It was a hot afternoon in a small village in the Savannah Region. A mother, Ama, sat outside folding clothes. Her daughter, 11-year-old Abena, ran to her in tears, holding her stomach, saying she felt strange.
Weeks later, the truth shocked the entire family. Abena was pregnant even though she had not seen her first menstruation. At the clinic, the nurse explained gently, “A girl can become pregnant even before her first period.”
Stories like Abena’s are rare, but they reveal a truth that many still do not understand. Once puberty begins, a girl’s body can release an egg before the first menstrual bleeding occurs.
This process, known as ovulation, means that a girl can get pregnant even before she starts seeing her period.
Startling Global and Ghanaian Statistics
The World Health Organisation (WHO), in its report titled Adolescent Pregnancy: Evidence Brief (2019), states that “about 21 million girls aged 15 to 19 years in developing countries become pregnant each year, and approximately 12 million of them give birth.”
The same document explains that pregnancy and childbirth complications remain among the leading causes of death for girls in this age group.
In Ghana, the situation is equally worrying. The 2022 Ghana Demographic and Health Survey Summary Report, published by the Ghana Health Service and Ghana Statistical Service, reveals that 15.2 per cent of girls aged 15 to 19 have ever been pregnant. In regions such as Savannah and the North East, the figures are even higher.
The Ghana Health Service Annual Report (2020) also recorded about 110,000 teenage pregnancies that year, one of the highest adolescent pregnancy rates in West Africa.
Among very young adolescents, UNFPA Ghana reported in its publication on Adolescent Pregnancy in Ghana: Trends and Patterns (2021) that between 2016 and 2020, 13,444 pregnancies occurred among girls aged 10 to 14 years.
According to the State of World Population Report (2023) by UNFPA Ghana, “every teenage pregnancy represents a missed opportunity.” The report explains that early pregnancy often leads to school dropout, early marriage and long-term health risks.
How does it happen?
To understand how this occurs, it helps to know what happens during puberty. When puberty starts, the brain sends signals in the form of hormones to the ovaries, instructing them to prepare eggs.
When an egg is ready, it is released from the ovary. This process is called ovulation.
If a girl has unprotected sex during this time and sperm is present, the egg can be fertilised, leading to pregnancy. Menstruation occurs later, only if no pregnancy happens.
Because ovulation comes before menstruation, a girl can become pregnant before ever experiencing her first menstrual period.
The youngest known mother in medical history, Lina Medina from Peru, gave birth in 1939 at just five years and seven months old.
Doctors confirmed that she had a condition known as precocious puberty, where ovulation begins abnormally early.
While her case was extremely rare, it proves that the body can ovulate even at a very young age.
Why this knowledge matters
Many parents, teachers and even young girls believe that pregnancy can only occur after menstruation begins.
This common misunderstanding has contributed to Ghana’s rising adolescent pregnancy numbers.
According to the State of World Population Report (2023) by UNFPA Ghana, adolescent pregnancy is one of the main factors preventing girls from continuing their education and reaching their full potential.
The report warns that girls who become pregnant too early face increased risks of health complications such as obstetric fistula, low birth weight and even maternal death.
The WHO also explains in the same Adolescent Pregnancy Evidence Brief (2019) that babies born to adolescent mothers are more likely to die in the first month of life compared to babies born to women aged 20 to 24 years.
Data from the Ghana Statistical Service show that in 2022, in ten out of sixteen regions, more than ten per cent of girls aged fifteen to nineteen had already given birth. This shows how urgently Ghana needs to focus on education, protection and empowerment before puberty begins.
What parents, teachers and health workers should do
1. Start early conversations. The UNFPA Ghana Adolescent Pregnancy in Ghana Report (2021) advises parents to begin discussing puberty and reproductive health before the physical changes start.
2. Use simple language. Explain the body’s changes in words that children can understand.
3. Encourage questions. Create safe spaces where children feel free to ask about their bodies.
4. Teach consent and respect. Every child must know that they have the right to say no to any form of abuse.
5. Support youth-friendly health services. Health facilities should be welcoming, respectful and confidential for young people seeking advice.
6. Keep girls in school. Education is one of the strongest protections against early pregnancy and child marriage.
The bigger picture
Adolescent pregnancy is not only a health problem. It is a social and economic challenge that limits opportunities for thousands of Ghanaian girls.
When a girl becomes pregnant too early, her education often ends, her health is put at risk, and her dreams are delayed.
UNFPA Ghana, through its State of World Population Report (2023), continues to call on families, schools, traditional leaders, faith-based groups and the media to speak openly about reproductive health.
The organisation believes that empowering girls with accurate information and life skills can break the cycle of early pregnancy and poverty.
Final thoughts
The idea that a girl can get pregnant before her first menstruation may sound surprising, but it is a scientific fact. Ovulation comes before menstruation, which means the body becomes fertile even before the first period appears.
The story of little Lina Medina and the thousands of young Ghanaian girls who face pregnancy before full maturity reminds us that this is not just biology. It is a call for action, education and protection.
As the State of World Population Report (2023) beautifully puts it, “Every girl deserves to enter motherhood by choice, not by chance.” Let us replace myths with knowledge, fear with openness and silence with meaningful conversation.
When we empower our daughters with truth and confidence, we protect their health, safeguard their education and secure their future.
Dr Michael Baah Biney is a medical doctor, Sexual and Reproductive Health and Rights (SRHR) advocate, and global health enthusiast writing on youth health, preventive medicine and public health equity in Ghana.
