Abstract
BackgroundMarried adolescent girls are vulnerable to risky sexual and reproductive health outcomes. We examined the association of fertility pressure from in-laws’ early in marriage with contraceptive use ever, parity, time until first birth, and couple communication about family size, among married adolescent girls.MethodsData were taken from a cross-sectional survey with married girls aged 15–19 years (N = 4893) collected from September 2015 to July 2016 in Bihar and Uttar Pradesh, India. Multivariable regression assessed associations between in-laws’ fertility pressure and each outcome, adjusting for sociodemographic covariates.ResultsWe found that 1 in 5 girls experienced pressure from in-laws’ to have a child immediately after marriage. In-laws’ fertility pressure was associated with lower parity (Adj. β Coef. − 0.10, 95% CI − 0.17, − 0.37) and couple communication about family size (AOR = 1.77, 95% CI 1.39, 2.26), but not contraceptive use or time until birth.ConclusionsOur study adds to the literature identifying that in-laws’ pressure on fertility is common, affects couple communication about family size, and may be more likely for those yet to have a child, but may have little effect impeding contraceptive use in a context where such use is not normative.
Highlights
Married adolescent girls are vulnerable to risky sexual and reproductive health outcomes
Plain English summary Adolescent girls who marry early are vulnerable to poor reproductive health outcomes including low contraception use and unwanted pregnancy due to low decisionmaking agency and communication with their husbands
Married adolescent girls in India live in a gender inequitable context facing fertility pressures from their in-laws and extended family rooted in social norms
Summary
Married adolescent girls are vulnerable to risky sexual and reproductive health outcomes. We examined the association of fertility pressure from in-laws’ early in marriage with contraceptive use ever, parity, time until first birth, and couple communication about family size, among married adolescent girls. Among girls aged 15–19, one in six is married and about 16 million give birth annually [2, 3]. They often lack knowledge, agency, and resources to make family planning decisions [4]. Women and girls often lack control over family planning and fertility decisions such as timing of pregnancy, family size, and contraception due to extended family’s influence [6, 7]. Fertility pressures from in-laws’ may be a particular concern, especially for adolescent wives who are more likely to be in joint families or residing near in-laws’ [8]
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