A new ICEH study on adolescent motherhood in Brazil highlights that nearly a quarter of Brazilian municipalities have adolescent fertility rates as high as those of the world's poorest countries. This unprecedented analysis also points to a strong correlation with the social deprivation prevalent in these cities. The research marks the launch of a special page dedicated to the studies of the International Center for Equity in Health (ICEH) on the Public Health Observatory, a Umane platform

Each year, about one in every 23 girls aged 15 to 19 gives birth to a child in Brazil. In contrast, in high-income countries, this number is just one in every 90. From 2020 to 2022, Brazil recorded over 1 million births to mothers aged 15–19, and more than 49,000 births among girls aged 10–14—an age group for which all pregnancies are, by law, considered the result of statutory rape.

These findings are from a comprehensive study on adolescent motherhood led by researchers from the International Center for Equity in Health at the Federal University of Pelotas (ICEH/UFPel). The study, which calculated adolescent fertility rates across all 5,570 Brazilian municipalities, is the highlight of a new section within the Public Health Observatory, created to monitor and raise awareness about health disparities in Brazil. The initiative is a partnership with Umane, a civil society organization that supports public health initiatives.

Brazil Off Track: 1 in 5 Municipalities Has Fertility Rates Comparable to the World’s Poorest Nations

Brazil’s national adolescent fertility rate stands at 43.6 births per 1,000 teenage girls—nearly double the average for upper-middle-income countries (24 per 1,000), and far higher than rates observed in BRICS countries such as Russia, India, and China, where the highest rate is 16.3 per 1,000.

“We expected that most municipalities would show fertility rates similar to those of countries with comparable income levels. Instead, what we found were patterns much closer to those seen in lower-middle- or even low-income countries,” explains epidemiologist Aluísio Barros, lead author of the study and researcher at ICEH/UFPel.

The national average hides a systemic problem: 69% of Brazilian municipalities have rates higher than expected for an upper-middle-income country. Alarmingly, 22%—or about one in five—have fertility rates as high as those of the world’s poorest nations.

This finding stands in sharp contrast to recent data from Brazil’s national statistics agency (IBGE), which reports that the country’s total fertility rate is 1.6 children per woman, closely aligned with rates in high-income countries (1.4). In other words, while adult Brazilian women have fertility levels comparable to those in wealthier nations, adolescent girls face much higher rates. Research has consistently shown that teenage motherhood is associated with a series of disadvantages, including lower educational attainment, reduced job opportunities, and lower wages.

A Country Divided: Stark Regional Disparities in Adolescent Fertility

The map of adolescent motherhood reveals a profound divide between Brazil's regions. While the South Region has a rate of 35 per thousand, the North Region's rate is more than double, reaching 77.1 per thousand. This disparity is reflected in the classification of municipalities: 76% of cities in the North fall into the low-income country fertility range, compared to only 5.1% in the Southeast, 9.4% in the South, 30.5% in the Northeast, and 32.7% in the Central-West.

The Greater the Deprivation, the Higher the Fertility Rate

Beyond regional differences, the study shows that socioeconomic deprivation is the strongest factor associated with high adolescent fertility rates. Researchers cross-referenced the data with the Brazilian Deprivation Index (IBP), an indicator that considers factors such as low income, illiteracy, and access to basic sanitation in cities. The results show a direct correlation: municipalities with greater resource scarcity, low income, illiteracy, and precarious infrastructure have the highest rates of adolescent fertility. This finding reinforces that adolescent motherhood is fundamentally a consequence of exclusion and a lack of opportunities.

"Our results show that Brazil is failing to protect its young people. Teenage pregnancy is not a choice; it is the outcome of a context of deprivation and lack of opportunities," states Barros. "We need public policies that address the root causes of the problem: poverty, school dropout, lack of access to services, and lack of future prospects. It is to shed light on these issues that we are launching the Health Equity Observatory," the author concludes.

“Investing in evidence-based research—like the studies developed by the International Center for Equity in Health—is essential to understand the many challenges Brazil still faces. In such a large, diverse, and unequal country, analyses like this one provide crucial input for crafting more effective public policies aimed at ensuring rights for all,” says Thais Junqueira, Executive Director of Umane. “Brazil’s Unified Health System (SUS) already offers a range of sexual and reproductive health services, including free access to contraception and educational programs for adolescents, often implemented in schools and through community organizations. The fact that adolescent pregnancy remains a major challenge today demands coordinated action and broader engagement from all sectors of society,” she adds.

Read the full article Maternity in adolescence in Brazil: high fertility rates and stark inequalities across municipalities and regions

Learn more about the ICEH special page on the Public Health Observatory (in Portuguese):