Child marriage, age of consent and perinatal health

Childhood marriages – often forced on girls – are common in low- and middle-income countries, where they are associated with pregnancy complications, marital rape, dropping out of school and mental health problems, Dr. Marcelo Urquia told seminar participants Nov. 6, 2019.

As a result, international agencies such as UNICEF have called for an end to the practice for anyone under 18. (Marriage is legal in Canada at age 16 with parental or judicial consent.) While rates of child marriage are declining worldwide, the practice is unlikely to be eradicated within 30 years, said Urquia, Canada Research Chair in applied population health.

The practice of child marriage sometimes persists among immigrants to North America but does it have the same health consequences in a high-income country? Urquia is studying that question, using large data sets from the U.S. and Canada.

Preliminary results suggest that in North America “there is no really clear evidence regarding whether child marriage is bad for health compared to other marital arrangements or age arrangements.”

Urquia said the difference might be a result of better-protected rights, higher-quality health care and less extreme patriarchy on this continent.

The burden of poor perinatal health here is borne by unmarried North American-born adolescents, he said. Supporting adolescent self-determination might be more effective at improving health than more laws restricting marriage.

Urquia pointed out that child marriage used to be part of European culture, citing the tender age of many Disney princesses. Like some modern child brides, many were trying to escape an even worse situation at home.

Urquia also looked at health data for underage girls who gave birth. The greater the age gap between the mother and father, the greater the likelihood of low birth weight and repeat underage births, he found.

Questions:

Are there some regions of North America with higher rates of child marriage?

Urquia said the practice is most common among immigrants from the Middle East and North Africa. It is also found among protestant cults, including those that are polygamous, and other religious extremists.

Are health outcomes for immigrants better in Canada, where prenatal care is free, than in the U.S.?

Immigrants use health services less than those born in Canada, Urquia said. However, the difference may be more pronounced in the U.S., where undocumented migrants are afraid that accessing services will lead to deportation.

Listen to podcasts from seminars in this series.

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