A troubling blind spot in TN's maternal health success — teen pregnancies

Over the past five years, Tamil Nadu has recorded a steady decline in the overall number of pregnancies, yet a troubling trend has emerged in the form of teenage pregnancies. The number of teenage pregnancies has surged by over 20 per cent in these five years, exposing gaps in underreported child marriages and failures in providing awareness on sex education among teenagers.

Data from the Tamil Nadu Health Department shows that the total number of pregnancies in the state fell by nearly 7 per cent, from 10.2 lakh in 2019-20 to 9.5 lakh in 2023-24. In stark contrast, the number of girls aged 13-19 who conceived rose from 11,772 to 14,360 during the same period, an increase of nearly 22 per cent.

Shocking statistics

Data revealpoint out that teen pregnancies now account for 1.5 per cent of all pregnancies in Tamil Nadu, against 1.1 about five years ago. Public health experts warn that even a fractional rise is significant, given the heightened risks adolescent mothers face, including anaemia, preterm births and maternal complications.

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While the overall government data includes teenagers ranging from ages 13 to 19, with 18 being the legal age of marriage for Indian women, official records in districts such as Nagapattinam, Tirunelveli, Tiruchi and Vellore have documented hundreds of births to girls under 18 within limited reporting windows.

An RTI response from Tirunelveli district earlier revealed that 1,448 girls under 18 gave birth over a 34-month period in 2021-23. Activists attribute many such cases to informal child marriages that go unregistered and unreported.

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Within months, she was married off in an unregistered temple ceremony. By early 2025, she was pregnant. A village health nurse familiar with cases in the region said such patterns are common.

“When girls discontinue school, families often feel pressure to get them ‘settled’ quickly. Even suspicion of a relationship can trigger marriage. By the time we intervene, the girl is already pregnant,” she said.

Though Kavya delivered her baby safely in a government hospital, her education has not resumed.

School dropouts, early pregnancies

Women’s groups say the data mirrors what they have been observing on the ground, a strong link between school dropouts and early pregnancies.

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Speaking to The Federal, a senior advocate and member of All India Democratic Women’s Association (AIDWA), who organised a stakeholders’ meeting in Tiruchi on teenage pregnancies, said, “There is a strong link between the dropout rates of girls and early pregnancies. Failure starts with not arresting dropout rates. There are some hotspots in each district, and identification of those regions and sensitising children to report such events would help us reduce teenage pregnancies. In cases of abuse or consensual relationships, instead of accusing the child, sensitive steps need to be taken to address the issue in each case.”

Nirmala recalled how several schoolgirls in Madurai who were abused by a headmaster were married off once the case was filed in court. “Families were anxious about the future of the girls and married them off. They were not ready to send those children back to school. Failure in admitting those children to a different school and providing them counselling pushed them to become child labourers and teenage mothers,” she explained.

Slowdown of societal development

Tamil Nadu Health Minister Ma Subramanian has publicly acknowledged that there is a rise in teenage pregnancies in the state. He told The Federal that the health department produced a documentary film on the ill-effects of underage marriages and pregnancies, and officials have been asked to screen the film in schools to spread awareness among teenagers.

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“Though overall pregnancies have dropped by 7 per cent in the past five years, teenage pregnancies have increased by nearly 20 per cent. In 2023–24 alone, 14,360 girls aged between 13 and 19 became pregnant,” the minister said.

He attributed the increase to early marriage, sexual abuse, and limited awareness of reproductive health. “Teenage pregnancy does not affect just one family. It slows down societal development,” he said, adding that the department has launched awareness campaigns targeting adolescents in schools.

What needs to be done?

Tamil Nadu has long been regarded as a frontrunner in maternal and child health indicators, with high institutional delivery rates and declining infant mortality. But experts caution that strong hospital-based systems cannot compensate for failures in prevention at the community level. School retention, they say, remains the single most effective safeguard against early marriage and adolescent pregnancy.

Child rights activist A Devaneyan argues that district-specific strategies are urgently needed. According to him, when the state celebrates declining fertility rates, the steady rise in adolescent pregnancies should be considered an alarm. “Hotspots must be identified. Reducing school dropouts is key. A one-size-fits-all approach will not work; vulnerable regions need focused intervention,” he told The Federal.

To report child marriage, dial helpline: 1098, 1091

Police helpline: 100

(This report was filed under Population First’s Laadli Media Fellowship 2026.)