By Anne Kuster, MAIDP 2020, former U.S. Research Fellow, Fulbright Association
Joanna and I met the summer we were both eighteen. I was working at Casa Mantay Home for Teen Mothers in Cusco, Peru, where Joanna lived with her five-year-old son, Ricardo. One day, Joanna pointed at a picture of my younger brother on my phone, asking “your son?” I explained that if Evan were my son, I would have had him when I was nine. I later learned that, at nine, Joanna was already being abused by her father and brothers; her son is the product of this abuse.
Joanna’s story is one of many involving gender-based violence and adolescent pregnancy. Across the globe, countries have identified reducing teenage pregnancy as key to addressing the UN’s 5th sustainable development goal and more completely contributing to overall development. In Peru specifically, despite current policies and social campaigns, approximately 14 out of every 100 adolescent girls are mothers (Sanchez & Favara, 2019). In addition, of the 7.3 million births to adolescents under the age of 18 that occur each year in the region, more than two million are to girls under 15 (UNFPA 2018). Adolescent pregnancy carries serious implications, not only for the health and wellbeing of young mothers and their children, but also for the development of the countries they call home.
Five years after my first summer at Casa Mantay, I returned to live alongside and learn from adolescent mothers themselves. Casa Mantay & I focused on using storytelling for empowerment, hoping that intentional reflection and introspection could help girls heal from past trauma and feel more prepared to contribute to their home communities. Over the course of our time together, it became evident that this adversity had imbued them with wisdom even greater than self-empowerment. Through their fight for survival, they gained an important perspective that can help shape effective government initiatives in the region to stop this cycle of nonconsensual premature motherhood.
Recognizing the staggering rate of adolescent pregnancies and associated social implications, Peru has expanded access to reproductive health education and care as outlined in the National Action Plan for Adolescents and Children (PNAIA) and the Educational Guidelines and Pedagogical Orientation for Comprehensive Sex Education published by the Ministry of Education. While this is undoubtedly key to improving maternal health outcomes and decreasing instance of pregnancy, hearing the experiences of the mothers at Casa Mantay make it clear that there is much more to be done.
First, rural communities have different cultural nuances than the metropolitan capital of Lima, some of which limit effective reproductive health education. School teachers frequently relegate discussion of such topics to the home. However, the historically conservative culture surrounding sex means some parents might choose to put off this conversation, despite the fact that every day, four Peruvian girls get pregnant before the age of 15 (2017 Peruvian Census). So even with laws nominally mandating reproductive health education, the quality and level of said education can vary dramatically. Further, girls from economically disadvantaged, more conservative communities in the rural parts of the country are the least likely to receive this vital education and therefore suffer disproportionately. For many of the girls at Casa Mantay, their first time receiving sexual health education was within the walls of the home, after giving birth.
Second, the causal effect of adolescent pregnancy is complicated. Reproductive and sexual health access and education are important pieces of the puzzle, but they’re just that – pieces of a multidimensional issue. The girls’ stories often reflected instances of incredible poverty, abuse at the hands of family members or neighbors, lack of economic opportunity, limited access to general education, and the all-encompassing experience of “machismo”. This reflects a truism acknowledged if not championed by the international development community: adolescent pregnancy requires a holistic approach to wellbeing that reaches beyond health education for solutions. To effectively achieve a reduction in adolescent pregnancy (and the increase in quality of life thereby associated), we need to support community development that encourages women and men to take equal footing not just in intimate relationships but also in social, political, and economic decision-making.
It is one thing to point out the flaws of a complex problem plaguing millions of under-resourced girls on the margins of society in Peru. It is a whole other feat for Peruvian policymakers to translate a handful of anecdotes into sustainable legislature that does what it’s meant to: reduce adolescent pregnancy rates and support those adolescents who are already pregnant or have given birth. Still, it bears repeating that the current policy initiatives are falling short, principally because they do not adequately value the sage voices of the women directly targeted by them. Future policymakers should therefore prioritize empathetic listening to the populations we hope to impact, because it’s the only way we can hope to make sustainable, long-lasting change.