"'Til Death do us Part": Understanding the Sexual and Reproductive Health Risks of Early Marriage
Childhood and adolescence are usually the greatest years of one’s life. This period is cut short, however, when marriage and adult responsibilities come too early. Although most nations have declared 18 as the legal minimum age to enter into marriage, in many developing countries the practice of early marriage for girls is widespread. In 2002, the Population Council predicted that over the following decade more than 100 million girls worldwide would marry before their 18th birthday. Some of these girls will marry as young as eight or nine, and many will marry against their will.
There are many consequences of child marriage on young girls’ sexual and reproductive health, and many of the meaningful life experiences of adolescence are lost forever.
(Not so) Good Intentions
The decision for a young girl to marry is most often made by her parents or the community. Social and gender norms, cultural beliefs and economic situations all contribute to the pressure put on girls to marry at a young age. Some parents believe that, by marrying their daughter at an early age, they are helping her to fulfill her main societal function – that of wife and mother. They may also believe that they are providing her with protection by limiting sexual relations to only one partner (and therefore reducing the risk of STIs and HIV), and by ensuring some kind of financial stability for both the daughter and the family.
No matter how good their intentions may be, the reality is that an early marriage generally offers no protection at all – in fact, the opposite is generally true – and it strips many young girls of their childhood, their dreams, their basic human rights and their health.
Though parents may believe they are protecting their daughter from STI and HIV transmission, they are typically putting their child more at risk. Husbands are often considerably older and have more sexual experience, sometimes entering the marriage already infected with STIs or HIV. Studies in parts of Kenya and Zambia show that teenage brides are contracting HIV at a faster rate than sexually active single girls in the same location.
Child brides face much pressure to have children soon after marriage, which not only interrupts efforts to reduce STI transmission through use of condoms, but also puts the girl at an increased risk of maternal death. Girls between the ages of 15 and 19 are more likely to experience complications during pregnancy and childbirth, including obstetric fistula. They are also more likely to have children with low birth weight, inadequate nutrition and anemia. The health of these young mothers is further compromised, as they are also more likely to develop cervical cancer later in life.
“Married adolescents have been largely ignored in development and health agendas because of the perception that their married status ensures them a safe passage to adulthood. Nothing could be further from the truth.”- Thoraya Ahmed Obaid, UNFPA Executive Director
The lack of power associated with child marriage poses additional reproductive health risks. Young wives often have limited autonomy and freedom, and are unable to negotiate sexual relations, contraceptive use, childbearing, and other aspects of domestic life. The inability to negotiate condom use puts them in a vulnerable position for contracting STIs and HIV.
Unequal gender relations and the large age difference between husbands and young wives also increases the likelihood of domestic violence. Women who marry young are more likely to be beaten or threatened, and are most likely to believe that a husband’s violence is justified.
Once married, young girls are typically forced to leave behind their family, friends and community and move to their new husband’s home. Their ability to attend school is disrupted, eliminating another source of social support and interrupting their education. With limited freedom to leave the home and converse with others, girls are left in isolation with little or no means of receiving information on reproductive health issues. They are often powerless to access health care services, as they may need permission to receive such services; if refused, they are typically unable to pay for health care services. Without health information or social services, married girls are unable to seek support. Their problems remain unknown or ignored by the community, and they becomes invisible victims.
Dream no more
Early marriage results in a loss of childhood. Girls are inhibited from realizing their dreams and aspirations. Their rights are violated and they lose the ability to choose how their life is fulfilled. Their right to choose when they become pregnant and how many children they will have is no longer theirs. Their sexual and reproductive health is sacrificed, sometimes to the point of causing death.
“I was promised to a man before I was 10. It was a traditional wedding. When the time came, I was sent over to my husband’s family. And when I saw him, I realized he was older than my daddy.”- Excerpt from the film 'Too Brief a Child'
Change is difficult
Changing social and gender norms is never easy. Families and communities, including boys and men, need to understand the risks associated with child marriage and become engaged in the process of making change. Powerless and isolated, married girls are in need of our support. But what can be done?
Providing opportunities for girls to continue their education or earn money, while expanding their skills and available choices in life, is one effective strategy to delay marriage. In Bangladesh, the implementation of a secondary school scholarship program for girls resulted in a declined rate of early marriage. The expansion of schooling and provision of job training helps to increase the autonomy and freedom of girls.
Although laws forbidding early marriage exist in most countries, much effort is still needed to ensure enforcement of such laws. Further work needs to be done to reduce the barriers young women face in seeking out health services and information outside their marital households, including access to family planning programs. Youth programs are effective in educating and empowering young women (as well as young men) about reproductive health and rights. Such programs should be encouraged and available not only in schools, but in communities and rural areas as well. Public education and advocacy projects that target policy-makers could be useful in preventing early marriage and in making visible the problems and risks that young brides face.
No matter what efforts are used to instill change, one thing remains certain: young girls' health, education, and social and economic needs should be addressed holistically and simultaneously. In addressing change in attitudes amongst communities, cultural and religious traditions need to be considered and integrated into the solution.
Violations of Human Rights
Child marriage is a violation of a girl’s sexual and reproductive rights, which include the rights to:
The highest attainable standard of sexual health
Be free from coercion, discrimination, violence and abuse
Consensual sexual relations
Pursue a satisfyin, safe and pleasurable sexual life
A choice of partner and consensual marriage
Seek, receive, and impact information and education related to sexual health, including information on how to protect against unwanted pregnancy, STIs, and HIV/AIDS
Decide freely and responsibly the number, spacing, and timing of her children, and to have the information and the means to do so
Access sexual and reproductive health services (Married girls seeking sexual and reproductive health services are often turned away from health facilities because they require a husband's consent before care is provided)
Before They're Ready
In some countries, the majority of girls are married before the age of 18:
|Democratic Republic of Congo||74%|