“Just saying “no” prevents teenage pregnancy the way ‘Have a nice day’ cures chronic depression.” – Faye Wattleton
Once again – but unfortunately for all the wrong reasons – the issue of children bearing children is in the air. And it should be – it’s still a major public health concern because of the risks posed to both the young mom and her developing baby.
During my time in obstetrics, I’ve also seen some very young mothers – teenagers, still in school. Some of them with family supporting them; others very much alone.
In Guyana, it was clear that I possibly lived a sheltered life since I remember being surprised when a few years ago (2013), I’d read that according to a report by the United Nations Population Fund (UNFPA), Guyana had the second highest rate of adolescent pregnancy in both the Caribbean and South America: 97 out of every 1000 girls between the ages of 15 and 19 were giving birth. I hadn’t seen this either in my village or at QC. Recently, I read of a 17-year-old Guyanese girl giving birth to her third child!
But here at Port of Spain General Hospital, at least the teenage mother-to-be’s I was seeing were those that made it to clinic for their antenatal checkups. Going by the figures of teenage pregnancies, it would seem like there are so many more pregnant teens that never get to go to those checkups.
Trinidad reported that they had 2500 teenage pregnancies in 2015, compared with our 3000 (with half of Trinidad’s population!) for 2013.
And missing those checkups is dangerous for both the mother and her baby. As I’d mentioned before, it’s incredibly important for pregnant women to have regular antenatal checkups so that the doctors will be able to deal with any of the myriad complications that can arise during pregnancy. And it’s doubly important for teenage mothers to get those checkups because there are so many extra complications that can happen due to their age.
Pregnant teenagers are at a higher risk of developing pre-eclampsia, a condition with high blood pressure, kidney damage, liver damage and a host of other complications that can progress to eclamptic seizures. They are also more likely to go into pre-term labour and deliver premature babies. Since teens often become pregnant before their bones are finished growing, their pelvises (‘hips’) aren’t usually wide enough, and a c-section often becomes necessary.
One of the requirements for this rotation was for us to accompany a patient to the Medical Social Worker. And after our visit, it was patently obvious why it was necessary. It was eye-opening and it certainly put things into perspective for us – suddenly complaining about the trials and travails of medical school seemed petty compared to those of several of our patients.
We were forced to confront the harsh reality of abuse and incest that some young women have to face. And according to the social worker, those aren’t rare cases.
She explained to us that as doctors, we’re not just supposed to treat the patient and move on – we’re supposed to be advocates for our patients. And in cases where the patient is a pregnant minor, we’re expected to call the Child Protective Unit right away.
The state and nation must move away from the “blame the girl” syndrome and recognise its duty to protect its girls. They are people too.
The report cited above has some good advice for us in the Caribbean: it called for a “…new approach (which) must target the circumstances, conditions, norms, values, and structural forces that perpetuate adolescent pregnancies on the one hand and isolate and marginalise pregnant girls on the other. Girls need to have access to both sexual and reproductive health services and to information.”
