Dechen Dolkar
Trashigang—A 19-year-old mother of two from Kanglung, Trashigang shoulders the full weight of motherhood. She gave birth to her first child at 17, a son now nearing two years old. Her second son, just eight months old, followed soon after.
Socioeconomic challenges forced her to leave school in 2020, dropping out of Class IX to support her family. In her village, cultural expectations often make early marriage a necessity for survival.
Unaware of contraceptive options, she didn’t use any before her first pregnancy. “I visited the hospital after missing my monthly period for two months, and that’s when the health staff confirmed I was pregnant,” she said.
She described feeling both happiness and nervousness upon learning she was pregnant, unaware of the health risks associated with early pregnancy. Her mother supported her during delivery. She breastfed her first son for nine months, but without understanding precautions, she soon conceived again. Now using contraceptives, she reflects on her journey, saying early motherhood has made her stronger. “I didn’t face any health complications,” she added.
Her experience mirrors a wider issue. Last year, Trashigang hospital recorded 15 cases of teenage pregnancies.
Nationwide statistics from the Royal Bhutan Police (RBP) reveal a concerning trend. From 2021 to early November 2024, 77 cases of teenage pregnancies were reported. This year alone, 24 cases have been documented, with Trashigang accounting for six. Thimphu and Mongar reported the highest numbers, with 14 and 11 cases, respectively.
In 2023, 25 cases of teenage pregnancy were reported, compared to eight in 2022 and 20 in 2021.
These cases are most prevalent among young mothers from low-income, often illiterate backgrounds. In rural Trashigang, where many girls leave school early to support their families, early marriage and teenage pregnancies are a common reality.
Young mothers in these areas often marry early and take on family responsibilities, entering adulthood without preparation. Financial struggles and the demand for labour at home force many to leave school, assuming adult roles prematurely. The reliance on agriculture and manual labour in villages further entrenches this cycle.
Another 19-year-old mother from Kanglung dropped out of school after Class VIII due to financial challenges. She worked as a babysitter in Thimphu, earning about Nu 5,000 a month, before returning to her village and getting married. Now raising a two-month-old daughter, she recalled the pain of a miscarriage last year at four months. “I didn’t know how it happened; it was heartbreaking,” she said.
After marriage, she and her husband used contraceptives for a few months before deciding to have a baby. Initially worried that health workers might reprimand her for getting pregnant again, she was relieved to find them supportive and caring, providing excellent healthcare.
“Even my family and the community were supportive,” she said. “In rural society, taking on the responsibilities of motherhood helps us mature faster.” Her mother often reminded her that becoming a mother at a young age was not uncommon in their community.
Similarly, a 19-year-old mother from Wamrong, who left school after Class VIII due to health and financial difficulties, reflected on her journey into early motherhood. She chose to stay in the village to assist her mother, embracing a life shaped by familial responsibilities and rural realities.
Now the mother of a one-year-old daughter, she recalled feeling hesitant during her first hospital visit, fearing disapproval from health officials. “They were supportive and provided health services,” she said. Reflecting on her experience, she believes motherhood is best delayed until after the age of 20. “After that age, we are mentally and physically prepared. I struggled a lot initially, being a young mother and working in the fields,” she said.
Another 19-year-old mother from Wamrong, raising a nine-month-old son, left school after Class VIII due to financial difficulties. The youngest of seven siblings, she admitted she did not want to continue her education, as she found academics challenging. Unaware of contraceptive options, she became pregnant shortly after marriage. Despite the hardships, she feels having children early can be advantageous.
Similarly, an 18-year-old mother from Yangneer, now caring for a one-year-old son, had her education cut short after Class II due to illness and the lack of someone to stay with her aging parents. Raised on farmland, she met her partner through mobile connectivity and married young to take on the responsibility of supporting her parents.
She said that although she was aware of contraception, her attempt to seek preventive measures at the hospital was unsuccessful, as the health service provider did not offer them, citing her young age. “I went to the hospital because I was sick, not knowing that I was pregnant. That’s when they told me I was expecting,” she recalled.
After her pregnancy was confirmed, health workers offered full support, advising her to prepare mentally and physically for motherhood. She said: “At my age, other girls in the village are still studying. I believe we should only have children after the age of 20, when we are fully grown and ready, both mentally and physically.” She has experienced no health complications and gave birth normally.
According to Trashigang’s dzongkhag health officer, the health department runs regular awareness programmes on teenage pregnancy, emphasising education, prevention, and support. These efforts include comprehensive sex education in schools.
The officer noted that the programs engage schools, communities, and families to highlight risks and prevention strategies. Initiatives like co-ordination meetings, school health programmes, the RENEW initiative, and DIASAN focal points play a central role in spreading awareness and providing support.
In 2020, over 237 teenage pregnancies were reported nationwide, with Thimphu recording the highest at 55 cases, followed by Chukha with 30 and Trashigang with 20 cases.
Officials attribute Trashigang’s high teenage pregnancy rates to poverty and a lack of education. Limited knowledge about sexual health and reproduction fosters misinformation and risky behaviors among teenagers. Societal attitudes favoring early marriage and restricted access to contraceptives and reproductive health services further exacerbate the problem.
In remote areas, inadequate healthcare, scarce educational resources, and poor communication about sexual health create conditions where teenage pregnancy becomes normalised. Although cultural norms around early marriage are changing in many parts of the country, they remain deeply rooted in remote regions like Sakteng and Merak, where teenage pregnancies are still common.
Teenage mothers face heightened health risks, including preterm births and low birth weights, according to the health officer. Many lack access to adequate prenatal and postnatal care, proper nutrition, and essential support systems, which can adversely affect both the mothers and their babies.
Social stigma and discrimination further marginalise these young mothers, depriving them of critical family and community support during a vulnerable phase of their lives. These challenges not only jeopardise their physical health but also impact their emotional well-being and long-term prospects.
Between June and October 2023, The PEMA Secretariat assisted 23 cases of teenage pregnancy, offering comprehensive support mechanisms.
An official from The PEMA’s response services explained that once a case is reported, protection services are activated, and officers assess the individual’s risks, needs, and circumstances to create a tailored support plan. Cases involving minors are referred to the RBP for investigation to ensure justice.
The PEMA facilitates medical checkups, provides counseling, and ensures family support through intervention and follow-ups to promote well-being. Post-delivery support mechanisms are also established in collaboration with organisations such as RENEW and Nazhoen Lamtoen, addressing the specific needs of young mothers.
For those wishing to resume education, PEMA assists with school relocations and admissions. Young mothers unable to return to school are connected to skilling and livelihood opportunities. Additionally, The PEMA is in the process of launching a reintegration and economic empowerment programme to support individuals in challenging circumstances.
The PEMA Secretariat is developing a robust reintegration and aftercare programme to support individuals in difficult circumstances. A new pillar focusing on reintegration and economic empowerment has been established within the Secretariat to address these pressing needs.
The Secretariat works in close collaboration with government ministries, civil society organisations, and local authorities to ensure vulnerable populations receive the necessary support and resources. “Every organisation has a role to play in preventing violence and supporting mental health. It’s time to come together to build a safe and supportive society,” an official said.
This story is published under an EU-funded project managed by Save the Children Bhutan in partnership with the Bhutan Transparency Initiative and RENEW.