Child marriage is a crippling medical and social burden to women in India and poses a demographic threat to the entire world, health experts warned in The Lancet yesterday.
Specialists in public health from India and the US looked at data for 22,807 women aged 20 to 24, selected from a geographical and social cross-section of Indian society, who took part in a survey in 2005 and 2006.
A total of 44.5 percent of the women had been wed by the time they were 18, set as the legal age for marriage since 1978. Of these, 22.6 percent had been married before the age of 16 and 2.6 percent before the age of 13.
Women who had been child brides were 37 percent likelier not to have used contraception before their first child was born; seven times likelier to have three or more births; and three times likelier to have a repeat childbirth in less than 24 months.
They were also more than twice as likely to have multiple unwanted pregnancies, nearly 50 percent likelier to have an abortion and more than six times likelier to seek sterilization compared with counterparts who had married after the age of 18.
They also at greater risk of a fistula — a tear in the genital tract — as well as pregnancy complications and death and sickness as a result of childbirth.
“Child marriage has serious consequences for national development, stunting education and vocational opportunities for a large sector of the population,” say the paper’s authors, led by Anita Raj, a doctor at Boston University School of Public Health in Massachusetts. “Furthermore, marriage at a very young age has grave health consequences for both the young women and their children.”
The paper gives the lie to those who claim that the practice would shrivel as a result of India’s rising prosperity and national policies aimed at preventing early marriage and encouraging access to contraception, education and economic opportunities for women.
A survey conducted in 1998 and 1999 estimated that 50 percent of Indian women aged 20 to 24 were married as children, which means that the phenomenon has retreated by just a fraction. The paper calls for efforts against child marriage to be beefed up, especially in rural areas.
“These results suggest that neither recent progress in economic and women’s development, nor existing policy or programmatic efforts to prevent child marriage and promote maternal and child health have been sufficient to reduce the prevalence of child marriage in India to that of most other developing nations,” it says.
The legal age of marriage in India is 18 years old for women and 21 years old for men.
In a commentary also published by The Lancet, fertility expert Vinita Salvi of the King Edward Memorial Hospital in Mumbai said legislation against child marriage in India “exists largely on paper.”
The country has 1.15 billion people, a phenomenon that was detrimental “not only for India but also for the entire world,” and child marriage played an important role in the demographic surge, Salvi said.
“Marriage at such ages has enormous adverse implications, not just for women’s health and empowerment in general, but also for humankind in the long term,” Salvi said.
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