Résumé : According to official statistics, Peru's adolescent fertility rate is 77/1000, and 11% of adolescent females are mothers, while 2.5% are pregnant. In 1998, an estimated 1.3 million women aged 15-19 were sexually active but not using contraception. The average age at first intercourse was 16.8 for males and 18.9 for females. Peruvian adolescents have high rates of maternal mortality and abortion. Those in poverty especially often lack prenatal care, and an estimated 15% of maternal deaths are in adolescents. Adolescent mothers go on to have more children, more closely spaced pregnancies, and perhaps more unsafe abortions than do women who were not pregnant before age 20. Children of adolescent mothers weigh less at birth and are 36% more likely to die in the first year of life than children of older mothers. Adolescent pregnancy is considered a public health problem because of the medical problems and social risks it entails. It is usually unplanned and often unwanted. Sexual abuse, forced sex, early union, and very low rates of contraceptive usage are among factors in adolescent pregnancy. Nearly one-third of sexually active adolescents report use of a method, but generally it is periodic abstinence not supported by adequate knowledge of the fertile period. Studies of adolescents throughout Peru have revealed relatively high rates of sexual activity, poor image and little use of condoms, lack of knowledge of the fertile period, and inadequate sexual negotiating skills among young women. Most adolescents were unaware that they had reproductive rights but desired to be respectfully treated by health personnel. Cultural attitudes that do not recognize the right of adolescents to sexual and reproductive health services are the greatest barrier to their access to care.
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