Adolescent Birth Research Articles

Association between quality of antenatal care service utilisation and adverse birth outcomes among adolescent women in 22 Sub-Saharan African countries. A mixed-effects multilevel analysis

ObjectivesThis study aimed to assess the association between the quality of antenatal care (ANC) service utilisation and adverse birth outcomes among adolescent women in Sub-Saharan Africa (SSA). MethodsA two-level mixed-effects model was employed using the recent Demographic Health Survey (DHS) data from 22 SSA countries. Both bivariable and multivariable multilevel analyses were conducted to assess the association between individual and community level factors with adverse birth outcomes. The results of the fixed effects model were interpreted in the form of adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs). ResultsIn SSA, 23.5 % of adolescent mothers experienced adverse birth outcomes. This study found that receiving high quality ANC was associated with a 28 % reduction in the likelihood of adverse birth outcomes (AOR = 0.72, 95 % CI: 0.63, 0.83). Among the individual-level factors, middle-aged adolescence (AOR = 1.23, 95 % CI: 1.11, 1.36), being a female newborn (AOR = 1.15, 95 % CI: 1.05, 1.26), single marital status (AOR = 0.87, 95 % CI: 0.78, 0.96) and higher educational status (AOR = 0.83, 95 % CI: 0.74, 0.93) were significantly associated with adverse birth outcomes. From the community-level variables, women from Eastern Africa had positive significant association with adverse birth outcomes (AOR = 1.30, 95 % CI: 1.15, 1.46). ConclusionsNearly one-fourth of adolescent women in SSA experienced at least one type of adverse birth outcome. Low quality of ANC was significantly associated with adverse birth outcomes. Policymakers need to consider a comprehensive, essential, and minimal package of ANC to enhance the quality of ANC, which is crucial for better adolescent birth outcomes.

‘I want to be a different kind of father’: a qualitative analysis of adolescent fatherhood in Perú

Adolescent parents and their offspring experience worse health outcomes throughout the life course. While over 90% of adolescent births occur in low- and middle-income countries, data from many such countries are lacking, particularly from fathers. This qualitative study conducted in Lima, Peru characterises the experience of adolescent fathers and identifies potential intervention targets. Interviews with young fathers and the mothers of their children were coded and analysed using thematic analysis and a grounded theory approach. Factors impacting their experience included family support, changes in their relationship with their partner, gender dynamics, and financial pressure. The study identified family and couple conflict, gendered expectations, and the father’s personal development as potential intervention targets. Further research is needed to develop interventions that effectively engage adolescent fathers in low- and middle-income countries such as Peru, and support their transition to fatherhood.

The Impact of Dietary Intake and Nutritional Status on Birth Outcomes Among Pregnant Adolescents: A Systematic Review

Birth outcomes have been linked to the overall maternal general health including nutrition as well as maternal age during pregnancy. Compared to adults, delivery outcomes during adolescence are poor. Nutrient intake and nutrition status during adolescent pregnancy may be linked to birth outcomes. This review aims to identify the association between dietary intake and nutrition status of pregnant adolescents and their maternofetal outcomes. Literature search on nutrient intake and nutritional status of pregnant adolescents (aged 11-19 years) which identified 17 English papers from 1995 to 2019 was reviewed. Papers that did not include data on birth outcomes in relation to nutrient intake or nutritional status were excluded. The review showed that most micronutrients with the exception of Riboflavin, vitamins B12 and C were below the recommended levels whilst macronutrients levels were above the recommended levels. Energy intakes were also below the recommended levels. Most studies presented normal hemoglobin levels in the first trimester of pregnancy but these levels decreased as pregnancy progressed to the third trimester leading to a high prevalence of anemia. Well-regulated provision and intake of micronutrient supplementation and nutrition education to improve healthy eating habits will significantly reduce poor birth outcomes such as low birth weights (LBW), still births, preterm deliveries, small or large for gestational age (SGA and LGA) and intrauterine growth restrictions in pregnant adolescents. This review provides to a large extent evidence to support the importance of adolescent nutrition and birth outcomes. There is the need to implement policies to improve adolescent nutrition through a multisectoral approach.

Adolescent Birth Rate: Between Women Participation in Parliament or Women Population with Secondary Education

This study is constructed to find causal relation between women's participation in parliament (X1) and the women population with secondary education (X2) toward adolescence birth rate in the world. The data was taken from UNDP Gender Inequality Index. This research used a quantitative method with an explanatory design in which the researchers try to see how two independent variables affect the dependent variable using multilinear regression. The finding shows that X1 generates positive causal inference while X2 creates negative causal reference toward the dependent variable with 0.009547 and -0.730165. It means that based on the hypothesis testing using multiple linear regression, it is revealed that the first hypothesis is rejected, and the competing hypothesis is accepted. By means that the involvement of women in parliament is not significantly affected in reducing the adolescent birth rate yet the higher population in secondary education is proven statistically significant in causing a lower adolescent birth rate in the world.

Assessing trends in internalizing symptoms among racialized and minoritized adolescents: results from the Monitoring the Future Study 2005-2020.

The prevalence of depressive symptoms has rapidly accelerated among recent US adolescent birth cohorts, yet there remains little understanding of trends among racialized and minoritized groups. These groups may experience depressive symptoms due to the deleterious effects of structural racism. Using 2005-2020 Monitoring the Future survey data, we examine all racialized groups using within-group analyses to observe trends in high levels of depressive symptoms across cohorts. Generally, across racialized groups and ages, the odds of high depressive symptoms increased in recent birth cohorts. For example, among 15- to 16-year-old students racialized as American Indian or Alaska Native and Black Hispanic/Latine, the 2003-2006 birth cohort had 3.08 (95% CI, 2.00-4.76) and 6.95 (95% CI, 2.70-17.88) times' higher odds, respectively, of high depressive symptoms as compared with the 1987-1990 birth cohorts. Moreover, in a given year, 15- to 16-year-olds generally experienced the highest depressive symptoms compared with 13- to 14-year-olds and 17- to 18-year-olds, suggesting that age effects peaked during midadolescence. Depressive symptoms increased among US adolescents by birth cohort, within all racialized and minoritized groups assessed. Public health efforts to reduce disparities may consider barriers such as structural racism that may impact the mental health of racialized/minoritized adolescents while increasing access to culturally competent mental health providers and school-based services. This article is part of a Special Collection on Mental Health.

Prevalence and Factors Associated with Teenage Pregnancy at Paynesville, Monrovia, Liberia: Facility Based Cross Section Study

Introduction: In Liberia, teenage pregnancy is a serious public health issue that causes social and economic hardship. Adolescent birth rates are among the highest in sub-Saharan Africa, according to statistics. There are significant differences in the prevalence of teenage pregnancy between and within nations. Most teenage pregnancies occur in places with poorer incomes and lower levels of education. The purpose of this research is to determine the prevalence of teenage pregnancy in Liberia and to investigate the risk factors related to it, particularly in the Paynesville city community of Duport Road cow field block "B.".
 Methods: The research that was done using the Duport Road Clinic as a resource center provided the data for this study. Fifty girls between the ages of 15 and 19 who visited the hospital and lived in the community throughout the study period were recruited as participants. Total population sampling was used to interview all 50 of the females. A population-based cross-sectional survey is used in this quantitative study to gather data, and IBM 20.0 SPSS was used for analysis.
 Results: According to the report, 50.2% of adolescent girls between the ages of 15 and 19 had started having children at the time of the survey. Teenage pregnancy in the community was significantly correlated with age (OR = 6.9; 95% CI: 4.647, 10.366, p – value 0.001), teenagers living with their parents (OR = 1.057; p > 0.001), non-use of contraception (OR = 2.53; 95% CI: 1.739, 3.683), and teenage girls who were aware of contraceptive methods (OR = 2.86, 95% CI = 0.443, 18.463).
 Conclusion: In conclusion, a number of factors, including early sexual initiation, cohabitation, lack of education, and contraceptive non-use, contribute to the high rate of teenage pregnancy in Liberia. Interventions including encouraging the use of contraception, discouraging early sexual beginning, and setting up family planning clinics are advised in order to lessen its prevalence.

Adolescent Childbearing and Associated Factors in Vietnam

This research examines the factors influencing adolescent girl childbirth in Vietnam by employing data from the 2019 Vietnam Population and Housing Census and socio-ecological theory. The research underscores the substantial impact of environmental systems on adolescent childbirth, encompassing age, marital status, educational level, living area, and ethnicity. Higher adolescent birth rates are observed among older adolescents, ethnic minorities, and those with lower levels of education; this highlights the significance of cultural norms, restricted healthcare access, and poverty in influencing these results. The study emphasizes the importance of education, access to healthcare, and community support in mitigating the occurrence of pregnancies among adolescents. It further advocates for focused interventions that enhance the development of human capital, with a specific focus on rural regions and ethnic minority populations. To lessen the hazards associated with adolescent pregnancy, the study recommends policies that reduce child marriage and early motherhood and enhance education and knowledge on sexual and reproductive health.

Using Total Cohort Fertility in Adolescence (TCFA) to analyse adolescent fertility trends and factors in Niger: Evidence from 1992 to 2012 demographic and health surveys.

Girls aged 10-19 currently represent 12% of Niger's population (2020). And this number continues to grow as the fertility rate is higher while mortality is declining faster. Using Niger's demographic and health surveys carried out between 1992 and 2012, the study investigated adolescent fertility, its trends and associated factors. It mobilised descriptive methods (Total cohort fertility in adolescence (TCFA) computation, distribution of the number of adolescent births, and computation of adolescent cohort childbearing mean age) and multivariate Logistic and Poisson models. The result shows the TCFA went from 1.29 in 1992 to 1.17 in 2012. Early sexual intercourse and marriage, infant mortality, the desire for a large family, and urbanisation are among the factors significantly associated with adolescent fertility in Niger. The study concludes that the high level of adolescent fertility in Niger does not seem to be changing.

Association between adverse childhood experiences and bodily pain in early adolescence.

We aimed to examine the relationship between lifetime exposure to adverse childhood experiences (ACEs) during the first decade of life and recent pain features reported in early adolescence. We conducted a prospective study using data from 4564 adolescent Generation XXI birth cohort participants recruited in 2005-2006. Adverse childhood experiences were reported by children at ages 10 and 13years using a 15-item questionnaire. Recent pain features (e.g., any pain, pain sites, recurrent pain intensity, and recurrent pain duration) were measured using structured questionnaires, including the Luebeck pain screening questionnaire at age 13. Using hierarchical binary and multinomial logistic regression analyses with progressive adjustments for confounders, we estimated the associations [adjused odds ratios (aOR) with their 95% confidence intervals (95% CI)] between exposure to ACEs at 10 and pain features at 13years. The study revealed a statistically significant association between exposure to ACEs reported at age 10 and any pain experienced at age 13 (OR=1.09; 95% CI [1.07, 1.12]). Even after accounting for the newly reported ACEs at age 13, the association with ACEs at age 10, remained significant (aOR=1.11 [95% CI, 1.08-1.14]). Consistent patterns were observed when the number of pain sites, recurrent pain intensity, or recurrent pain duration were used as outcome variables instead of any pain at age 13. Adverse childhood experiences occurring during the first decade of life predict the onset of pain features during early adolescence. Consequently, childhood exposure to adversity should be considered a pivotal initial exposure in a pathway leading to chronic pain later in life.

From 'Pen Sao' to 'Tue Pa': Understanding diverse pathways to adolescent pregnancy in Lao People's Democratic Republic through qualitative investigation with girls in Vientiane Capital, Vientiane Province, and Luang Namtha.

Adolescent birth rates in Lao People's Democratic Republic (PDR) remain the highest in Southeast Asia. There is growing recognition that adolescent pregnancy in Lao PDR is occurring within and outside marriage, but there is a lack of robust qualitative evidence to understand girls' pathways to adolescent pregnancy and contributing factors, especially outside of union (cohabitation or marriage). This study aimed to improve understanding of pathways to adolescent pregnancy in Lao PDR among girls who experienced pregnancy at age 18 or below. We conducted participatory timeline interviews with 57 girls from urban, peri-urban, and rural communities in Vientiane Capital, Vientiane Province, and Luang Namtha, and follow-up interviews with a subset of 20 girls. We identified six pathways to pregnancy, including pathways outside (n = 23) and within union (n = 34). Outside-union pathways diverged according to the nature of sex preceding pregnancy (consensual/pressured, or forced), and pregnancy intention (unplanned, partner-led, or planned). Within-union pathways diverged according to the nature of the relationship before union (romantic or no romantic relationship/arranged union), who initiated the union (couple/girl, parent/partner, or pressured), and pregnancy intention. Factors contributing to girls' pregnancy included barriers to sexual and reproductive health (SRH) information and services; partner's control over reproductive decision-making; male sexual entitlement and alcohol use driving pressured/forced sex; cultural acceptance of child marriage and early union; and attitudes and norms regarding sex and pregnancy outside of union. Our findings support strengthening comprehensive sexuality education, including a focus on addressing myths about contraception, building girls' and boys' communication skills, engaging in respectful relationships, and addressing harmful gender norms. Our findings also highlight the need to improve girls' access to adolescent-responsive SRH services, address harmful substance use, challenge sociocultural barriers to young people accessing SRH information and services, and respond to sociocultural and financial drivers of child marriage/early union that contribute to adolescent pregnancy.

Characteristics, utilization of reproductive health services and AI prediction among Taiwanese adolescent mothers during the COVID-19 pandemic.

Although adolescent birth rates have declined globally, the sexual and reproductive health of adolescent mothers remains an area of specific concern, and these were impacted by the COVID-19 pandemic. This study investigates characteristics, utilization of reproductive health services (RHS) and artificial intelligence (AI) prediction during the pandemic. We conducted an exploratory study using data for 2020-2022 from the Taipei City Government Health Bureau. Adolescent mothers under the age of 20 received post-birth telephone-based RHS, covering contraception, abortion, postpartum care, and social welfare support. The data analysis included descriptive statistics, and various machine learning techniques were employed, including random forest, SVM, KNN, logistic regression, and Bayesian network analysis. Of 112 participants, most were aged 17 to 19 (80.4%) and married (58.0%). The majority had full-term deliveries (86.6%) with healthy infants. A high percentage had not used contraception before conception (60.7%), and some had had earlier abortion or termination experiences (13.4%). In the examination of eight influential factors, the machine learning models, specifically the random forest and Bayesian network analyses, exhibited the highest accuracy, achieving 90.91% and 89%, respectively, in predicting service acceptance. The key determinants identified were abortion experience and marital status, directly influencing the acceptance of services. The COVID-19 pandemic reduced hospital visits for adolescent mothers, but the RHS provided timely guidance. Telemedicine consultations and internet-based psychological consultations may play a crucial role in facilitating such services in the future.

Prenatal care utilization and perinatal outcomes among pregnant adolescents in Mexico, 2008-2019.

To describe utilization of prenatal care and outcomes of low birth weight and preterm birth among adolescent births in Mexico. We used birth certificate data and included live births to individuals 10-24 years, 2008-2019. Our outcomes were binary measures of adequate prenatal care, low birth weight, and preterm birth. We compared adolescents (10-14 years, 15-16, and 17-19) to those 20-24 years. We included individual-, clinical-, and municipality-level variables, used multivariable logistic regression, and calculated adjusted predicted probabilities. We also tested whether receipt of prenatal care moderated the relationship of age with preterm birth and low birth weight. We included a total of 12 106 710 births to women 10-24 years. The adjusted predicted probability of adequate prenatal care increased with age: 56.07% (95% CI 55.82-56.31%) adjusted probability among adolescents 10-14 years compared with 65.51% (95% CI 65.48%-65.55%) among individuals 20-24 years. Receipt of adequate prenatal care in part mitigated disparities in preterm birth and low birthweight across all age groups: 7.30% (95% CI 7.17%-7.43%) adjusted probability of delivering a preterm infant among those 10-14 years who received adequate prenatal care compared with 9.37% (95% CI 9.20%-9.53%) among those 10-14 years without adequate prenatal care. In Mexico, adolescent pregnancies are associated with inadequate prenatal care as well as higher odds of preterm delivery and low birth weight. Youngest adolescents (10-14 years) have the highest probability of adverse outcomes. Adequate prenatal care may help partially mitigate disparities in poor perinatal outcomes.

Childbirth in adolescents - features and outcomes

Introduction. Adolescent pregnancies significantly impact the welfare of young mothers, their infants, and the general population. These pregnancies represent a public healthcare concern associated with numerous consequences. Aim: To investigate the prevalence of adolescent pregnancies and their outcomes. Material and Methods. This retrospective descriptive study included adolescents who gave birth at the Gynecology and Obstetrics Clinic between January 1, 2020 and December 31, 2020. Data on anthropometric measurements, number and mode of deliveries, newborn birth weights, and complications were collected from medical records and statistically analyzed. Results. A total of 174 adolescents (aged 13-19) were included in the study. Most were first-time mothers living in common-law unions. Four spontaneous twin pregnancies were documented. No significant differences were found in the anthropometric measures between younger (<15 years old) and older (16-19 years old) adolescents. Pelvic measurements did not affect the mode of delivery. Younger adolescents and those with smaller pelvic measurements experienced longer hospitalizations. Vaginal delivery was the prominent mode of birth. Newborns delivered by caesarian section had significantly lower birth weights and lengths. While no significant complications during labor and delivery were observed, there was notable postpartum blood loss and higher rates of anemia in the puerperium. Conclusion. Although the number of adolescent pregnancies and births is declining, it still remains a significant concern. Welldeveloped perinatal care and the promotion of reproductive health within educational and health systems could not only further reduce pregnancy rates but also ensure optimal conditions for normal pregnancies and deliveries in adolescents.

Mother, child and adolescent health outcomes in two long-term refugee camp settings at the Thai-Myanmar border 2000-2018: a retrospective analysis.

The study assessed mothers, children and adolescents' health (MCAH) outcomes in the context of a Primary Health Care (PHC) project and associated costs in two protracted long-term refugee camps, along the Thai-Myanmar border. Myanmar refugees settled in Thailand nearly 40 years ago, in a string of camps along the border, where they fully depend on external support for health and social services. Between 2000 and 2018, a single international NGO has been implementing an integrated PHC project. This retrospective study looked at the trends of MCAH indicators of mortality and morbidity and compared them to the sustainable development goals (SDGs) indicators. A review of programme documents explored and triangulated the evolution and changing context of the PHC services, and associated project costs were analysed. To verify changes over time, interviews with 12 key informants were conducted. While maternal mortality (SDG3.1) remained high at 126.5/100,000 live births, child mortality (SDG 3.2) and infectious diseases in children under 5 (SDG 3.3) fell by 69% and by up to 92%, respectively. Maternal anaemia decreased by 30%; and more than 90% of pregnant women attended four or more antenatal care visits, whereas 80% delivered by a skilled birth attendant; caesarean section rates rose but remained low at an average of 3.7%; the adolescent (15-19 years) birth rate peaked at 188 per 1000 in 2015 but declined to 89/1000 in 2018 (SDG 3.7). Comprehensive PHC delivery, with improved health provider competence in MCAH care, together with secured funding is an appropriate strategy to bring MCAH indicators to acceptable levels. However, inequities due to confinement in camps, fragmentation of specific health services, prevent fulfilment of the 2030 SDG Agenda to 'Leave no one behind'. Costs per birth was 115 EURO in 2018; however, MCAH expenditure requires further exploration over a longer period.

Adölesan Annelerin Sosyo-Demografik, Gebelik ve Doğum Özellikleri

Introduction: Adolescence is considered the transition period from childhood to adulthood. Pregnancy at an early age is encountered for various reasons, along with the sexuality that begins in this period. Having a child at an early age carries a high risk for both mother and baby.
 Objective: This study was conducted to determine adolescent mothers' socio-demographic, pregnancy, and birth characteristics in Bartın province.
 Method: The study was conducted as cross-sectional and descriptive. 89 adolescent women who gave birth between August and December 2008 in Bartın province constituted the population. Data were collected through a survey created by the researchers in line with the literature. SPSS 15.0 package program was used to evaluate the data. Mean and percentage were used in statistical evaluation. 
 Results: It was determined that 83% of the adolescent mothers, whose average age was 18, 3 ±0.73 years, were older adolescents, 15% had primary school education or lower, 98% were housewives and worked unpaid in family businesses, and 14% did not have any social security. While 54% of the mothers live in the nuclear family before marriage, 78% live in the extended family after marriage. It was observed that 52% of the adolescent mothers got married by escaping, and 87% had adolescent marriages. It was determined that most adolescent mothers did not receive any information about family planning methods before marriage and did not use pre-pregnancy family planning methods. It was observed that 65% of the adolescent mothers had health problems during their pregnancies, 21% of the babies born had health problems postpartum, 16% of the babies were prematüre, and 8.9% had low birth weight.
 Conclusion: Adolescent mothers should receive family planning information and counseling to prevent adolescent pregnancies, an essential maternal and child health risk group. In primary care studies, it is thought that the risks to maternal and infant health will be reduced by planning appropriate reproductive health services for adolescents.

Adolescent fertility and its impact on educational attainment in Nigeria: A propensity score matching approach

ABSTRACT Teenage childbearing remains a persistent challenge in Nigeria, characterized by a high rate of early adolescent births. This study examines the impact of teenage fertility on educational attainment of young mothers in Nigeria. Utilizing data from the 2018 Nigerian Demographic and Health Survey, we applied propensity score matching techniques to construct a matched sample of non-fertile teenagers aged 15 to19 years that closely corresponds to a sample of fertile teenagers. The results of our analysis reveal that the average treatment effect of teenage fertility is a reduction in education attainment by nearly two and half years. Furthermore, being fertile during the teenage years is associated with a 25 percent decrease in the probability of completing secondary school. This underscores the significant educational challenges faced by young mothers in Nigeria due to early childbirth. Addressing the challenge of early childbearing among adolescent girls in Nigeria is critical not only for the well-being of these girls but also for the country's overall development and future prospects.

Can cash transfer interventions increase contraceptive use and reduce adolescent birth and pregnancy in low and middle income countries? A systematic review and meta-analysis

Becoming pregnant and giving birth under the age of 20 is associated with a range of adverse social, socioeconomic and health outcomes for adolescent girls and their children in Low and middle income countries. Cash transfers are an example of a structural intervention that can change the local social and economic environment, and have been linked with positive health and social outcomes across several domains. As part of a wider review of structural adolescent contraception interventions, we conducted a systematic review on the impact of cash transfers on adolescent contraception and fertility. Fifteen studies were included in the review with eleven studies providing evidence for meta-analyses on contraception use, pregnancy and childbearing. The evidence suggests that cash transfer interventions are generally ineffective in raising levels of contraceptive use. However, cash transfer interventions did reduce levels of early pregnancy (OR 0.90, 95% CI 0.81 to 1.00). There was suggestive evidence that conditional, but not unconditional, cash transfers reduce levels of early childbearing. Given that much of the evidence is drawn from interventions providing cash transfers conditional on school attendance, supporting school attendance may enable adolescent girls and young women to make life choices that do not involve early pregnancy.

Factors associated with adolescent pregnancy in Maharashtra, India: a mixed-methods study

Reducing the adolescent birth rate is paramount in achieving the health-related Sustainable Development Goals, given that pregnancy and childbirth are the leading cause of mortality among young women aged 15–19. This study aimed to explore predictors of adolescent pregnancy among girls aged 13–18 years in Maharashtra, India, during the COVID-19 pandemic. Using a mixed-methods approach, primary data were gathered from two regions in Maharashtra between February and April 2022. Quantitative data from face-to-face interviews with 3049 adolescent girls assessed various household, social, and behavioural factors, as well as the socioeconomic and health impacts of COVID-19. Qualitative data from seven in-depth interviews were analysed thematically. The findings reveal that girls from low socioeconomic backgrounds face a higher likelihood of adolescent pregnancy. Multivariable analysis identified several factors associated with increased risk, including older age, being married, having more sexual partners, and experiencing COVID-19-related economic vulnerability. On the other hand, rural residence, secondary and higher secondary education of the participants, and higher maternal education were associated with a decreased likelihood of adolescent pregnancy. In the sub-sample of 565 partnered girls, partner's emotional abuse also correlated with higher rates of adolescent pregnancy. Thematic analysis of qualitative data identified four potential pathways leading to adolescent pregnancy: economic hardships and early marriage; personal safety, social norms, and early marriage; social expectations; and lack of knowledge on contraceptives. The findings underscore the significance of social position and behavioural factors and the impact of external shocks like the COVID-19 pandemic in predicting adolescent pregnancy in Maharashtra, India. Plain Language Summary: Adolescent pregnancy is an important health issue for young girls. In South Asia, one out of every five adolescent girls becomes a mother before turning 18, and in India, around 9% of girls aged 15–19 get pregnant yearly. This study focused on understanding the factors associated with adolescent pregnancy in Maharashtra, India, especially after the COVID-19 pandemic. We collected information from both urban and rural areas in Maharashtra. A total of 3049 adolescent girls participated in a survey, and seven girls participated in detailed interviews. Our analysis showed that factors like older age, being married, having multiple sexual partners, and experiencing economic difficulties due to COVID-19 increased the chances of adolescent pregnancy. On the other hand, living in rural areas, higher education for both the girls and their mothers reduced the likelihood of adolescent pregnancy. Qualitative analysis revealed that economic challenges, concerns about safety and societal norms, early marriage, societal expectations, and lack of knowledge about contraceptives could contribute to adolescent pregnancy in Maharashtra.

Sequencing of Births by Wantedness: Implications for Changes in Mid-Life Health Among Aging NLSY79 Women.

As life course frameworks highlight and gerontological studies confirm, the health implications of early birth timing (e.g., adolescent births) and unplanned births (e.g., unwanted or mistimed births) extend years after those births into mid and later life. Yet past research often overlooks the considerable diversity in sequencing and timing of unplanned births even within the same individual (e.g., having both wanted and unwanted births), which are likely fundamental for women's long-term health trajectories. We develop a holistic understanding of birth timing and wantedness to provide insight into when and how childbearing histories matter for aging women's health. We use sequence analysis with hierarchical cluster method and estimate regression models using the 1979 National Longitudinal Survey of Youth (N = 3,231) to examine how timing and patterning of births by wantedness are associated with changes in physical and mental health from ages 40 to 50. We identify 7 clusters of childbearing sequences. Of those 7 clusters, respondents with sequences characterized by wanted births in their 20s and 30s had the smallest declines in health in mid-life, whereas respondents with sequences with mainly unwanted births at any age or with mainly mistimed births beginning in adolescence had the greatest health declines. Adjusting for social and economic variables accounted for some, but not all, health differences across childbearing clusters. This project demonstrates the need for comprehensive life course perspectives on long-term health implications of birth wantedness and timing, recognizing diversity within and between individuals.

Subdermal contraceptive implants and repeat teenage motherhood: Evidence from a major maternity hospital-based program in Uruguay.

Teenage fertility is a social problem because of its private and public costs in countries of different development levels. Reductions in adolescent birth rates do not necessarily follow drops in overall fertility due to the demographic transition model. This paper analyses the impact of a subdermal contraceptive program on repeat teenage motherhood. Using a regression discontinuity design, we find that the intervention reduced mothers' likelihood of having another child in the next 48months by 10 percentage points. This reduction is not random, and we also identify small positive selection in subsequent births.