MEXICO CITY, MEXICO – At 15, María Isabel Ibarra Hernández is pregnant with her second child.
She was 13 when she first became pregnant. At the time, she had been dating her baby’s father for nine months and living with him for four months, she says.
This morning, María Isabel is visiting the Community Health Center in the Hank González neighborhood of Ecatepec de Morelos municipality in Mexico state.
Teenagers carry nearly one-fifth of the pregnancies in Mexico state, according to the National Institute of Geography and Statistics. More than 40 percent of the residents of Ecatepec – which adjoins Mexico City, the nation’s capital – are poor, according to the Municipal System of Statistical and Geographical Information.
The weekly workshop for pregnant teenagers is part of Holistic Care for the Teenage Mother, a program managed by Mexico’s National System for the Integral Development of the Family.
The program operates in neighborhoods that account for most of Ecatepec’s teenage pregnancies, says Tania Pelcastre Ángel, who runs the system’s office in the municipality.
This is María Isabel’s first time at the workshop. She knew nothing about preventing pregnancy before she got pregnant because she left school after the second grade and had never been to the health center, she says.
María Isabel would have preferred to wait for motherhood, but her boyfriend was eager to have a child, she says. She asked him to wait until she had her “quinceañera” party, a celebration that marks the transition of a 15-year-old girl into adulthood. But they did not use protection.
“The truth is that I did fall in love with my husband,” she says. “He used to ask me for a child, and I gave it to him.”
María Isabel and her boyfriend, the father of both of her children, fought constantly and are separated. Now living with her parents, she says all she wants to do is to support her children.
She plans to look for a stable job after her second child is born. Meanwhile, she sells merchandise in subway cars.
Aiming to reduce unplanned teen pregnancies, the Mexican government has promoted prevention for three years. But critics says its campaigns target teenagers who can control their sex lives without taking into account how marginalization, gender violence, and access to sex education and contraception affect other teens. Although the government has also implemented actions to guarantee teenagers access to contraception, reproductive rights activists say access will not reduce the pregnancy rate unless programs ensure that teens obtain contraceptives and learn to use them effectively. Furthermore, sex education should go beyond providing information and promote sexual and reproductive rights, activists say.
Although the country’s overall fertility rate fell between 1999 and 2013, the fertility rate among 15- to 19-year-olds increased from 64 to 66 births per every 1,000 teens, according to the National Institute of Geography and Statistics.
More than 40 percent of pregnancies among 15- to 19-year-olds are not planned or desired, according to the National Population Council.
The Mexican government has focused on teenage sexual and reproductive health only in the past few years, according to the council. In 2011 and 2013, the council and the Ministry of Health launched campaigns aimed at helping 15- to 19-year-olds avoid unplanned pregnancies and sexually transmitted diseases.
The campaigns strive to empower teenagers to assume responsibility for sexual decisions, says Rufino Luna Gordillo, deputy director general of sexual and reproductive health for the National Center of Gender Equity and Reproductive Health, which is under the Ministry of Health.
“If you take the responsibility to initiate an active sexual life, there [is] the responsibility of protection for themselves, including for their partner,” he says. “The idea is to empower these teens that if they can make this decision, they must also decide to protect themselves.”
Marisol, 17, a participant in the Holistic Care program in Ecatepec’s San Agustín neighborhood, agrees that teens must protect themselves. Marisol, who is nine months pregnant, requests partial anonymity for fear of being stigmatized.
“You have the responsibility,” she says. “You know what you want for your future. I think it would be an issue in which each person would know how to take care of themselves.”
Isabel Fulda, executive analyst of Grupo de Información en Reproducción Elegida, which means “information group for reproductive choice,” an organization that promotes and defends women’s reproductive rights, criticizes the government for promulgating the idea that teenagers alone are responsible for unplanned pregnancies.
“The idea is always: The youth get pregnant because they do not take care of themselves,” Fulda says. “But in reality, the responsibility there is the state’s, and the large number of teen pregnancies that there are, are the product of structural problems and deficiencies that the state should cover.”
The government must address social factors that contribute to teenage pregnancies, including poverty, social inequality, discrimination, gender violence, and a lack of access to contraception and sex education, Fulda says.
Marisol says she left school because of family problems and moved in with her boyfriend. They had been living together for two months when she became pregnant.
Marisol says she got pregnant because she was not careful with contraceptives. She had previously used the calendar method, in which a woman tracks her menstrual cycle and refrains from sex while ovulating, but abandoned it when she started living with her boyfriend. They sometimes used a condom.
Although 90 percent of young people ages 12 to 19 have at least heard about contraceptive methods, only about 33 percent of sexually active females and 15 percent of sexually active males used protection in their first sexual encounters, according to the 2012 National Health and Nutrition Survey.
Further, 36 percent of sexually active teens have never used contraception, according to the National Population Council.