One of the first deliveries I ever attended as a young midwife in the UK was a 13-year-old girl's.
She was so scared. I was completely shocked. I kept thinking she could be my little sister.
Biologically, she was still a child.
But there she was, when it was all over, cradling a child of her very own: suddenly she was a mother.
Over the course of my career, attending births around the world, I've since encountered so many other frightened young faces.
About 16 million girls aged 15 to 19 years and two million girls under the age of 15 give birth every year.
Adolescent pregnancy is a universal issue that occurs for many different reasons. But in nine out of 10 cases in developing countries, where complications during pregnancy and childbirth are a leading cause of death, the young mother is already married.
This is a denial of her rights, a form of violence under a veil of legitimacy.
If we're going to do anything about it, we need to call it what it is.
The United Nations recognizes child marriage as a serious human rights violation that threatens the achievement of nearly all the Millennium Development Goals, a set of priority targets the international community agreed to achieve by 2015.
When girls become brides, their education is cut short and their opportunity to develop new skills and earn income becomes limited, often trapping them, their families and their communities in a cycle of poverty.
When girls become sexually active before they are biologically and psychologically ready, they are vulnerable to HIV, especially child brides who marry older, more sexually-experienced husbands. They can also lack the power to negotiate safer sex and have little access to information or services to prevent either pregnancy or infection. An estimated 50,000 adolescent girls die each year from pregnancy and childbirth related causes.
When girls become mothers, their babies are more likely to be born too soon and have low birth weight. Stillbirths and deaths during the first week of life are 50 per cent higher among babies born to adolescent mothers than among babies born to mothers in their twenties.
Despite the fact that 158 countries have set the legal age for marriage at 18 years, laws are rarely enforced in communities where child marriage is common practice. It's a complex issue that has existed for centuries, rooted deeply in gender inequality, tradition and poverty. But change is possible.
Malawi, for instance, has started down a road to significantly curtail child marriage, citing an opportunity to avert 30 percent of maternal deaths, reduce the neonatal mortality rate and support girls in becoming educated citizens who can contribute to the development and economy of the country. Beyond working with parliamentarians to raise the age of marriage to 18 years by 2014, the government has taken steps to provide universal access to primary education and is working with chiefs to sensitize their communities on the importance of sending children to school.
With the international community in the process of preparing a post-2015 sustainable development framework, it's crucial that we demand a prominent place for the girl child, recognizing gender inequality and violence against women and girls as major obstacles to the unfinished business of the MDGs that need to be addressed for future progress.
This week governments, civil society and other global and local actors have come together to tackle all forms of violence against women and girls at the 57th session of the UN Commission on the Status of Women. The Partnership for Maternal, Newborn & Child Health has seized this occasion to join the Governments of Bangladesh, Malawi and Canada, and a host of partners spanning various global health and development sectors, to convene a high-level panel on child marriage in support of Every Woman Every Child, a movement spearheaded by UN Secretary-General Ban Ki-moon which aims to save the lives of 16 million women and children by 2015.Strategies for ending child marriage being recommended to the UN Commission include:
- Supporting and enforcing legislation to increase the minimum age of marriage for girls to 18 years;
- Providing equal access to quality primary and secondary education for both girls and boys;
- Mobilizing girls, boys, parents and leaders to change practices that discriminate against girls and to create social, economic, and civic opportunities for girls and young women;
- Providing girls who are already married with options for schooling, employment and livelihood skills, sexual and reproductive health information and services (including HIV prevention), and offering recourse from violence in the home; and
- Addressing the root causes of child marriage, including poverty, gender inequality and discrimination, the low value placed on girls and violence against girls.
If families, communities, governments, religious leaders and civil society organizations at the local and global level rise up to attack this issue from all fronts we can make considerable progress in our final push to reach the MDGs and in our efforts beyond 2015. We must remember the numbers represent individual names and faces -- missed targets mean dead women and children, many of these young girls.
Let's imagine them all as our sisters. As girls, not brides.
Follow Carole Presern on Twitter: www.twitter.com/CarolePMNCH