Programmes that focus on sexual health, reproductive rights, and the importance of delayed marriage and childbearing are essential in curbing teenage pregnancies.
Published Feb 14, 2025 | 9:00 AM ⚊ Updated Feb 14, 2025 | 9:53 AM
Pregnancy. Representative image.
Synopsis: Tamil Nadu has seen a rise in the number of teenage pregnancies. This alarming statistic underscores the need for urgent intervention to tackle this growing issue. According to activists, teenage pregnancies are often higher in areas where educational access is restricted, and caste-related stigma discourages open dialogue about relationships and reproductive health.
Priya* was not ready for the sudden change. The morning found her — otherwise a bubbly girl of 16 — moody and nauseating. The girl knew she had to become another person, too early in life.
“I was still in school when I got pregnant,” she said. “I didn’t know what was happening to me, and I didn’t know how to ask for help. My parents were always working, and no one explained things to me. Now, I am struggling to balance taking care of my baby and my studies,” Priya is one among the teen mothers of Tamil Nadu.
Teenage pregnancy has been a perennial problem in the South Indian state despite its robust healthcare infrastructure and educational systems.
Recent data from the National Family Health Survey (NFHS) highlighted a rise in teenage pregnancies in the state, with the rate increasing from five percent to 6.3 percent between 2015-16 and 2019-21.
This uptick comes at a time when India, overall, has witnessed a decline in adolescent childbearing during the same period.
Tamil Nadu’s reversal in teenage pregnancy trends stands out, especially when considering the national context. While India’s national teenage pregnancy rate decreased from eight percent in 2015-16 to seven percent in 2019-21, the state bucked the trend with a rise in its numbers.
This is even more striking when compared to other states in the South. For example, Kerala has consistently had the lowest teenage pregnancy rate in the country, improving further from three percent to 2.4 percent.
Telangana made impressive progress, halving its rate from 10.5 percent to 5.8 percent, while Andhra Pradesh remains a challenge, with one of the highest rates at 12.6 percent.
Between 2015 and 2023, government hospitals across 15 districts in Tamil Nadu reported a staggering 8,742 cases of underage pregnancies.
Dharmapuri alone accounted for the highest number, with 3,249 cases. Other districts, including Karur and Vellore, also recorded substantial figures.
In 2023, the trend continued as districts such as Salem and Trichy emerged as new hotspots, each reporting over 1,100 teenage pregnancies.
In total, more than 10,000 teenage pregnancies are estimated to occur annually across the state. This alarming statistic underscores the need for urgent intervention to tackle this growing issue.
Sumithra Devi, a programme manager at the NGO Aarvam in Vyasarpadi, shed light on the underlying causes of teenage pregnancies in Chennai, particularly among daily wage workers.
“Many children, especially those aged between 13 and 18, are left unattended because their parents have long working hours. This absence leaves them vulnerable to infatuations and sexual experiences, without proper guidance,” she pointed out as one of the reasons for teenage pregnancies.
“Most of them have no sex education, and they don’t have a support system to help them understand what to do when these situations arise. The education system hasn’t equipped them with the tools they need to navigate these challenges,” Devi explained.
The absence of sexual education and awareness, compounded by the absence of adult supervision, plays a critical role in the rise of teenage pregnancies in these vulnerable communities, she said.
Several teenage mothers in Chennai shared their experiences, offering insight into the challenges they face.
Shalini* is 18, and a mother. She recalled her life before and after becoming a teenage mother.
“I was just beginning to explore my future when I found I was pregnant. There was no one I could talk to about it. My friends and I never discussed these things openly. I wish I had someone to guide me before it was too late,” she said.
Kanaka* of Vysarpadi is eight months pregnant. “I got married early — it was my choice. Now, I’m eight months pregnant. When I found out about my pregnancy, I approached the nearest hospital for assistance,” she said.
“According to the rules, they provided me with 34 tablets, covering all three trimesters, along with four scans to monitor my baby’s health. Everything was completely free of cost since I registered just after turning 18,” the expectant mother added.
“At first, I was scolded by the hospital staff for not being more cautious, but they still helped me without hesitation,” she further said.
The issue of teenage pregnancy in Tamil Nadu is intertwined with socio-economic and geographic disparities.
The NFHS data showed higher teenage pregnancy rates in rural areas compared to urban regions. For instance, in NFHS-4 (2015-16), 9.2 percent of rural teenage women were pregnant compared to only five percent in urban areas.
This gap persists in NFHS-5 (2019-21), where 7.9 percent of rural teenage women bore children compared to just 3.8 percent in urban areas.
Additionally, socio-economic factors such as education level and wealth also influence teenage pregnancy rates.
In both NFHS surveys, teenage pregnancy rates were highest among women with no schooling and those in the lowest wealth quintiles.
The figures show a significant difference between those with no schooling (18-20 percent) compared to those who had 12 or more years of education (four percent). This reinforces the critical role education plays in preventing teenage pregnancies.
Tamil Nadu has implemented several initiatives to address teenage pregnancies, focusing on prevention, education, and support for young mothers.
The Chief Minister’s Girl Child Protection Scheme, introduced in 1992, aims to promote enrollment and retention of girls in schools, ensuring education at least up to the intermediate level. It encourages girls to marry only after reaching 18 years of age and advocates for family planning norms. This scheme indirectly addresses teenage pregnancies by promoting education and delayed marriage.
The Tamil Nadu State Child Policy, formulated to safeguard children’s rights, emphasizes protection from practices like child marriage, which contribute to teenage pregnancies. The policy focuses on the importance of education and health, creating a safe environment that discourages early pregnancies.
In 2023, the state launched the “First 1,000 Days of Life” scheme, which provides financial assistance to pregnant women, covering the period from pregnancy to one year after delivery. This initiative ensures proper nutrition and healthcare for both mother and child, addressing the health challenges associated with teenage pregnancies.
The Cradle Baby Scheme, introduced in 1992 and expanded in 2011, aims to prevent female infanticide by setting up centres where unwanted female infants can be safely surrendered. While it primarily targets gender-based infanticide, it indirectly addresses unplanned teenage pregnancies.
The Tamil Nadu government also conducts educational and awareness programmes to raise awareness about the consequences of teenage pregnancies.
Certain districts, like Salem and Trichy, have been identified as hotspots for teenage pregnancies, prompting targeted awareness campaigns.
Aarvam’s Sumithra Devi opined that education and awareness are key to addressing the issue of teenage pregnancy. Without comprehensive sex education, young girls remain vulnerable to early pregnancies, often without the support systems they need to make informed decisions.
Programmes that focus on sexual health, reproductive rights, and the importance of delayed marriage and childbearing are essential in curbing teenage pregnancies.
In Tamil Nadu, where the literacy rate is high, the gap lies in imparting the right kind of education that empowers young people to make informed decisions. Schools and NGOs working on the ground must collaborate to ensure that students, particularly in vulnerable communities, receive the education they need to understand sexual health and avoid early pregnancy.
Teenage pregnancy in Tamil Nadu is a multifaceted issue that requires a combination of education, awareness, and access to healthcare services, another volunteer with Aarvam, Anand said.
“Young children often don’t fully understand the consequences of their actions, particularly when it comes to sensitive topics like relationships, love, and attraction. It’s alarming that these discussions are happening in classrooms without the necessary guidance. If children are openly talking about ‘love’ and ‘attraction’ in school, they are likely either overhearing these topics at home or being influenced by external sources such as peers, media, or social environments, he said.
“The root problem lies in the fact that no proper awareness is being provided to these children at an early stage — either at home or schools,” Anand added.
He said proper awareness could deter youngsters from early marriages and pregnancies.
Anand said medical care provided to young expectant mothers is inadequate to address the issue. “Medical treatment is provided to address immediate issues, but the underlying problem is rarely addressed. Once they turn 18, they are considered adults, and society assumes they will somehow manage. However, these issues often complicate their future,” he said.
“In some cases, the young husband might leave, or the family might break down under the pressure. This is why it is essential to provide awareness and education about relationships, family planning, and the challenges of early marriages. Without this, we are failing to prepare the next generation to make informed decisions, leaving them vulnerable to complex and often tragic situations,” he explained.
According to social activists, hospital staff in Tamil Nadu often avoid filing POCSO (The Protection of Children from Sexual Offences Act) cases in teenage pregnancy cases because they feel it might create additional complications for the child.
Since they have to handle the process on their own, they see it as lengthy and unnecessary. In most cases, the teenagers are close to turning 18, so the focus remains on providing them with the 34 prescribed tablets instead of initiating legal proceedings.
Activist A Devaneyan said child marriage has been an issue in India for more than a thousand years. Though the numbers have decreased in some regions like Uttar Pradesh and Rajasthan, the issue remains a matter of concern.
“In the digital era, elopement by teenagers has increased due to caste-based practices, love affairs, and other socio-cultural issues. States like Tamil Nadu, despite being developed, face contradictions in addressing teenage pregnancies and child marriages effectively,” he said. Devanayan also advocated open discussions around sex education.
“Prevention must be the cornerstone of tackling child marriage and teenage pregnancies. The focus should shift from reactive protection to proactive prevention by educating communities, equipping youth with knowledge, and ensuring proper implementation of existing laws and schemes,” he said.
Devanayan pointed at another reality. “The fear of love affairs transcending caste boundaries has led to a lack of proper education and opportunities for adolescents. Families often restrict young people, especially girls, from pursuing higher education or accessing knowledge outside their immediate surroundings, fearing they might form relationships that defy caste norms. This fear and control have, in some cases, contributed to the prevalence of teenage pregnancies.”
He further added that teenage pregnancies are often higher in areas where educational access is restricted, and caste-related stigma discourages open dialogue about relationships and reproductive health.
“Education should serve as a tool for empowerment, breaking these cycles of fear and control. However, the lack of comprehensive sex education and awareness programmes further exacerbates the problem. Until casteism and the associated societal pressures are addressed, teenage pregnancies will remain a symptom of a much larger systemic issue,” he said.
The POCSO Act mandates that the police register an FIR upon receiving information about any sexual activities involving a child — a person under the age of 18 —and conduct a thorough investigation.
However, doctors say that they prioritise the patient’s health since teenage pregnancies are usually complicated. Moreover, the medical community also highlights that families hide the actual age of patients out of fear of legal repercussions.
However, according to Section 19(1) of the POCSO Act, a person will be prosecuted if they deliberately fail to report the offence. There have been also cases where doctors were prosecuted after dealing with reported teenage pregnancies.
Dr Priya Selvaraj, Director of GG Hospital, Fertility Research and Women’s Speciality Centre told South First, “POCSO cases must be reported to the local police authorities within the area of the hospital location. According to law, as medical practitioners, we are the primary examiners and caregivers. The law requires us to provide the necessary aid and intervention possibly free of cost.”
“If a case arrives at a private institution, in a situation where the required care cannot be given owing to the need for higher intervention then they are duty-bound to make a timely referral, especially in cases involving teenage pregnancies and related complications or if extremely compromised in physical health. Confidentiality must be maintained at all times.”
She said age verification is crucial, requiring substantial evidence to confirm the individual is under 18.
“A major concern among medical practitioners is the families’ fear of legal repercussions — efforts to save a life or report dutifully may backfire if complications arise due to late referrals from the victim’s side or other factors. Families often withhold crucial details due to fear of social rejection or, in some cases, their own involvement,” she added.
Dr Priya concluded that while guidelines exist, further streamlining is necessary to protect and support the medical fraternity, enabling them to report fairly and treat victims ethically and without fear.
Dr Asokan, Chief of the Indian Medical Council (IMA), told South First, “Doctors face a serious dilemma when dealing with teenage pregnancies under the POCSO Act.”
“Legally, we are bound to report cases involving minors to the police and the Child Welfare Committee (CWC), ensuring confidentiality through a sealed process. However, doctors are often unfairly blamed or even face legal consequences for simply following the law.”
“There have been cases where doctors, including my wife, were arrested despite acting in the best medical interest of the patient. In one instance, a teenage girl with a non-viable fetus required termination, which was medically necessary. Yet, due to legal complications, my wife was arrested, and the case against her is still ongoing.”
Doctors are not the enemy — we are here to help. Activists and the public must understand that medical professionals are bound by law and ethics. Instead of vilifying doctors, the system should strengthen support structures like the CWC to ensure proper legal and medical aid for young mothers in distress,” Dr Asokan said.
Dr Dilip Kumar Dutta, a gynaecologist and the former president of IMA West Bengal, told South First, “Teenage pregnancy is a serious health concern, especially in rural and Adivasi areas, where economic struggles and lack of education play a major role. The risks involved are severe — higher maternal mortality rates, anaemia, hypertension, obstructed labour due to underdeveloped pelvises, and even cervical cancer.”
“Many young mothers are forced to undergo C-sections, which their bodies are not prepared for, leading to long-term health complications,” he added.
“Another major issue is the lack of awareness about contraception. Without proper knowledge of condom use or oral pills, teenagers face a higher risk of pelvic infections. Before the age of 18, their bodies are not fully developed, increasing the chances of complications that could be life-threatening. Currently, statistics show that over 60 percent of teenage pregnancies occur in rural and semi-urban areas, with many girls becoming pregnant before 21,” he said.
“This is unsafe and preventable. The government should actively promote reproductive education and access to contraception to protect young girls from avoidable health risks. Proper medical care is crucial, and teenage pregnancies should always be handled by experienced gynaecologists to ensure the best possible outcomes, Dr Dutta concluded.
(*Names changed. Edited by Rosamma Thomas with inputs by Sumit Jha.)
