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LABOUR

The dangers of adolescent mothers

By Sam Ssali Kiggundu.

When a young woman between ages 15 and 19 becomes a mother, her health and that of her child are often threatened.  The numbers reveal the heightened risk: women under the age 17 are more likely to experience a premature labor, miscarriage and still birth, and they are up to four times as likely as women older than 20 to die from pregnancy – related causes. 

Because adolescent women have not yet completed their growth (in particular, their height and pelvic size), their bodies are often not developed adequately enough to carry pregnancy.  This puts them at a greater risk of obstructed delivery and prolonged labor, which can lead to permanent injury or death for both the mother and the infant.  Studies indicate that adolescents are much more likely to suffer from obstetric (tears between the vagina and the urinary tract or rectum that cause fecal and urinary incontinence).  One study in Niger found that 80 percent of all cases of fistula occur in women between the ages of 15 and 19.  The first two years after first menstruation are an especially vulnerable age for adolescents.

The story below illustrates one Southeast Asian adolescent girl’s need for access to reproductive health services including family planning, and antenatal, delivery, and postpartum.  All workers reading it must take head because it is a true story.

A few months after Aziza turned 15 years of age, she married and moved into her husband’s home.  Her mother had prayed fervently before she departed that insha – allah Arabic for ‘’God willing’’ Aziza would present her husband with a son soon to make her position secure in the household.  When a few months later, Aziza began to feel sick in the mornings, there was much joy in both families.

As Aziza’s pregnancy progressed, her husband noted she looked pale and was constantly tired.  The doctor confirmed that Aziza was severely anemic and was not gaining enough weight.  She was too young to be having a baby, the doctor said. The doctor warned the family about possible complications during pregnancy and delivery, as Aziza was scarcely more than a child herself and her body had not yet developed sufficiently.

During the antenatal checkups, the doctor warned against a home delivery, but when Aziza’s contractions began some three weeks early, Aziza’s mother – in – law did not heed the warning, Babies had always been born at her home.  When 14 hours had passed, Aziza was put into a cycle – rickshaw and wheeled to the hospital.

The labor was complicated because by this time 20 hours had passed and Aziza’s water had burst hours before reaching the hospital.  Aziza was exhausted and weak.  To save her life, the doctor performed a cesarean section.  Aziza suffered life – threatening hemorrhage, but she and her new born baby girl survived.

The doctor counseled Aziza’s husband against the hazard of another pregnancy too soon.

The health worker explained contraceptive options for preventing another pregnancy.

Aziza’s husband realized just how fortunate they had been.

‘’I have made a mistake which must never be repeated in our family,’’ he announced to his mother upon returning home.  ‘’Our little Husaina will be breastfed and strong.  She will not have another brother or sister for at least three years.  She will go to school and not be married off before she is at least 20.’’

While Aziza wanted to have a baby, many adolescents get pregnant unintentionally.  The health risks of pregnancy for young women are complicated by their lack of access to information about contraceptives.  Because adolescent pregnancies are often unintended or mistimed, many young women choose to terminate the pregnancy.  Where legal abortion services are available, access is often restricted for teenage girls because of economic, geographic and cultural barriers.  Regardless of the law, young women are more likely to seek abortions from untrained providers and to attempt dangerous, late, and often self induced abortions.  As a result, young women often account for a disproportionate share of both complications and deaths due to abortions.

Policies and programs that encourage later marriage and delayed childbearing and expanded economic and educational opportunities for girls and women have been put in place in order to reduce adolescent maternal deaths.  Girls please stand warned ■

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