You can get pregnant before your first menstruation

It was a hot afternoon in a small village in the Savannah Region. A mother, Ama, sat outside folding clothes. Her daughter, eleven-year-old Abena, ran to her in tears, holding her stomach and saying she felt strange. Weeks later, the truth shocked the entire family: Abena was pregnant even though she had never 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 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 a girl can get pregnant even before menstruation starts. Startling Global and Ghanaian StatisticsThe World Health Organization (WHO), in 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.” Pregnancy and childbirth complications remain among the leading causes of death for girls in this age group. In Ghana, the situation is equally concerning. The 2022 Ghana Demographic and Health Survey Summary Report shows that 15.2 percent of girls aged 15 to 19 have ever been pregnant. In regions such as Savannah and North East, the figures are even higher. The Ghana Health Service Annual Report (2020) 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 Adolescent Pregnancy in Ghana: Trends and Patterns (2021) that between 2016 and 2020, 13,444 pregnancies occurred among girls aged 10 to 14 years. The State of World Population Report (2023) explains, “every teenage pregnancy represents a missed opportunity,” as early pregnancy often leads to school dropout, early marriage, and long-term health risks. How Does Pregnancy Before Menstruation HappenTo understand this, it helps to know what occurs during puberty. When puberty starts, the brain sends hormonal signals to the ovaries to prepare eggs. When an egg is ready, it is released from the ovary—this is ovulation. If a girl has unprotected sex during this time and sperm is present, the egg can be fertilized, leading to pregnancy. Menstruation occurs later only if no pregnancy happens. Because ovulation comes before menstruation, a girl can become pregnant before experiencing her first 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 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, and therefore, pregnancy can occur if unprotected sex happens. Why This Knowledge Matters for GhanaMany parents, teachers, and even young girls believe that pregnancy can only occur after menstruation begins. This misunderstanding has contributed to Ghana’s rising adolescent pregnancy rates. According to the State of World Population Report (2023) by UNFPA Ghana, adolescent pregnancy is a major factor preventing girls from continuing their education. Early pregnancy increases risks of complications such as obstetric fistula, low birth weight, and maternal death. The WHO also notes that babies born to adolescent mothers are more likely to die within the first month of life compared to those born to women aged 20–24 years. Data from the Ghana Statistical Service show that in 2022, in ten out of sixteen regions, more than ten percent of girls aged 15–19 had already given birth. These numbers underscore the urgent need for education, protection, and empowerment before puberty begins. What Parents, Teachers, and Health Workers Should Do Start early conversations. UNFPA Ghana advises parents to discuss puberty and reproductive health before physical changes start. Use simple language. Explain the body’s changes in words children can understand. Encourage questions. Create safe spaces for children to ask about their bodies. Teach consent and respect. Every child must know they have the right to say no to abuse. Support youth-friendly health services. Clinics should be welcoming, respectful, and confidential. Keep girls in school. Education is one of the strongest protections against early pregnancy and child marriage. The Bigger PictureAdolescent pregnancy is not just a health problem—it is a social and economic challenge. Early pregnancy often ends a girl’s education, puts her health at risk, and delays her dreams. UNFPA Ghana, through its State of World Population Report (2023), calls on families, schools, traditional leaders, faith-based groups, and media to speak openly about reproductive health. Empowering girls with accurate information and life skills can break the cycle of early pregnancy and poverty. Final ThoughtsThe idea that a girl can get pregnant before her first menstruation may sound surprising, but it is a scientific fact. Ovulation occurs before menstruation, meaning the body is fertile even before the first period appears. The story of Lina Medina and the thousands of young Ghanaian girls facing 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) says, “Every girl deserves to enter motherhood by choice, not by chance.” Replacing myths with knowledge, fear with openness, and silence with conversation allows us to protect their health, safeguard 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.