More than 1,000 girls in Paraguay age 14 or younger gave birth between 2019 and 2020, according to a new Amnesty International report that blames rampant sexual violence, poor sex education and some of South America’s more restrictive abortion laws.

In the much more populous United States, where the Supreme Court has signaled it could uphold a law that drastically scales back access to abortion, 2,253 births by girls between the ages of 10 and 14 were reported in 2016, the latest year for which comparable statistics were available. Uruguay, which is near Paraguay and whose population of some 3.5 million people is about half that of its neighbor, reportedly has about one-third as many births by girls in that age group; it loosened curbs on abortion in 2012.

Paraguay’s stringent laws — termination of pregnancy is allowed only if a pregnant individual’s life is in danger — reflect the influence of religious and conservative factions that support abortion restrictions. In 2019, one of its legislative chambers declared itself “pro-life” and removed sex education materials from schools, according to Freedom House, a watchdog.

In a move that spurred international indignation, authorities barred a 10-year-old girl who was allegedly raped by her stepfather from having an abortion in 2015. The age of heterosexual sexual consent in the South American country is 14, meaning that many of the 1,000-plus pregnancies were likely to be the result of sexual assault. More than 80 percent of sexual violence cases in Paraguay occur within the family, Amnesty said.

The Catholic Church in Paraguay reportedly supported the 2015 decision on sanctity of life grounds. Paraguay’s ministries for public health and adolescent affairs could not immediately be reached for comment early Thursday. Pregnancy and childbirth-related complications are the leading cause behind deaths of girls between 15 and 19, according to the World Health Organization.

“Paraguay does not have a proper system to prevent sexual violence and protect survivors,” wrote Amnesty’s researchers. “ … [F]orcing girls or adolescents who have been raped to carry a pregnancy to term and leaving them with no choice but to become mothers is a form of institutionalized violence.”

While the debate around reproductive rights looks set to continue through next year’s midterm elections in the United States, countries such as Ireland and Argentina have recently moved to expand access to abortions.

“The recognition that people have the right to reproductive autonomy and to choose if and when to have a child is a notion that is spreading around the world,” said Laura Lindberg, a researcher at the Guttmacher Institute, which advocates for abortion rights.

She warned that a potential reversal of Roe v. Wade, a landmark U.S. Supreme Court decision that established a woman’s fundamental right to end a pregnancy, could lead to more teenage mothers there. Younger teens, in particular, “face greater challenges … traveling to other states where abortion is legal, whether because of lack of information, cost or other barriers,” she said.

The Latin American and the Caribbean region is alone in reporting a rising number of births among girls younger than 15 years old, according to a 2020 brief by international public health agencies. Teenagers with Indigenous and African heritage, as well as those from economically underprivileged backgrounds, were more likely to get pregnant, the report said.

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