77% of Ghanaians have access to contraceptive services, yet the country is still battling an incredibly high rate of adolescent pregnancies, unsafe abortions and maternal deaths. 350 out of every 100,000 women who give birth in Ghana die, and as many as 26% of all maternal deaths are adolescents.

Increased access to modern contraceptives should be accompanied by a sharp decline in unplanned pregnancies and unsafe abortions throughout the country, but evidence from Morhe et al. (2015) shows just the opposite. A survey of young women outside Kumasi found an astonishing 36.7% of adolescent women had completed at least one abortion. With widespread access to effective contraceptives, why are so many young women still suffering from the consequences of unplanned pregnancies and unsafe abortions?

The answer lies in the stigma. In Ghana it is not uncommon for the term “bad girl” to be applied to a young woman who seeks contraceptive services, is known to be engaging in premarital sex, becomes pregnant or has an abortion. This all-encompassing term is not only derogatory, but debilitating. Once someone is labeled a “bad girl” even her friends may choose not to interact with her due to the fear they may be infected with her immorality. “Bad girls” face verbal harassment, abandonment by partners, and on occasion, even beatings. Unfortunately, those who are supposed to be support systems for young women facing unplanned pregnancies are often the people perpetuating the “bad girl” stigma; health providers and even family members are often the root of the problem. A young woman asking for contraceptives may be turned away by a nurse because the nurse believes she is too young to be engaging in sexual intercourse. Without access to contraceptives, this young woman may become pregnant at a young age. As a pregnant adolescent, she will be forced to drop out of school or to suspend her career, may be abandoned by her partner, and in extreme cases, beaten by her family members.

Though Ghanaian culture greatly values family and community, other traditional values prevent the issue of sexual and reproductive health from ever surfacing in family conversation. As adolescents grow older and are not educated about sexual and reproductive health at school or by family members, peers are the main source of information about sex. Rumors spread like wildfire, leading to misconceptions, misinformation and an overall misunderstanding about all things relating to sexual and reproductive health. In interviews with Ghanaian women from Accra and Kumasi, researchers found that the spread of false information about contraceptives is incredibly prevalent. Women across the board reported that they did not use contraceptives because they had heard of people who have experienced extreme side effects such as weight loss or gain, cancers, fibroids, increased illness, infertility, decreased intellectual capability of children conceived while on birth control, and even sexual and physical weakness. Though many birth control methods do have side effects, they are rare and are not nearly as harmful as those described in these interviews. The lack of general education surrounding sexual and reproductive health continues to contribute to false beliefs that are preventing women from seeking family planning, leading to a high prevalence of unsafe sex, adolescent pregnancies and unsafe abortions.

To combat false beliefs, and ultimately reduce the number of adolescent pregnancies, maternal mortalities and unsafe abortions, Ghana must invest in implementing a sexual and reproductive health program in the education system (Comprehensive Sexuality Education). The provision of accurate sexual and reproductive health information will combat misconceptions and ultimately lead to an increase in family planning that will combat major health issues and save lives. The high rate of adolescent pregnancy in Ghana points to the fact that telling a young person to wait to engage in intercourse until marriage does not work. It is time for Ghana to embrace cultural shifts and focus on protecting young people rather than ostracizing those seeking contraceptives.