ERDENEBULGAN, ARKHANGAI PROVINCE, MONGOLIA — Seventeen-year-old Gerelee’s rosy face turns deep red as she considers the sharp swerve of her life in the past year.
“Even now, I cannot believe that I have become a mother,” she says, looking down at her 6-day-old daughter.
Rates of teenage pregnancy in Mongolia, albeit well below the global average, were until recently among the highest in the western Pacific region, in large part due to poor sexual and reproductive health education, limited access to reproductive health care for adolescents, and a reluctance to discuss sex at home. Each year, some 4,000 girls become pregnant, 650 of whom typically terminate their pregnancies. In Mongolia, abortion is legal until 22 weeks, with late-term abortions — between 13 and 22 weeks — requiring medical supervision. Minors, however, need the consent of a parent or guardian to terminate their pregnancies.
In some families, pregnant girls don’t tell their parents until it is too late. “A mother brought her daughter in thinking she had gained weight,” says Nomin-Erdene Altangerel, senior physician at the Shim Bileg Family Health Center, “when, in fact, the daughter was eight months pregnant. There is often no option other than giving birth once the fetus is older than five months.” Some girls don’t even realize they are pregnant until then — according to one survey, nearly 20% of teenage mothers said they found out after five months. More than three-quarters said they had never used contraceptives.
Gerelee, who requested partial anonymity due to fear of stigma, says she hid her pregnancy from her parents for five months. “I occasionally talked about reproduction with my older sister but never with my parents,” she says. “Since parents are not educated on these issues, they are unable to discuss it with their children,” says Dr. Oyun-Erdene Bolduukhai, dean of the family and psychology faculty at the International University of Ulaanbaatar. Moreover, she says, schools also typically fail students in this regard. Between 7% and 11% of the content covered in health and biology class in public schools deals with reproductive health — which the country’s human rights commission deems “extremely insufficient.”
“We have a health subject, but they don’t exactly teach sex education,” says Enerlen Batbaatar, an 11th grader at a public school. “Since we don’t have anyone to talk about it, we sometimes find information on the internet.”
“I know I need to talk to my children,” says Odontuya Daramkhuu, a mother of four. “But I don’t know how to talk to them. When I was a teenager, I never talked about it with my parents or my siblings, so I worry about how my children will react, that they will misunderstand, and not want to talk to their mother again.”
Others think their children are receiving sex education at school. “We don’t talk about it because we think it is covered in school,” says Munkhgerel, a mother of three who requested partial anonymity for the same reason. She was surprised to learn that often this isn’t the case.
Khorloo Khukhnokhoi, GPJ Mongolia
“Adolescence is an important stage of growth and development, and it is an important period to lay the foundation for health education,” says Orolzodmaa Baasankhuu, officer in charge of youth, men and reproductive health at the Mongolian health ministry. Currently, there are 34 clinics — run by doctors, nurses and/or social workers — that provide comprehensive health services for Mongolian youth across the country, she says, adding that in 2021, 3.6% of all births were by teenagers, a decrease of 0.3% from the previous year.
While parents typically refrain from talking about sex, it is quite common for them to bring their daughters to the hospital to have an abortion, says Khulan Bat-Erdene, head of the Orkhon chapter of the Mongolian Family Welfare Association, a nonprofit working toward universal access to sexual health care. (Teenagers accounted for 4.7% of all abortions in 2021, down by 0.1% from the previous year, Orolzodmaa says.) Abortion as de facto contraception in the absence of sex education is a violation of girls’ rights, she says. “Having an abortion as a teenager is not only harmful in terms of health but also creates huge psychological fear in girls — they lose confidence in building a family and giving birth once they are adults.”
In recent years, there has been unprecedented scrutiny on young Mongolians’ sexual and reproductive health rights. In 2021, after students began protesting the practice, Mongolia prohibited so-called virginity testing in schools, although Global Press Journal reporting indicates that these forced examinations were still taking place last year. Activists working to increase young people’s access to sexual health care also decry the state’s gendered focus — educating adolescent boys on safe sex, for instance, can drastically reduce unwanted teenage pregnancies. “That is why I ask both boys and girls to attend when I organize trainings on reproductive health at schools,” Khulan says.
“I felt shy attending the training alongside the boys in my class,” says Narangoo Gankhuu, a ninth grade student. “But afterward I understood the importance of sex education.”
Online, some have taken matters into their own hands. The Waiting Room, a podcast by two Germany-based Mongolian women in their late 20s and early 30s, explores topics deemed too risque in other quarters: virginity, queerness, sex for people with disabilities. Their YouTube channel has over 125,000 subscribers and over 17 million views total. “I started listening to the Waiting Room podcast in 2021,” says Maralmaa Ayurzana, 15. “I was a little shy at first, afraid that people would find out.” But the more she listened, the more she learned — and unlearned. “For example, there is a belief among girls that they will not get pregnant the first time they sleep with someone — which is incorrect,” she says. “I am very happy that such a podcast has appeared.”
Gerelee, who plans to graduate this year, wishes she had access to such information earlier. Her life has changed drastically in the past year. She wants to be a hairdresser and received certification for it last year — but for the time being, she and her child’s father are living with her parents in their rural home, so that the family can help raise the child. There is no opportunity to be a hairdresser here.
“I wish schools taught lessons on reproduction, and I wish students were aware of contraceptive methods,” she says. “Personally, I am thinking of using contraception after two months.”