Researchers: Alonso Quijano-Ruiz, Marco Faytong-Haro
Method: Cross-sectional study
Data source: 2018 National Health and Nutrition Survey (ENSANUT)
Target group: Adolescent women
Sample: 978 adolescent women and their mothers
Outcomes of interest: Early sexual initiation, teenage pregnancy, contraceptive use
Journal and publisher: SSM - Population Health, Elsevier
Link to manuscript: https://doi.org/10.1016/j.ssmph.2021.100782

Several studies have shown that adolescent women’s sexual and reproductive health is associated with characteristics of their mothers. One of these characteristics is sexual empowerment, understood as a woman’s capacity to influence decision-making and sexual behavior within a relationship; for example, the possibility to demand condom use from her partner. This study used data from the 2018 National Health and Nutrition Survey (ENSANUT) to examine whether mothers’ sexual empowerment can predict their daughters’ sexual initiation, the likelihood of having been pregnant, and contraceptive use.

The findings indicate that a lack of sexual empowerment on the part of mothers increases the likelihood of early sexual initiation among daughters. Likewise, daughters of mothers who experienced teenage pregnancies are also more likely to become pregnant at an early age. Finally, the probability of daughters using contraceptives increases as the mother’s level of education rises.

Policy issue

In recent years, Latin America has managed to reduce the rate of adolescent motherhood; nevertheless, in Ecuador this figure remains among the highest in the region. Early motherhood significantly limits young women’s educational and employment opportunities, thereby contributing to the perpetuation of poverty and social disadvantage. A central factor behind this phenomenon is the restriction of women’s sexual empowerment, often imposed by social norms that legitimize violence and sexual coercion within relationships, as well as those that associate contraceptive use with promiscuity or infidelity. These restrictions hinder women’s ability to exercise control over their reproductive decisions.

This study explores how mothers’ sexual empowerment may generate positive intergenerational effects by strengthening their daughters’ capacity to delay sexual initiation and to prevent unplanned pregnancies through contraceptive use.

Study details

This study used data from the 2018 ENSANUT¹, a nationally representative survey that collects information on health conditions, nutrition, and the use of health services in the Ecuadorian population.

The main objective was to determine whether the likelihood of early sexual initiation and teenage pregnancy among young women is associated with their mothers’ sexual empowerment. Sexual empowerment was measured according to the mother’s ability to reject sexual violence and coercion, as well as her ability to insist that her partner use contraceptives. Another indicator of low sexual empowerment that was included is having had children at an early age.

Three outcome variables for daughters were included:

• Early sexual initiation: Having had sexual intercourse at age 16 or younger.
• Teenage pregnancy: Having had a pregnancy, regardless of its outcome.
• Contraceptive use: Use of any contraceptive method during the first sexual encounter.

A logistic regression was used to analyze the association between mothers’ sexual empowerment and daughters’ sexual health. The model included control variables related to the mother, the daughters, and the household.

Findings and policy insights

The main findings of the study were:

• Early sexual initiation is more likely among adolescents whose mothers lack sexual empowerment and who had a teenage pregnancy themselves.
• Adolescents who have already experienced a pregnancy often have mothers who were also teenage mothers.
• Adolescents are less likely to initiate sexual activity and more likely to use contraceptives when their mothers have high levels of education.
• Adolescents who learned about contraceptives through peers or the internet tend to engage in sexual activity more often than those who acquired this knowledge in school.

These findings underscore the need for policies that strengthen mothers’ empowerment, as doing so may help delay sexual initiation among adolescent girls. The study also highlights the importance of addressing traditional gender norms and stereotypes within sexual education programs. Given the sensitivity of this issue in Ecuadorian society, fostering active parental involvement in these discussions is essential.