Coordinated efforts are needed to mitigate the harmful health, social, and economic effects of pregnancy on adolescent girls, a report from the United Nations Population Fund (UNFPA) argues. According to Motherhood in Childhood: Facing the Challenge of Adolescent Pregnancy (132 pages, PDF), the 2013 edition of the UNFPA's State of the World Population series, approximately 19 percent of girls under the age of 18 in developing countries give birth every year. Of these 7.3 million girls, 2 million are age 14 or younger and the most likely to suffer the gravest long-term health and social consequences from pregnancy, including high rates of maternal death, obstetric fistula, premature delivery, and perinatal mortality. The report also found that the sudden transition from childhood to forced marriage and motherhood also takes a toll on girls' psychosocial well-being, often terminates the young mother's education, and limits her ability to earn an income. The report argues that reducing rates of adolescent pregnancy in developing countries requires a much more substantial investment in girls, including interventions to keep girls in school, expand health education, improve access to contraception, end sexual coercion and violence, and involve men and boys in such efforts — while also supporting girls who are pregnant or have children.