Discussant notes

1. Discussant notes Monica Das Gupta Development Research Group The World Bank

2. Adolescent childbearing has many negative effects • Bad for individual health: • Higher infant mortality • Higher maternal mortality E.g. UNFPA reports that in Bangladesh maternal mortality is 3x higher at ages 15-19 than at age 20-24, and IMR 34% higher than at age 20-29 (partly because higher proportion of first births, and lower maternal SES) • Bad for population health: • Low birthweight children (studies in OECD find ass with lower education & income) • Maternal morbidity (damage to immature systems) • Increases rate of population growth: • Shorter generations, builds population momentum that partly offsets gains of reducing the no. of children per woman • Bad for girls’ prospects of economic security: • Schooling • labor-force participation • lifetime earnings

3. Adolescent childbearing has many negative effects • Bad for individual health: • Higher infant mortality • Higher maternal mortality E.g. UNFPA reports that in Bangladesh maternal mortality is 3x higher at ages 15-19 than at age 20-24, and IMR 34% higher than at age 20-29 (partly because higher proportion of first births, and lower maternal SES) • Bad for population health: • Low birthweight children (studies in OECD find ass with lower education & income) • Maternal morbidity (damage to immature systems) • Increases rate of population growth: • Shorter generations, builds population momentum that partly offsets gains of reducing the no. of children per woman • Bad for girls’ prospects of economic security: • Schooling • labor-force participation • lifetime earnings

4. Adolescent childbearing has many negative effects • Bad for individual health: • Higher infant mortality • Higher maternal mortality E.g. UNFPA reports that in Bangladesh maternal mortality is 3x higher at ages 15-19 than at age 20-24, and IMR 34% higher than at age 20-29 (partly because higher proportion of first births, and lower maternal SES) • Bad for population health: • Low birthweight children (studies in OECD find ass with lower education & income) • Maternal morbidity (damage to immature systems) • Increases rate of population growth: • Shorter generations, builds population momentum that partly offsets gains of reducing the no. of children per woman • Bad for girls’ prospects of economic security: • Schooling • labor-force participation • lifetime earnings

5. Adolescent childbearing has many negative effects • Bad for individual health: • Higher infant mortality • Higher maternal mortality E.g. UNFPA reports that in Bangladesh maternal mortality is 3x higher at ages 15-19 than at age 20-24, and IMR 34% higher than at age 20-29 (partly because higher proportion of first births, and lower maternal SES) • Bad for population health: • Low birthweight children (studies in OECD find ass with lower education & income) • Maternal morbidity (damage to immature systems) • Increases rate of population growth: • Shorter generations, builds population momentum that partly offsets gains of reducing the no. of children per woman • Bad for girls’ prospects of economic security: • Schooling • labor-force participation • lifetime earnings • Intergenerational transmission of poverty

6. Adolescent childbearing is highest among the poor / disadvantaged • Developing countries: data indicate teen pregnancy negatively ass with wealth quintile (Greene and Merrick citing Gwatkin et al 2007) • Studies in the US indicate higher probability of teen pregnancy if low-income family, one-parent household, or less educated mother • Orphans: Studies in Southern Africa indicate that girls more exposed to early sexual activity than boys. Exposed to HIV and conception

7. The poor / disadvantaged seem to have the least to lose from teen childbearing • US studies show lower SES teens have less loss of income from early childbearing than others: • lifetime costs of childbearing, especially early childbearing are particularly high for skilled women (Ellwood et al 2004) • Cherlin (2001) summarizes this literature • Parents also make similar calculation: India age at marriage • 19.7 for highest wealth quintile, 15.4 for lowest quintile • Lowest in poorest state (Bihar)

8. Policies need to build on the fact that the poor/disadvantaged have the least to lose from adolescent childbearing • Importance of Bank’s Gender Action Plan, to increase poor women’s access to the labor market, agricultural resources, land, and credit • BRAC model offers: • training followed by microfinance • even if no land, can train in e.g. poultry rearing; poultry and livestock vaccinator training; tailoring and other non-farm businesses (CCTs for schooling seems logistically complex for countries with low administrative capacity)

9. Policies also depend on who is the “decider” • Most discussion relates to situation where teenagers make the choices that lead to teen pregnancy • But simple policy handle if parents marry daughters young (e.g. India): NFHS shows parents flout law on minimum age at marriage (18 for women). Of women aged 20-24 in 2005-06: • nearly half (47%) were married before age 18, and 22% had given birth • (fell from 63.4% of women aged 35-39 married by age 18 and 32% gave birth) note early marriage often involves economic and physical support of joint family while raising young children, so may have less costs that Maynard documents (child abuse, crime, etc.) • Not hard to implement the marriage law more rigorously in India • Efforts to raise women’s income (the perceived cost of early childbearing) important regardless of who is “the decider”