Makwanpur | Despite numerous campaigns pushing the slogan “Marriage after 20,” the harsh truth is that teenage pregnancy in Makwanpur remains alarmingly high. This disturbing reality clashes with the official declarations of many local units as “child-friendly,” where young girls under 20 are still becoming mothers at a troubling rate. While the government and NGOs pump millions of rupees into child rights and awareness programs, the situation on the ground tells a very different story—one that is being ignored under layers of political slogans and fancy workshops.
Makwanpur, a district that proudly boasts of several child-friendly local units, including Manahari Rural Municipality, which was the first to earn this title in January 2020, along with Makwanpurgadhi, Bakaiya, and Hetauda Sub-Metropolitan City, is witnessing a gap between official claims and reality. The child-friendly local governance indicators explicitly call for eliminating child marriage, yet the rate of teenage pregnancies shows this goal is far from being achieved. Ramilaa Sapkota, the president of the NGO Federation in Makwanpur, didn’t mince words when she said that these “child-friendly” labels are often just hollow declarations. She pointed out that despite millions spent and workshops held in expensive hotels, few initiatives actually reach the grassroots level where change is desperately needed. People are beginning to question whether these programs are truly for the children or just empty promises for political gain.
The data paints a bleak picture. According to the Makwanpur District Public Health Office, as of April 2024, a staggering 432 girls under the age of 20 had already given birth this fiscal year alone. Out of a total of 3,842 deliveries, 113 were home births, and shockingly, 44 of those were teenage mothers delivering without any medical support. Looking back at previous years reveals a consistent pattern: in 2022-23, 529 teenagers gave birth out of 5,172 total deliveries, with 166 home births, and in 2023-24, 491 teenage mothers out of 4,430 total births were recorded, including 128 home deliveries. These figures underline a harsh reality—teenage pregnancy in Makwanpur is not only widespread but also often involves unsafe birthing conditions.
This problem is not confined to rural areas. Hetauda Sub-Metropolitan City, which is considered the district’s urban center with better access to health services, recorded the highest number of teenage births, with 201 teenage mothers out of 2,544 total deliveries. Rural municipalities like Manahari, Makwanpurgadhi, Bakaiya, Kailash, Thaha, and Bagmati also report significant numbers, demonstrating that teenage pregnancy is a widespread social challenge crossing urban-rural divides.
Hetauda Hospital, the district’s main public health facility, confirms this disturbing trend. Year after year, hundreds of teenage girls come to the hospital to deliver their babies. In 2021-22, 255 of the 3,360 deliveries were teenage mothers. The following year, this number rose to 276 out of 3,896, and in 2023-24, 218 teenage births were recorded out of 2,735 deliveries. Even this year, as of April, 181 teenagers had given birth at the hospital, making up approximately 7.3% of all births. The fact that every single month reports teenage deliveries shows this is an ongoing crisis, not a seasonal anomaly.
Medical staff at Hetauda Hospital explain that teenage pregnancies pose serious health risks for both mother and child. Young girls’ bodies are often not fully developed to handle childbirth, which results in high-risk deliveries, frequently requiring cesarean sections. In 2023-24, out of 2,471 deliveries at the hospital, 876 were cesarean, and many complicated cases involved teenage mothers. Devaki Khatri, head of the maternity ward, notes that these girls often face severe complications such as excessive bleeding, high blood pressure, and postnatal depression. Beyond physical risks, the emotional and psychological toll is immense, as many young mothers are unprepared for the challenges of parenthood.
The persistence of teenage pregnancy in Makwanpur reflects a deeper systemic failure. Despite national laws banning child marriage and local governments branding themselves as child-friendly, poor implementation, weak accountability, and persistent social norms allow these young girls to be trapped in cycles of early motherhood. Education and healthcare services have not been effectively mobilized to address the root causes, and the gap between policy and practice grows wider each year.
Makwanpur’s situation is a wake-up call that slogans and labels mean little without real action. Until local governments and communities prioritize teenage pregnancy as a serious health and social issue, the district will continue to see young girls robbed of their childhood and future. The message of “marriage after 20” remains just words unless backed by honest commitment and tangible change on the ground.