Putting the lens on teenage pregnancy crisis

Teenage pregnancy has been a healthcare crisis in Meghalaya for the past several years. With a rate of about 7.9%, which is more than the national average of 6.8%, it has been a challenge for successive governments to spread awareness

According to state data, teenage pregnancy accounts for 10% of the total pregnancies in Meghalaya. In fact, it is one of the major reasons for the high maternal and infant mortality rates. A recent study released by Martin Luther Christian University gives an insight into the problem and analyses it from a socio-cultural perspective.

Teenage pregnancy, as defined by UNICEF, occurs between the ages of 13-19 years. Pregnancy at this age not only affects the individual physically but psychologically too, subsequently creating an unhealthy environment for the unborn child. According to the United Nations Population Fund (UNFPA), girls becoming pregnant immediately after attaining puberty “face health risks such as obstetric fistula, and their babies face greater risks as well”.

The problem of teenage pregnancy is global. UNFPA data shows that 20,000 girls under the age of 18 give birth every day, which amounts to 7.3 million births a year. Adolescent pregnancy in India is high with 62 pregnant teens and that India, from among 10 countries, had the highest number of women between 20-24 years of age who gave birth before 18 years of age.

The MLCU study, titled ‘A Report on Teenage Pregnancy with a Special Focus on Familial, Legal and Socio-cultural Context in Meghalaya’, found that the mean age of pregnancy is 16 years. In 52% of the cases, the pregnancy occurred during the first sexual experience. The study found that most of these women continued with the pregnancy because they wanted to take responsibility for their actions and also for abortion was against their religious belief.

According to the 2021 MLCU report, adolescence lacks the cognitive and emotional maturity that is necessary to make wise and healthy decisions let alone their understanding of their sexuality and are thus not prepared to cope with the consequences of sexual activity.

“A study in Ghana found that the incidence of teenage pregnancy is because the teenager or the adolescent has little information on the physical changes that take place in their bodies during the transitional period from youth to adulthood. This has resulted in unplanned pregnancies for a majority of teenagers and has led to developmental and socio-economic problems,” the study noted.

Lack of sex education often leads to curiosity among teenagers. In this context, there has to be a concerted effort by parents, schools and governments to take adequate measures to spread awareness of sex and sexuality, the consequences of early pregnancy and responsibilities among adolescents. This will help in answering their questions and douse curiosity.

“Sex education is an instruction and training given to adolescents about the anatomy of human beings, sexual intercourse, reproductive health, emotional relationships, reproductive rights and responsibilities, contraception, family planning, abstinence, sexual orientation, body image, decision-making, communication, sexually transmitted infections and how to avoid them. Sex education would include a broad program aiming to build resilience in lifelong sexual health and helping students to obtain the right information, the right attitudes, beliefs and values and their own identity, their relationships and intimacy,” the report said.

According to the report, 69% of teenage mothers received sex education and 30% did not have any such education.

Reasons for continuation of pregnancy

The report looks at various facets of the problem, including the reasons why most teenagers continue with their pregnancies. It states four main reasons for this:

• Feel the need to take responsibility
• Stigma on abortion
• Support from families and partners
• Feeling of insecurity with partners

Challenges for teenage mothers

There are several challenges that teenage mothers face in the form of health consequences, nurturing of the baby, psychological impact and lack of support from families and partners.

The impact on the health of teenage mothers is inevitable. One of the respondents, who gave birth at the age of 16, said she faced several health issues and was under treatment. In fact, her health deteriorated so much that she had to give up the child for adoption.

Many young mothers also faced the problem of nurturing their babies. They do not have any knowledge of providing the necessities to their babies, such as giving baths, breastfeeding and taking care of the health of the baby.

Teenage mothers have also expressed the psychological stress they have undergone. Few have talked about their suicidal thoughts, feeling of regret and wish to turn back time and said the experience was horrible. One respondent, who gave birth at the age of 19, said she was mentally disturbed and needed support. “I looked to my family for help but they were not willing to help. I even thought of ending my life to escape the situation.”

A few respondents said their parents refused to extend any support as they were holding on to the anger when they came to know about the pregnancy. In most cases, the partners avoided any responsibility as they were young too. In such cases, the mothers would receive no support from any quarters.

Though a child born out of wedlock is not stigmatised in Meghalaya, teenage mothers do face stigma, even among peer groups. This adds to the already existing stress.

Recommendations

The report not only delves into the causes of teenage pregnancy and explains its impact on individuals and society and the economy but also lays down suggestions for stakeholders.

At the government level, the report recommends training of trainers in reproductive health and life skills education so that the knowledge can be dissipated among adolescents. There is also a need for capacity building programmes on understanding adolescence, implications of reproductive health and life skills education among religious leaders, school and college teachers, ASHA and Anganwadi workers and social groups such as seng kynthei and seng samla.

It also points out that the information education communication on sexual relationships between minor girls and adult males (POCSO Act) “should not instil fear in young teenagers who might become pregnant before the age of 18 years as this will cause repercussions on the maternal health of mothers when the Maternal Mortality Rate has increased from 187 (HMIS 2014-15) to 211 (HMIS 2015-16) in all the districts of Meghalaya”.

Keeping in mind the practice of cohabitation in the state, there is a need for initiating a state policy that will address the well-being of all children on issues related to consensual sex as romantic relationship.

“Perhaps a two-year proposal on creating a model village whereby different interventions will be implemented as experimental in addressing issues related to children with the objective of creating a village which is free from child labour, violation of child rights, teenage pregnancy and other issues related to children,” the report said.

At the institution level, the study emphasises the need for mandatory reproductive health and life skills education for all children from the age of 13 years and above. Adolescent counselling centres should also be set up in schools and churches for better access to awareness programmes.

Besides, families should play an important role in making children aware of the issue. Strong family values and responsible parents can help mitigate the problem to a great extent.

“Low level of education is also one of the contributing factors of teenage pregnancy. Therefore, there is a need to educate parents to motivate and support the importance of education as the level of motivation of the children to stay in school is very low,” the study pointed out.

Young parents often find it difficult to complete their education, which directly impacts society and the local economy. To avoid this, there should be promotional programmes encouraging the use of contraceptives among teenagers.

A policy to encourage antenatal check-ups among young pregnant teenagers should be made.

The report also recommends a mandatory social investigation report after a teenage pregnancy is reported. There should be vocational training and education centres, especially for teenage parents that will encourage them to complete their studies and become financially independent. Also, financial assistance for establishing any vocational trade should be encouraged.

Children are the future of any state and country and it becomes imperative that all stakeholders join hands to build a support system that will teach adolescents to make decisions about their sexual life. This will not only prevent teenage pregnancy but will help in reducing the rates of suicide and crime among the youth in the long run.

(This article is directly based on ‘A Report on Teenage Pregnancy with a Special Focus on Familial, Legal and Socio-cultural Context in Meghalaya, 2021’ submitted by the Centre for Social Research, Action and Development, School of Social Work, MLCU)