Abstract
The debate about whether to permit girls to attend school after becoming pregnant has been in the headlines in Sierra Leone, Tanzania, and elsewhere.1Bhalla N Tanzania lets pregnant girls attend school with World Bank project.https://www.reuters.com/article/us-tanzania-women-education-trfn/tanzania-lets-pregnant-girls-attend-school-with-world-bank-project-idUSKBN21P2WEDate: 2020Date accessed: July 29, 2020Google Scholar Advocates for permitting girls to remain in school affirm that education is a human right.2Human Rights WatchLeave no girl behind in Africa: discrimination in education against pregnant girls and adolescent mothers.https://www.hrw.org/report/2018/06/14/leave-no-girl-behind-africa/discrimination-education-against-pregnant-girls-andDate: 2018Date accessed: February 19, 2020Google Scholar Critics propose that permitting girls to return might encourage more adolescent pregnancy, even as countries seek to reduce adolescent childbearing.3The LancetPreventing teenage pregnancies in Brazil.Lancet. 2020; 395: 468Google Scholar Evidence on the consequences of girls returning to school after they become pregnant is limited, and identifying the effect on subsequent outcomes can be challenging.4Psaki S Does getting pregnant cause girls to drop out of school?.https://www.devex.com/news/sponsored/does-getting-pregnant-cause-girls-to-drop-out-of-school-85810Date: 2015Date accessed: February 19, 2020Google Scholar Allowing pregnant girls in school mitigates one adverse consequence of pregnancy (ie, having to drop out), and the benefits of being in school might disincentivise second pregnancies. Peers who interact with pregnant classmates might also update their beliefs about pregnancy, either favourably or unfavourably. We examined Demographic and Health Surveys data from nine countries in Africa that overturned bans on girls returning to school after pregnancy between 1993 and 2015 (appendix p 3). Across these nine countries, the average pregnancy rate among girls aged 14–20 years was 14·4% in the year of the policy change that allowed pregnant girls in school (the year of the policy change varied across countries). 2 years before the policy change, the pregnancy rate was at 13·7%, showing that the rate subsequently rose by 0·7%.2 years after the policy change, the average pregnancy rate across countries was 13·3%: an absolute reduction. We calculated the expected pregnancy rate—based on the trend in the 2 years before the policy change—and observed how different the actual pregnancy rate was relative to the expected rate. If the pregnancy rate had continued to change at the same rate in the 2 years after the policy change as it had in the 2 years before the policy change, the average rate across the nine countries would have been 15·1%. However, the observed rate 2 years after the lifting of the ban is just 13·3%. Although the change in pregnancy rate varies across countries, the rate after the policy change falls in six of nine countries relative to expectations (appendix p 1); two of those declines are statistically significant. The proportion of girls who report both having been pregnant and currently attending school rises across countries in the 2 years after the policy change. This evidence suggests that allowing girls who have been pregnant to attend school is unlikely to boost fertility. In fact, it might even boost the human capital of these girls. We declare no competing interests. Download .pdf (.36 MB) Help with pdf files Supplementary appendix
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