The high social cost

The material cost of the consequences of child marriage is far exceeded by the more intangible costs relating to the quality of life, the suppression of human rights, and the denial of women's potential to participate fully in the development process.

THOUGH largely prevalent in North India, child marriage is neither confined to the rural areas nor to certain pockets. The practice is prevalent in all States, in varying degrees.

While Rajasthan tops the list (one in 18), Kerala (one in 135) lies at the bottom. Rajasthan, Madhya Pradesh, Bihar, Uttar Pradesh, Jharkhand and Haryana together account for 63 per cent of all under-age marriages. Andhra Pradesh is the only southern State that is comparable with the northern States in terms of incidence of child marriage, with one in 40 persons married below the legal age.

Urban areas and metros are no exception. For example, Chennai (1 in 43) and Kolkata (1 in 47) have higher incidences than their respective - Tamil Nadu (one in 66) and West Bengal (one in 49).

The National Family Health Survey (NFHS) II (1998-99), in a survey of women who were married below the age of 18, found that in Bihar they accounted for 71 per cent, in Rajasthan 68.3 per cent, in Madhya Pradesh 64.7 per cent, in Andhra Pradesh 64.3 per cent, in Uttar Pradesh 62.1 per cent, in Maharashtra 47.7 per cent, in Karnataka 46.3 per cent, in West Bengal 45.9 per cent, in Haryana 41.5 per cent, in Gujarat and Assam 40.7 per cent, in Orissa 37.6 per cent, in Tamil Nadu 24.9 per cent, in Jammu and Kashmir 22 per cent, in Kerala 17 per cent, in Punjab 11.6 per cent and in Himachal Pradesh 10.7 per cent. The NFHS is a sample survey and not a head count that the Census is.

The NFHS II findings also showed that 59 per cent of married women between 15 and 19 years of age were illiterate; this percentage was expected to go up to 79 per cent and 73 per cent for the Scheduled Tribes and Scheduled Castes respectively. The all-India dropout rate for girls was 41.9 per cent at the primary-school level, 57.95 up to the elementary level and 71.51 per cent at the secondary level.

Quoting from a 1993 survey conducted among 5,000 women in Rajasthan, a United Nations Children's Fund (UNICEF) report of 2001 titled "Early Marriage: Child Spouses" said that 56 per cent of the sample had married before the age of 15 and of them 17 per cent had been married before the age of 10. The consequences of early marriage for women are rather apparent: early pregnancies, obstetric complications, higher rates of neonatal mortality, infant mortality and under-five mortality. Child brides are also vulnerable to domestic and sexual violence.

Various studies have documented a high degree of positive correlation between the incidence of under-age marriage and birth rates. For example, Uttar Pradesh, where child marriages are common, has the highest birth rate of 31.6, while Kerala, with very few such marriages, has a birth rate of 16.8, one of the lowest in the country.

CHILD marriage has profound physical, psychological, intellectual and emotional consequences. Several studies have documented its impact on maternal mortality. For instance, a hospital-based study in Mumbai by Saroj Pachauri and A. Jamshedji ("Risks of Teenage Pregnancy" (1983), Journal of Obstetrics and Gynaecology) shows that while the maternal mortality ratio among women between 20 and 29 was 138 per 100,000 live births, for adolescents it was 206.

A community-based survey in rural Andhra Pradesh by Masuma Mamdani ("Adolescent Reproductive Health: Experience of Community-based Programmes" in Saroj Pachauri's Implementing Adolescent Reproductive Health Agenda for India: The Beginning, 1998) shows that adolescent mortality ratios (1,484 per 100,000 live births) are twice that reported among women aged 25-29 (736).

Anaemia, one of the most common contributing causes of maternal death and morbidity, is very common among adolescent girls. According to a study done in Karnataka by J. Bhatia and John Cleland ("Self-reported Symptoms of Gynaecological Morbidity and their Treatment in South India" (1995), in Studies in Family Planning), women below 18 years at the time of pregnancy were one and a half times more anaemic than women between 18 and 24, and almost twice so compared with women over 25 years.

Adolescence, malnutrition, anaemia and the deprivation of extra nutritional demands compound health risks during pregnancy for girls who marry as children. These risks, studies show, are further aggravated by poor antenatal care. The National Family Health Survey (1998-99) shows that 35 per cent of pregnant women below 20 received no antenatal care.

A significant percentage of maternal morbidity is associated with unsafe abortions had by adolescents and the complications arising from them. According to the NFHS, the percentage of abortions among adolescents aged 15-19 is double that among women aged 20-49. It also shows that 10 per cent of all adolescent pregnancies end in miscarriage or stillbirth compared with 7 per cent among older women.

These data, however, pertain only to the reported cases. The incidence of abortions and the number of pregnancies among girls are thought to be grossly underestimated. For instance, according to a hospital-based study in Mumbai by Vinaya Pendse ("Maternal Deaths in an Indian Hospital: A Decade of Change", in Berer Marge and Ravindran Sundari edited Safe Motherhood Initiatives: Critical Issues, 1999), the abortion rates were 158 for every 1,000 pregnant women among adolescents, compared to 77 among women aged 20-29, and stillbirth rates in these two age groups were 35 and 29 respectively for every 1,000 women.

Infants born to young mothers also suffer a great health risk. According to Jaya Sagade, they are likely to experience a 30 per cent higher risk of perinatal and neonatal mortality in the first year than infants of older women. According to the NFHS, the neonatal mortality rate was 70.8 per 1,000 live births among infants of adolescent mothers compared to 44.8 among infants of mothers aged 20-29.

Another severe consequence of child marriages is their serious impact on the mental health of the young girls. Health researchers have documented the impact of child marriages along with gender inequalities on mental health consequences (see for example, L. Dennerstein, J. Astbury and C. Morse, Psychological and Mental Health Aspects of Women's Health, Geneva, WHO, 1993). According to Leyla Gulcur (in Evaluating the Role of Gender Inequalities and Rights Violation in Women's Mental Health, 2000, Health and Human Rights Journal), child marriage, along with little or no education, economic dependence, denial of decision-making power, inequality within the home, and sexual exploitation, impacts seriously on the mental health.

Apart from serious health consequences, child marriage, according to Jaya Sagade, also takes away the educational opportunities of adolescent girls, limiting their opportunities for employment and income generation and "sowing the seeds for a lifetime of dependency". Studies such as "Reproductive Health-seeking by Married Adolescent Girls in Maharashtra" (2001) by Alka Barua and Kathleen Kurz show that adolescent wives are observed to have little autonomy and decision-making authority in their homes, exposing them to other risks, including violence.

Social workers report that many husbands tire of their marriages after the third, fourth or fifth child, when their wives are still teenagers. Many such girls, divorced or widowed early, are left to fend for themselves and their children.

THE institution of patriarchy, the feudal set-up, the low status of women, the economic and social disadvantages, the lack of awareness about the law, the health consequences, the lack of alternatives, the limited political commitment and, the traditional and cultural norms, all overlap and compound the problems of child marriage.

According to Jaya Sagade, in most cases, marriage is the mere transference of the father's domination over a woman in favour of a husband's. When done at an early age, it is felt, it is easy to get the bride to adapt well to her socially determined position. It also helps to control her sexuality and reproduction, which, according to Michael Koeing ("Patriarchy, Women's Status and Reproductive Behaviour in Rural North India" (1992), Demography India), is at the heart of unequal gender relationships.

According to Purnima Mane ("Socialisation of Indian Women in their Childhood: An Analysis of Literature" (1991), Indian Journal of Social Work), through culturally embedded concepts of virginity and chastity, men not only control women's sexuality but often see it as a symbol of the honour and status of the family. Marriages are, therefore, arranged either immediately after or sometimes even before the girl attains puberty, regardless of the law.

Offences under the Child Marriage Restraint Act (CMRA) are cognisable only for the purpose of investigation, and violators of the law attract a mild punishment or penalty. For instance, if the bride is below 18 at the time of marriage, the bridegroom, the one who performs, conducts or directs the marriage, and the guardian or person in charge of the minor girl are liable for a simple imprisonment of three months and a fine.

Says Jaya Sagade: "Legal rights operate within the complexities of the prevailing socio-economic system. Law reforms may not remove the structural inequalities of the life systems, which make it difficult for individuals to realise their rights." According to her, law is important but is only part of a necessarily multi-faceted approach.

Jaya Sagade recommends "social legislation" as the way forward. She asks: "If a girl is not to be married off what is she to do?" She also provides an answer - that young active adolescent girl's mind must be occupied in constructive work. So, the best thing to do is to educate the girls properly.

In an interview to a newspaper earlier this year, demographer Ashish Bose argued that improving education did not simply mean increasing the literacy rate but more years of schooling, lower dropout rates and improved quality of education. He believes that education increases a girl's awareness and strengthens her ability to make informed decisions. Many cases of infant and maternal mortality, he said in the interview, were directly related to factors that could be controlled by a more aware expecting mother.

The cost of allowing the continuation of the practice of child marriage is phenomenal. According to Jaya Sagade, much of the cost is hidden because statistics on this are difficult to come by. She argues that the material cost of the consequences of child marriage is far exceeded by the more intangible costs relating to the quality of life, the suppression of human rights, and the denial of women's potential to participate fully in the development process.