World Health Organization defines Teenage Pregnancy as “any pregnancy from a girl who is 10-19 years of age”. This is the period when structural, functional, and psychosocial developments occur in a child to prepare her for assuming the responsibility of motherhood. Teenage pregnancy is one of the most important social and public health problems all over the world with varying prevalence rate. Teenage pregnancy represents a high-risk group in reproductive terms because of the double burden of reproduction and growth.
Pregnant teenagers face many of the same pregnancy related issues as other women. There are additional concerns for those under the age of 15 as they are less likely to be physically developed to sustain a healthy pregnancy or to give birth. For girls aged 15–19, risks are associated more with socio-economic factors than with the biological effects of age. Risks of low birth weight, premature labour are connected to biological age, being observed in teen births even after controlling for other risk factors (such as accessing prenatal care etc.).
One in four Indian women (26.8 percent) is married before 18, and 7.8 percent of women aged 15 to 19 are pregnant or mothers, according to the latest available 2015-16 National Family Health Survey (NFHS)-4 data.
The reality is that early marriage and consequently pregnancy is most often not the result of a deliberate choice, but the absence of choices, and of circumstances beyond a girl’s control. It is a consequence of little or no access to school, employment, reliable information about healthcare, and poor utilisation of health services and patriarchy.
FACTORS CAUSING ADOLESCENT PREGNANCY:
One of the main important factors in the rate of teenage pregnancy are early marriage and traditional gender roles. In India, early marriage and pregnancy is more common in rural areas compared to urban areas. The lack of education on safe sex, is one of the major causes of teenage pregnancy. It is evident that many of the teenagers are not taught about the methods of birth control.
Some of the important factors causing Adolescent Pregnancy are stated below:
Lack of Contraception:
This is the most important factor and it could be due to lack of education and due to which adolescents do not know how to avoid becoming pregnant and are unable to obtain contraceptives even where they are widely available.
Age discrepancy in relationships:
Teenage girls in relationships with older boys, and in particular with adult men, are more likely to become pregnant than teenage girls in relationships with boys their own age. They are also more likely to carry the baby to term rather than have an abortion.
Social Pressure:
The legal age of marriage in India being 18, early marriages are not common. In many of the societies as soon as the girls reach menarche, they are under pressure to marry and bear children as they may be unable to refuse sex.
Medico-Legal aspects in teenage pregnancy:
Providing care for adolescents presents healthcare professionals with several special challenges, including consent, confidentiality, and legal issues. Legal and ethical issues are clear for children and individuals age 18 and older.
According to section 3 sub-clause (4) of the Medical Termination of Pregnancy act 1971, No pregnancy of a woman, who has not attained the age of eighteen years, or, who, having attained the age of eighteen years, is a lunatic, shall be terminated except with the consent in writing of her guardian.
The principal of confidentiality ensures that an individual’s health information not be shared without the person who consented to care giving explicit permission. And, while some minors feel comfortable having their health care information shared with their legal parent or guardian, for others, they would forgo care if confidentiality could not be guaranteed
CONCLUSIONS AND RECOMMENDATIONS:
Teenage pregnancy today, still represents one of the most important public health problems. There is no doubt that the obstetrical problems can be managed by modern medicine and so the risk of Teenage pregnancy can be diminished. The health care provider should consider Teenage pregnancy as a ‘high risk’ pregnancy and should educate the pregnant teenagers to have a greater number of antenatal visits so that the signs and symptoms of various complications of teenage pregnancy could be recognized at the earliest. Attention should be given to the use of various screening and diagnostic tests and to the interventions needed if any complication does occur during the course of pregnancy.
The factors driving teenage pregnancy are complex and varied, as are the effects on the teenage girls – and therefore require multifaceted interventions. Hence it is recommended that:
What policy makers could do:
- Provide stable funding for comprehensive educational and support services to pregnant and parenting teenagers. Working with India’s leading healthcare NGOs the government can curate campaigns in this direction towards sustainable futures.
- Develop programmes that empower teenagers to cope with the challenges that they face during adolescent relationships and pregnancy, and how to avoid unwanted sex.
- Implement culturally-appropriate school-based and out-of-school health and sex education starting before the age of 14 years.
- Establish youth friendly clinics to safeguard colleges and universities.
About the Author:
Abhishek Ganesan is a lawyer in training at Symbiosis Institute, Pune and Research Intern at CHD Group.
Disclaimer: Views expressed are the authors own. CHD Group takes no liability on behalf or for the contents expressed.