduction.

From the introduction

Capacity and Consent: Empowering Adolescents to Exercise their Reproductive RightsNotably, the Committee on the Rights of the Child and the Special Rapporteur on the Right to Health have strongly affirmed the importance of adolescents’ sexual and reproductive rights, urging states to take a host of specific measures to ensure the full exercise of these rights. Their renewed calls to action for states to prioritize these rights provides a strong foundation for states to build upon in strengthening their current laws, policies and practices to respect, protect, and fulfill adolescents’ sexual and reproductive health and rights.

Currently, one in four adolescent girls aged 15-19 have an unmet need for contraception – meaning that they are sexually active or considering becoming sexually active but do not have modern methods of pregnancy prevention. The failure to enable and empower adolescents to prevent pregnancy results in over 7 million girls under the age of 18 giving birth each year, and nearly one-fifth of girls in the developing world becoming pregnant before the age of 18.

Unintended pregnancy and childbearing can profoundly alter adolescents’ lives, undermining their educational attainment, economic opportunities, and ability to participate in public and political life. These affects are exacerbated for girl children, who have greater sexual and reproductive health needs due to their reproductive capacities, are likely to face greater barriers in accessing sexual and reproductive health services, and must contend with gender roles and stereotypes surrounding childrearing. For many girls, bearing a child signifies the end of their formal education, either due to formal expulsion by the school as a sanction for becoming pregnant, or as a result of their childrearing obligations or need to work in order to support the child.

Enabling girls to delay pregnancy is a key element of realizing their right to education, which in turn enables them to have greater economic opportunities, social empowerment and financial independence. At the same time, girls may face greater barriers in accessing sexual and reproductive health services. In part, this is due to the stigma surrounding girls’ sexuality and social norms dictating that girls should only be sexually active for the purpose of procreation or only in the context of marriage. Gender norms and stereotypes can also result in girls being denied access to family resources, such as the financial means to pay for health services; receiving less education, and therefore having less information about their sexual and reproductive health and rights; and having greater household responsibilities, resulting in less time to seek and access health services.

Furthermore, pregnant adolescents may face inadequate access to quality maternal health care, paired with unique risks that can accompany early childbearing. As a result, 70,000 girls die each year as a result of complications during pregnancy or childbirth, making it the leading cause of death for girls aged 15-19 in developing countries. Furthermore, 3.2 million minors in developing countries undergo clandestine, unsafe abortions each year, placing their lives and health in jeopardy. In places with high rates of child marriage, girls – including young girls – who become married can face significant pressure to become pregnant almost immediately, in order to demonstrate their fertility, resulting in early pregnancies and their attendant health risks.

Further, although much of the research around adolescent pregnancy and childbearing has focused on developing countries, inadequate sexual and reproductive health services for adolescents is pervasive in both developed and developing countries, with disproportionate effects for poor adolescents, racial and ethnic minorities, and rural adolescents.

Download the report Capacity and Consent. Empowering Adolescents to Exercise their Reproductive Rights (PDF), Centre for Reproductive Rights, 2017