Peer-reviewed article
Contemporary pathways to adolescent pregnancy in Indonesia: A qualitative investigation with adolescent girls in West Java and Central Sulawesi
Sherria Ayuandini, Marie Habito, Steven Ellis, Elissa C. Kennedy, Maki Akiyama et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This qualitative study explored how adolescent girls in Indonesia become pregnant by interviewing 79 girls aged 15-21 years across West Java and Central Sulawesi. The research identified six distinct pathways to pregnancy: three occurring within marriage (driven by financial need, family reputation concerns, or romantic progression) and three outside marriage (involving consensual, pressured, or forced sexual relationships). The study found that child marriage acceptance, stigma around premarital pregnancy, harmful gender norms, violence, and limited access to sexual and reproductive health services all drive adolescent pregnancy in Indonesia.
Key points
- Indonesia has the highest number of births to adolescent girls aged 15-19 years in Southeast Asia, with slowing reduction rates despite national programmes
- Six distinct pathways to adolescent pregnancy were identified, differentiated by whether pregnancy occurred within or outside marriage and the circumstances involved
- Pregnancies within marriage were motivated by financial reasons, reputation protection, or romantic relationship progression
- Pregnancies outside marriage involved consensual sex, unwanted or pressured sex, or forced sex
- Key drivers include acceptability of child marriage, stigma around premarital pregnancy, harmful gender norms, gender-based violence, and barriers to sexual and reproductive health information and services
Limitations
The study provides rich qualitative insights into pathways and drivers of adolescent pregnancy but does not quantify the prevalence of each pathway or measure the relative importance of different drivers. The findings are specific to two Indonesian provinces and may not represent experiences across the entire country or region.
Abstract
In the last decade, reduction in adolescent fertility rates in Indonesia has slowed despite national programmes and policies focused on addressing child marriage. Indonesia currently has the highest number of births to adolescent girls aged 15-19 years in Southeast Asia. There is a need to develop a more nuanced understanding of the drivers of adolescent pregnancy in Indonesia to inform programmes and policies tailored to young people's needs and priorities. This study explored adolescent girls' pathways to pregnancy across two provinces (Central Sulawesi and West Java) in Indonesia. We conducted participatory timeline interviews with 79 girls aged 15-21 years from urban, peri-urban, and rural communities and inquired about their relationships and life experiences leading up to pregnancy. We conducted follow-up interviews with 19 selected participants to validate and clarify preliminary findings. We identified six pathways to adolescent pregnancy which were broadly differentiated by the timing of pregnancy relative to marriage. Three pregnancy pathways within marriage were further differentiated by the main motivation for marriage-financial reasons, protecting the girl and family's reputation, or to progress a romantic relationship. Three pregnancy pathways outside marriage were distinguished by the nature of the sexual relationship preceding pregnancy-consensual sex, unwanted or pressured sex, and forced sex. Drivers of adolescent pregnancy include the acceptability of child marriage and stigma surrounding premarital pregnancy, family and social expectations of pregnancy following marriage, harmful gender-based norms and violence, and lack of sexual and reproductive health information and access to services. Adolescents follow varied pathways to pregnancy in Indonesia. The idealisation and acceptance of child marriage is both a catalyst and outcome of adolescent pregnancy, which is occurring amid stigma surrounding premarital sex and pregnancy, harmful gender-based norms and violence, and barriers to contraceptive access and use. Our findings emphasise that there are many drivers of adolescent pregnancy and different pathways will require intervention approaches that address child marriage alongside other key contributors.