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Dominican Republic: Policies Fuel Teen Pregnancy

Girls Need Comprehensive Sexuality Education, Health Services, Safe Abortion

A 15-year-old girl holds her child at her home in Santo Domingo, Dominican Republic. The Dominican Republic has the highest adolescent pregnancy rate of all the countries in Latin America and the Caribbean, according to the Pan American Health Organization (PAHO). © 2019 Tatiana Fernández Geara for Human Rights Watch
(New York) – Adolescent girls in the Dominican Republic are being denied their sexual and reproductive rights, including access to safe abortion, Human Rights Watch said in a report released today. The authorities should carry out a new plan for comprehensive sexuality education and decriminalize abortion to curb unwanted teen pregnancy and reduce unsafe abortion.

The 50-page report, “‘I Felt Like the World Was Falling Down on Me’: Adolescent Girls’ Sexual and Reproductive Health and Rights in the Dominican Republic,” documents how authorities have stalled the rollout of a long-awaited sexuality education program, leaving hundreds of thousands of adolescent girls and boys without scientifically accurate information about their health. The country has the highest teen pregnancy rate in Latin America and the Caribbean, according to the Pan American Health Organization (PAHO). The country’s total ban on abortion means an adolescent girl facing an unwanted pregnancy must continue that pregnancy against her wishes or obtain a clandestine abortion, often at great risk to her health and even her life.

“Girls need to be equipped with the information and health services to prevent unwanted pregnancy, and to make informed choices about their bodies and relationships,” said Margaret Wurth, senior women’s rights researcher at Human Rights Watch. “By denying their sexual and reproductive rights, Dominican authorities are failing to give girls and young women every opportunity to continue their education and live healthy, successful, and fulfilling lives.”

The report is based on interviews with 30 girls and women who became pregnant before turning 18, and dozens of other people including students, LGBT youth, healthcare and social service providers, and experts in the field.

The Dominican Republic’s high teen pregnancy rate is a consequence of the country’s inadequate sexuality education and unmet need for contraception. Public health data shows 20.5 percent of girls and young women ages 15 to 19 in the Dominican Republic become pregnant in their teens. Most of these pregnancies are unplanned or unwanted. Laws criminalizing abortion create pervasive fear and drive abortion underground, forcing women and girls to resort to unsafe measures to end unwanted pregnancies.

Rosa Hernández stands in her home below a photo of her daughter, Rosaura Almonte Hernández, who died in 2012 at age 16. Rosaura, known as “Esperancita,” had leukemia. Doctors initially denied her chemotherapy treatment because she was pregnant, and the Dominican Republic’s abortion ban prohibited her from terminating the pregnancy. © 2018 Tatiana Fernández Geara for Human Rights Watch

Girls and young women described extreme distress on learning of an unplanned pregnancy. “I felt like the world was falling down on me,” one young woman said. “I was going crazy, thinking I can’t have a kid.” “I was terrified,” said another.

The country’s abortion ban has distinct harmful impacts on adolescent girls, Human Rights Watch found. Sexual activity is often highly stigmatized for adolescent girls. A girl facing an unwanted pregnancy may be less able than an adult woman to seek help, potentially leading her to resort to less safe abortion methods. Several girls and young women said they tried to end a pregnancy clandestinely before age 18. International human rights experts have found that denying girls and women access to abortion is a form of discrimination and jeopardizes a range of human rights.

United Nations experts have urged governments to provide students with comprehensive sexuality education, beginning at an early age. Under international human rights law, as well as domestic legislation in the Dominican Republic, children have a right to information about sexual and reproductive health.

The Dominican Republic has come under international scrutiny for failing to provide scientifically accurate, rights-based sexuality education in schools. In 2015, the authorities announced plans to incorporate comprehensive sexuality education into the national curriculum and developed materials for educators and counselors. But the National Board of Education has not approved the new approach so that it can be carried out nationwide.

Some schools offer sexuality education workshops or instruction, but there is no mandatory and consistent approach. “It is up to the goodwill of the teacher,” one expert said.

A May 2019 order by the education minister mandating the creation of a gender policy for the ministry and the education system could require authorities to provide comprehensive sexuality education. It remains to be seen whether this new strategy will be effectively carried out to ensure adolescent girls’ rights.

Many adolescents in the Dominican Republic also struggle to get confidential, non-stigmatizing health services, and some go without important sexual and reproductive health care, such as contraception. “They don’t receive quality services and confidential treatment,” an expert said. A 2013 Health Ministry survey, the most recent data available, found that 27 percent of girls and young women ages 15 to 19, and 21 percent of those ages 20 to 24 have an unmet need for contraception.

Early pregnancy carries serious health risks for young mothers and their babies. Some of the young mothers interviewed experienced complications during pregnancy or childbirth, some resulting in the babies’ deaths.

Pregnant students and young mothers often find it difficult, or impossible, to continue their education. Some said they faced discriminatory attitudes from teachers or school administrators and left school during pregnancy or after giving birth. Some never returned.

The Dominican Republic should decriminalize abortion, carry our plans to provide comprehensive sexuality education in schools, and address other barriers jeopardizing girls’ sexual and reproductive rights.

“A teenage girl’s life and plans should not be derailed by an unwanted pregnancy,” Wurth said. “Lawmakers in the Dominican Republic should ensure that adolescent girls can get reliable sexual and reproductive health information, including at school, and adequate health services, including safe and legal abortion.”

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