Sofia was only 15 years old when she married Rashid in 2008. Marrying off daughters at an early age is a standard practice for many families living in rural Bangladesh. After her wedding, Sofia joined a local employment group that provides adolescent girls with the tools needed to gradually change cultural practices, particularly those pertaining to marriage and pregnancy. The group's activities include discussions on how to most effectively change behavior related to reproductive health as well as one-on-one counselling. It also offers peer-to-peer support and life skills training that help adolescents say no to early marriage. The empowerment group is one of more than 10,000 groups supported by some local Non Government Organizations (NGOs) working all over Bangladesh. These NGOs work through Canada's Adolescent Reproductive Health Project which also aims to increase access to quality health services for adolescents. During one of the group sessions, Sofia came to understand the potentially harmful effects of early marriage and pregnancy.
While maternal mortality in Bangladesh has declined by nearly 40 percent since 2001, the rate remains high with 194 maternal deaths per 100, 000, live births in 2010, dropping from 322 in 2001 with a projected decrease to 143 by 2015. Girls who get pregnant are at risk of serious health complications. These include dangerous hemorrhage and fistula, a painful internal injury caused by obstructed childbirth that commonly leads to serious maternal morbidities and social exclusion.
When Sofia heard about those risks, she invited her husband, Rashid, to discuss pregnancy with a counsellor. After hearing about the risks, Rashid agreed to delay having children for 5 years despite pressure from his parents and neighbours to produce an offspring. Together, the couple met with a female health care provider, who informed them about the various family planning options available.
Sofia's mother-in-law and neighbours continued to pressurize the newlyweds. Deeply rooted cultural practices and traditions caused a rift between Sofia and Rashid and their extended family, some of whose members insulted and criticized the couple. Unable to convince their close relatives of the risks, Sofia and Rashid returned to the counsellor. They took the help of a parent peer who has been trained to speak to other parents about adolescent issues. Sofia's mother-in-law and neighbours eventually came to understand the harmful effects of early pregnancy on mother and child.
Today, the village no longer pressurizes the couple; their parents and neighbours now support them and speak out against early marriage and pregnancy.