Maternal, newborn, child and adolescent health

Adolescent reproductive health

What needs to be done to promote the sexual and reproductive health of adolescents and to prevent adolescent mothers and their babies from dying in pregnancy?

Prevent unintended pregnancies and other sexual and reproductive health risks

Adolescents require:

  • information including comprehensive sex education;
  • access to a full range of sexual and reproductive health services, including condoms, other means of contraception as appropriate and other interventions for the prevention, treatment and care of sexually transmitted infections, including HIV; and
  • safe and supportive environments free from exploitation and abuse.

Families and communities need to support adolescent mothers

Adolescent mothers often lack knowledge, education, experience, income and power relative to older mothers. In some cultures, they may also have to bear the effects of many judgemental attitudes, making an already difficult situation even worse.

Men, parents, mothers-in-law and other decision makers at the household and community level should be involved to ensure their support and acceptance for pregnant adolescents. This includes ensuring home-based care practices before, during and after the pregnancy and the timely use of services and skilled birth attendants.

Information about the signs of complications should be disseminated widely to pregnant adolescents and the community at large, so that everyone knows when a situation is an emergency and what to do.

Adolescent mothers’ access to education, livelihood skills and information about how to prevent further pregnancies and their ability to deal with domestic violence should be improved.

Health workers need to be able to respond to the special needs of pregnant adolescents

Skilled health workers need to be able to provide a range of services in outpatient and other clinical settings that will help save the lives of pregnant mothers and their babies. Although the content of these services is similar for adolescent mothers and older mothers, health workers need to be able to work with adolescents and know how to respond to their specific health needs.

They should be able:

  • to provide adolescents with an early start to antenatal care and to options for continuing or terminating the pregnancy – adolescents tend to delay seeking abortion, resort to the use of less skilled providers, use more dangerous methods and delay seeking care for complications;
  • to be alert to special problems that require particular attention among adolescents, including anaemia, poor nutritional status, malaria, HIV and other sexually transmitted infections and access to services for preventing the mother to child transmission of HIV;
  • to develop a plan for birth with the adolescent and her family, including the place of birth, availability of transport and the costs involved;
  • to give special attention to adolescents younger than 16 years during obstetric care because they are at especially high risk of complications and death; and
  • following delivery, to give adolescents special support for infant feeding and care and to ensure that they have access to information, skills and services, including adequate counselling, to prevent subsequent pregnancies.

Health systems need to be able to respond to the special sexual and reproductive health needs of adolescents

There is considerable consensus that well-functioning health systems are needed to achieve Millennium Development Goal 5. Within this, the quality of the services provided to adolescents need to be improved and adolescents’ use of the services available increased.

This requires:

  • collecting and analysing national statistics in ways that make it easier to understand the needs of pregnant adolescents, their numbers and their use of services;
  • developing health worker competencies to deal with the special information, clinical and psychosocial needs of adolescent mothers; and
  • ensuring that the legal and policy environment enhances access to the care that adolescents need.