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Geneva, Switzerland, WHO, 2006. 35 p.Marriage is widely regarded as a place of safety to shelter from the risks of adolescence. In many parts of the developing world, parents and policy makers see marriage as a walled garden where cultural and family values protect young girls from defilement and stigma. Particularly in poorer and rural areas, there is pressure on parents to marry off their daughters while they are very young before they become an economic liability. Millions of girls reluctantly enter into marriage while they are still children, just sexually mature but unready in every other way for this profound change in their lives. Typically, an adolescent bride knows little of her new husband or new life, has little control over her destiny and is unaware of the health risks that she faces. When an adolescent girl starts a sexual relationship with a man 10 years older than she is, he may be sexually experienced. If he is infected with a sexually transmitted infection (STI) or with HIV, a marriage certificate offers no protection. In the context of the AIDS pandemic, it is a chilling fact that the majority of unprotected sex between an un-infected adolescent girl and an infected older man takes place within marriage with the blessing of parents and community. Neither AIDS nor STIs respect marriage as a place of safety. (excerpt)
Lancet. 1995 May 27; 345(8961):1358.Paul Livingstone Armstrong, 82, has sought to convince the medical profession and the general public of the known hazards of adolescent pregnancy since 1973. According to the "World Health Report" of the World Health Organization (WHO), maternal mortality rates at ages 15-19 are double those at 20-24; those at 10-14 are 5 times higher in some countries. In 14 African countries at least 50% of the women marry before age 18; in Niger, where nearly 50% marry before age 15, 2 out of 5 have one child by age 17. In China, due to family control, the maternal age range is 23-26; the paternal age range is 26-29. In Japan, 16% of women under 25 bear children; in the US, 43% do (1993 data). Livingstone Armstrong has produced demonstration kits with life-size plastic pelvises for ages 16, 19, and 23 for the Charing Cross and Westminster Medical School, London, UK. In 1985, the World Health Assembly (WHA), whose meetings Livingstone Armstrong has attended steadily, approved a resolution urging governments to promote a delay in child bearing until both parents, but especially the mother, are adults--fully grown, adequately nourished, and disease-free. However, some governments viewed the resolution as useless because of the social, economic, and religious circumstances of their populations. Livingstone Armstrong continued his efforts and donated his kits in a limited, judicious manner to places such as one of the refugee camps along the Thai-Cambodian border. The result was genuine interest by delegations to the most recent WHA meeting and orders from Tanzania, Uganda, Kenya, Zimbabwe, and Zambia for the kits, which are now being used in Gambia to train traditional birth attendants and village elders (all men).