Sharp rise in adolescent marriage, pregnancy despite gains in maternal health

Bangladesh has made notable progress in reducing infant deaths and expanding access to skilled maternal care, but a sharp rise in adolescent marriage and pregnancy is threatening to undermine these gains, the United Nations Population Fund (UNFPA) said on Wednesday.

The warning comes as UNFPA welcomed the preliminary findings of the 2025 Multiple Indicator Cluster Survey (MICS), released by the Bangladesh Bureau of Statistics with technical support from UNICEF.

The national survey tracks 172 indicators, including 27 linked to the Sustainable Development Goals, offering one of the clearest snapshots of women’s and children’s wellbeing in the country.

The report highlights encouraging improvements. Infant mortality has fallen from 34 deaths per 1,000 live births in 2019 to 29 in 2025. Facility-based deliveries have climbed to 71%, while 77% of births are now attended by skilled professionals. UNFPA credited the government’s long-term investment in maternal health, midwifery, and service delivery for the progress.

However, the same dataset reveals troubling setbacks. Although marriage of women aged 20–24 has declined modestly, from 51.4% in 2019 to 47.2% in 2025, the share of girls aged 15–19 who are currently married has jumped from 32.9% to 38.9%. UNFPA estimates that at the current pace, Bangladesh would need over 200 years to eliminate child marriage.

Alongside these trends, the adolescent birth rate has risen from 83 to 92 births per 1,000 girls aged 15–19—underscoring how early marriage continues to drive early childbearing, with lasting physical, mental, and social consequences.

Shifts in fertility patterns also point to wider systemic gaps. The country’s total fertility rate has edged upward, partly due to disrupted family planning services during the COVID-19 pandemic and a decline in contraceptive prevalence to 58.2%. Access to modern contraception remains uneven, limiting women’s ability to make informed, rights-based decisions.

Another red flag is the steep rise in Caesarean section deliveries, up from 36% in 2019 to 51.8%. The spike is concentrated in under-regulated private facilities, raising concerns about unnecessary surgeries, safety risks, and financial strain on poorer families. UNFPA stressed the need for more trained midwives, stronger clinical governance, and expanded emergency obstetric care in public facilities.

The survey also points to gaps in managing high-risk pregnancies and delivering quality care during and after childbirth, with worrying figures related to eclampsia, haemorrhage, prolonged labour, and delayed breastfeeding initiation.

UNFPA said Bangladesh now needs a decisive push for ensuring the provision of stronger family planning services, uninterrupted contraceptive supplies, more midwives at public facilities, and a national effort to delay marriage and prevent adolescent pregnancy.

“There is no pathway to national progress without investing in the health, rights, and education of women and girls,” said Catherine Breen Kamkong, UNFPA’s Representative in Bangladesh.

UNFPA reaffirmed its commitment to supporting the government as it works to protect women, adolescents, and young people—and safeguard the country’s long-term development goals.

The reporter can be reached at [email protected]