One of the study’s most alarming findings is that two out of every three female garment workers were married before their 18th birthday. Nearly 65 per cent had their first pregnancy during adolescence.

A landmark longitudinal study released today by icddr,b has shed stark light on the sexual and reproductive health and rights (SRHR) of female garment workers in Bangladesh, revealing deeply entrenched vulnerabilities in a workforce already under strain. The 24-month cohort follow-up, conducted between August 2022 and December 2024, paints a troubling picture of early marriage, adolescent pregnancy, violence, and severe gaps in reproductive health services for some of the country’s most marginalised women.

One of the study’s most alarming findings is that two out of every three female garment workers (approximately 66 per cent) were married before their eighteenth birthday. Nearly 65 per cent had their first pregnancy during adolescence.

Among the cohort of 778 women aged 15 to 27 from the Korail and Mirpur areas in Dhaka and Tongi in Gazipur, nearly one-third reported at least one unintended pregnancy, while one in four said they had undergone abortion or menstrual regulation. The data suggest that many of these young women enter into motherhood under conditions of constrained choice and limited support.

Encouragingly, use of contraceptives before the first pregnancy appeared to halve the risk of teenage pregnancy within these groups, pointing to the preventive potential of early access to family planning. But the study also shows that women experiencing spousal violence were 26 per cent more likely to become adolescent mothers, reinforcing how domestic abuse intensifies reproductive risks.

Violence in Homes and Factories: A Double Burden

Violence emerged as a persistent, cross-cutting thread in the women’s experiences. The study tracked psychological abuse in factories, which rose from 48 per cent to 55 per cent over the course of the study period. At the same time, spousal violence remained “alarmingly common.”

Reporting of workplace violence was extremely rare: just 1 per cent of survivors formally reported such incidents to authorities. Informal support-seeking also plummeted, dropping from 35 per cent at baseline to 21 per cent at endline. The decline suggests rising isolation or disillusionment with support mechanisms.

The link between violence, coercion, and adverse reproductive outcomes is clear: women with greater decision-making power and freedom of movement reported significantly lower risks of violence, sexual abuse, and forced fertility.

Gains in Knowledge, But Gaps in Access

Despite the challenges, the study uncovers some positive trends in awareness and attitudes. Knowledge of long-acting contraceptives climbed sharply from 49 per cent to 70 per cent, while awareness of emergency contraception increased from 15 per cent to 39 per cent. The cohort also exhibited more positive gender attitudes around family planning and decision-making.

Yet, when it comes to actual access, the gaps are stark. Only 22 per cent of factories provided sanitary pads, and just 14 per cent offered family planning commodities for workers. Many women still face stigma when trying to purchase contraceptives in local shops, reinforcing the need for confidential and factory-based services.

Voices from Experts and Stakeholders

At a seminar organized by icddr,b to unveil the findings, experts underscored the urgency of policy and programmatic shifts. Dr. Ubaidur Rob, former country director of the Population Council Bangladesh, emphasized that rising female workforce participation must be matched by unintended pregnancy prevention and better SRHR support.

Farzana Sharmin, Joint Secretary of the Bangladesh Knitwear Manufacturers and Exporters Association, called attention to the patriarchal blind spots: “Women’s voices are often overlooked … contraceptives must be made easily accessible, and awareness must be increased.” She stressed the need to align government clinic schedules with women’s work hours.

Independent researcher Yasmin H. Ahmed highlighted how stigma constrains access: “Due to stigma, many women still cannot buy contraceptives from shops. Therefore, services and counselling must be ensured within factories.”

Dr. Ruchira Tabassum Naved, Emeritus Scientist at icddr,b and the Principal Investigator, observed that “despite economic progress, the SRHR situation of garment workers is poorer than that of other women.” She urged a multi-stakeholder approach involving government, development partners, industry, and civil society to address the layered inequities.

Implications and the Road Ahead

This cohort study offers some of the most robust longitudinal data to date on how sexual and reproductive realities unfold among female garment workers – a population of millions whose labour is central to Bangladesh’s economy and export sector.

The findings validate what many women have long known: that economic inclusion without rights and health security is incomplete.

Key implications emerge:

Early intervention is critical: With over half the cohort married before 18 and many entering motherhood in adolescence, delayed marriage and timely contraceptive access must be central to strategies.

Violence and empowerment are core levers: Reducing domestic and workplace violence and strengthening women’s autonomy matter not just for safety but for reproductive autonomy and health.

Factory-based SRHR services are essential: Given persistent stigma and some factories’ reluctance, providing confidential contraceptives, counseling, and menstrual health supplies in the workplace could bridge critical gaps.

Coordinated policy action is necessary: Government ministries, industry associations, NGOs, and international partners must collaborate to reorient health and labour policies toward this vulnerable cohort.