Muazzam Nasrullah, et al., “Girl Child Marriage and Its Effect on Fertility in Pakistan: Findings from Pakistan Demographic and Health Survey, 2006–2007,” Maternal and Child Health Journal 18, no. 3 (April 2014): 534-543.

URL: link.springer.com/article/10.1007/s10995-013-1269-y

Abstract

Child marriage (before 18 years) is prevalent in Pakistan, which disproportionately affects young girls in rural, low income and low education households. Our study aims to determine the association between early marriage and high fertility and poor fertility health indicators among young women in Pakistan beyond those attributed to social vulnerabilities. Nationally representative data from Pakistan Demographic and Health Survey, 2006–2007, a cross-sectional observational survey, were limited to ever-married women aged 20–24 years (n = 1,560; 15 % of 10,023) to identify differences in poor fertility outcomes [high fertility (three or more childbirths); rapid repeat childbirth (<24 months between births); unwanted pregnancy (any ever); pregnancy termination (any stillbirth, miscarriage or abortion ever)] by early (<18) versus adult (≥18) age at marriage. Associations between child marriage and fertility outcomes were assessed by calculating adjusted odds ratios (AORs) using logistic regression models after controlling for demographics, social equity indicators (education, wealth index, rural residence), contraception use, marriage duration and culture-specific factors (husband’s desire for more children, son preference). Overall, 50 % of ever-married women aged 20–24 years in Pakistan were married before the age of 18 years. Girl child marriage was significantly (p < 0.001) associated with low social equity indicators (poverty, rural residence, and no formal education). Adjusted logistic regression models showed that girl child marriage was significantly associated with high fertility (AOR 6.62; 95 % CI 3.53–12.43), rapid repeat childbirth (AOR 2.88; 95 % CI 1.83–4.54), unwanted pregnancy (AOR 2.90; 95 % CI 1.75–4.79), and pregnancy termination (AOR 1.75; 95 % CI 1.10–2.78). Girl child marriage affects half of all ever-married women aged 20–24 years in Pakistan, and increases their risk for high fertility and poor fertility health indicators, highlighting the need of increasing the age of marriage among women in Pakistan. Efforts to eliminate girl child marriage by strict law enforcement, promoting civil, sexual and reproductive health rights for women can help eliminate girl child marriage in Pakistan.

Nasrullah, et al. analyze data from a population-wide demographic survey in Pakistan to assess the prevalence and impact of girl-child marriage. The authors found that over half of the women in Pakistan were first married before the age of 18, which then led to increases in the risk of poor fertility indicators, including rapid repeat childbirth and pregnancy termination. Note that although the authors argue for “increased reproductive rights” as a solution to some of these health concerns, Her Dignity Network does not believe that increased access to abortion will help improve the health and dignity of married girl-children or their infants. The full text of this article is available by subscription only.