Some papers recently released by the Guttmacher Institute on adolescent pregnancy in Central America have got me thinking about the issue, since here in Nicaragua, it's not uncommon to begin having children in your teens. No big surprise, since sex education is basically non-existent, quality health services and complete health information are a distant dream for most of the population, and abortion is illegal without exception. In the organization where I work, the phenomenon breaks down primarily along class and educational lines: the women who clean the offices and work in the cafeteria almost all started having kids during their adolescence, whereas the women in the program staff (researchers, trainers, and writers), who generally had more resources and more schooling growing up, started having kids later in life, or don't have children at all.

There are exceptions to the rule, of course, but the trend is clear, and the Guttmacher Institute's research confirms it: a quarter of all births in Nicaragua are to girls between the ages of 15 and 19, and almost half of women aged 20-24 had at least one child before they turned 20. Women living in poverty (in a country where the average income is $2 a day), women living in rural areas, and women with less education, are all more likely to give birth as adolescents. Yet among all 15- to 19-year-old sexually active women surveyed, 86 percent did not want a child in the next two years, and over a third said they wanted to use contraception but either couldn't afford it, didn't know where to get it, or had been denied access to it.

These trends intensify across the border in Honduras, which has the highest adolescent birth rate in Central America. In 2001, only a third of Honduran women aged 20-24 had finished primary school, and today, a full 70 percent of women with low levels of schooling give birth before they reach the age of 20. Yet in Honduras, as in Nicaragua, over two-thirds of adolescent girls say they do not want to have a child in the next two years, and nearly half lack access to contraception, though they say they would like to use it.

The trends continue further north in Guatemala, where only two-fifths of 20- to 24-year-old women have completed primary school, including only 1 in 10 indigenous women. Forty-four percent of 20- to 24-year-olds become mothers before their 20th birthdays (the figures climb to 68 percent among women with no education, and 54 percent among indigenous women). Yet as in Nicaragua and Honduras, across educational, income, and ethnic lines, 83 percent of adolescent girls in Guatemala say they do not want a child in the next two years.

The statistics square with the experiences of women I've met here, many of whom had their first child well before they were expecting to. As one of my colleagues, who had her daughter at 16, explained, "I didn't know anything about how to prevent pregnancy until I got pregnant myself. After I had my daughter, I learned fast." My colleague loves her daughter, but she also knows that having a child compromises her ability to "salir adelante" (get ahead). She herself is the oldest of 14 children, and her mother's childbearing years finally drew to a close when a doctor agreed to sterilize her in secret (her husband refused to use contraception).

Reading over these statistics, and hearing her story, I can't help thinking about my own adolescence—steeped in plans, dreams, goals, and information, motherhood was the last thing on my mind. Last week, when a taxi driver asked me if I had any kids (the most common question I get after "Where are you from?"), I told him "Todavía no" (not yet). "But you'll have them, won't you?" he asked. I said yes, but that I was only just approaching a point in my life where I felt ready. He nodded, then said, "You gringas are disciplined, you know how to plan your lives." I told him I didn't think it was discipline as much as information and opportunity—first of all, I learned how to avoid getting pregnant before it was too late, and always had access to the means to do so (I was lucky enough to enter high school in the 1990s, that magical era when the U.S. government wasn't waging a war against comprehensive sexuality education). I definitely wanted to have kids some day, but I had a lot that I wanted to accomplish beyond just procreation, and I was confident that if I played my cards right, I would undoubtedly have the opportunity to do so. Not so for many young women growing up in Nicaragua, who face a decidedly different set of options and opportunities.

Differences notwithstanding, I don't want to draw too stark a contrast, since the United States does have the highest teen birth rate in the industrialized world, and certain communities face adolescent pregnancy rates almost as high as Nicaragua's. But I do want to point out that when we talk about reducing unintended adolescent pregnancy, we can't just throw abstinence at the problem, or limit our discussions to why or whether or not adolescents are having sex. When we talk about adolescent pregnancy, we also have to talk about disparities in access to information, in health services, in educational and economic opportunities. Because nobody makes decisions in a vacuum, even though current public policies often appear to be written in one.