“The Stories Behind the Statistics” is a series we developed for the Gates Foundation blog, “Impatient Optimists.” The following post is the third in our three-part series on adolescent pregnancy. The original post, located on “Impatient Optimists,” is available here.

Gaj Bahadur Gurung works as the program coordinator for the National Federation of Women Living with HIV and AIDS in Nepal.

For a young girl in Nepal or South Asia, pregnancy can be disastrous. If it occurs outside the context of marriage, it will bring her disgrace and might lead to expulsion from her family and school. The young woman may be perceived as deviant in the community and will be considered a curse for her family.

Young women have little choice or control over contraceptives. For unmarried young girls in South Asia, male condoms are their only contraceptive option. Yet, patriarchal gender roles and norms make it difficult or impossible for girls to negotiate condom use with a male partner and often inhibit girls from even buying condoms or other types of contraception.

A lack of appropriate information also contributes to adolescent pregnancy. Parents rarely discuss sexual and reproductive health with their children, and the school curriculum has outdated and inadequate information. In spite of the attempts by nongovernmental organizations to disseminate information, some people are difficult to reach, especially low-income girls in mobile populations.

Early marriage is another major contributor to pregnancy among adolescents. Early marriage is quite normal in this culture, and once married, a young woman is expected to give birth to prove her family’s honor. Once a young married woman becomes pregnant, she receives tons of affection, but often she drops out of school, becomes more economically dependent on her family, and has less social interaction.

Policies and programs must both help prevent early and unintended pregnancy (for married and unmarried women) and mitigate the negative consequences for girls who do become pregnant. Programs should provide young women access to, control over, and informed choice about sexual and maternal health services. Youth-friendly maternity services with easy access for young girls would minimize health risks to mother and baby during pregnancy, delivery, and the post-delivery period.