At 14, Naina (name changed) ran away from home to marry. Now, before turning 20, she is a mother of two daughters and facing pressure from her husband’s family to end her marriage.

But divorce would not necessarily give her a way out.

She has no education to fall back on, no independent income and, because she eloped as a child, little support from her own family. Her parents have stopped speaking to her. Her husband has grown increasingly distant since moving to Kathmandu to study. At home, she says, she has faced repeated abuse, including being blamed for having two daughters instead of a son.

“I have no one to talk to from my parents’ side either. Where am I supposed to go now? I have two daughters and no education?” said Naina, whose name has been changed to protect her privacy.

She has twice gone to the police seeking help over the abuse. On both occasions, she says, the response ended with a written agreement asking the couple to reconcile.

“They make us sign an agreement and send me home. Once I return, the same behaviour starts again,” she said.

Naina’s dilemma is increasingly familiar in rural Achham, where girls who marry before adulthood can find themselves leaving school, becoming pregnant before their bodies are fully mature and entering marriages in which they have little power to make decisions about their health or future.

For some, the consequences are physical. For others, they include violence, pressure to have sons and eventually divorce. Many face several of these at once.

Health officials say the pattern is especially worrying because pregnancy itself can expose adolescent mothers to serious health risks.

Data from the Achham District Health Office show that 3,005 girls under 20 became pregnant in the six years from fiscal 2020-21 to 2025-26. During the same period, 362 babies were stillborn across the district.

Health workers say most of those stillbirths involved mothers under 20.