August 2, 2013 by Samuel Adebayo (dayspringsk05@yahoo.com)
Dr. Samuel Adebayo
| credits: File copy
| credits: File copy
Teenage pregnancies are pregnancies below the age of 20. A teenager is a person aged from puberty to maturity. Adolescence — a Latin word meaning “to grow up” — is a transitional stage of physical and psychological human development that generally occurs during the period of puberty to legal adulthood. The period is closely associated with teen years.
Adolescent pregnancy is a major contributor to both infant and maternal health problems and mortality. Adolescence aged less than 16 years faces four times the risk of maternal death than women in their 20s; while the death rate of their neonates is about 50 per cent higher.
Adolescent pregnancy requires special physical and psychological attention during pregnancy, childbirth and the post-natal period for preserving their health and that of their baby.
An estimated 16 million girls ages 15 to 19 give birth every year, with 95 per cent of these births occurring in developing countries. This makes up 11 per cent of all births worldwide.
Globally, two per cent of adolescent births take place in China, 18 per cent in Latin America, while 50 per cent of all adolescent births occur in seven countries of the world, viz: Bangladesh, Brazil, DR of Congo, India, Nigeria and USA. The Netherlands is one of European countries with lowest adolescent pregnancy rate, with a mere four adolescent births per 1,000 women. Perhaps this is because sex educations in The Netherlands begins from primary school.
Culture, tradition and religion play a significant role in issues that may lead to teenage pregnancy. Girls in many countries marry very early, even before they start menses. Others have it as a tradition that the first menses should be in the girl’s husband’s house, even if she starts menstruating at 10 or 11 years of age.
In most poor nations of the world, poverty also plays a significant role in young girls getting pregnant. Unfortunately, that will start another vicious cycle, because early motherhood often compromises a girl child’s education. As bad as it is, the majority cannot even learn any trade and so, their children also continue the poverty line from one generation to another.
Expectant teenage mothers are at risk of various complications in pregnancy and during childbirth because of lack of physical and biological readiness for pregnancy and childbirth.
The teen mother may fall in labour below 37 weeks gestation. This is mainly because the mother has immature reproductive organs that are ill-prepared to carry a pregnancy to full term. Immature cervix and metabolic system has been associated with preterm contraction and birth.
Worse still, sexually transmitted diseases are commoner with teen pregnancy and this may also predispose to preterm delivery.
High blood pressure is another major risk often faced by teen mothers. Normally, there is an increased demand for circulatory function in pregnancy; but for a pregnant teen where her cardiovascular system is underdeveloped, it is obvious that the developing cardiovascular system is not fully prepared for the extra circulatory load associated with pregnancy.
Apart from developing gestational hypertension, teenage pregnancy is also associated with increased incidence of pre-eclampsia (high blood pressure with protein in the urine), which may progress to eclampsia where convulsion is also associated.
The increased tendency for high blood pressure in teen pregnancy may also predispose her baby to low birth weight, especially when the mother is below 15 years of age.
Again, smoking and drug abuse are commoner with teenagers, and these could also lead to low birth weight. All of these issues do lead to serious complications for both the baby and the mother.
Anaemia (shortage of blood) may also be associated with teenage pregnancy than those pregnant women in their 20s and above.
Adolescent bodies are not fully developed to go through the process of pregnancy and childbirth without adverse impacts. Adolescent mothers face higher risk of obstructed labour than women in their 20s, and that’s why they need adequate emergency obstetric care.
Suffice to say, obstructed labour can lead to uterine rupture and high risk of death of both the baby and the mother.
Adolescent birth is also associated with high morbidity, while those who survive prolonged obstructed labour may develop obstetric fistula, which is the leakage of urine or feaces.
In Nigeria and Ethiopia, more than 25 per cent of fistula patients became pregnant before the age of 15, and more than 50 per cent before the age of 18. The majority of these girls with fistula suffer psychological problems, what with their inability to control urine leakage, or faecal matters; while many are sometimes abandoned by family and friends and even their husbands, leading to eventual isolation in the society.
Long term complications of fistula may include infections, ulcer, amenorrhea (absence of menstrual flow) and infertility. All these are as a result of subjecting the immature reproductive system to pregnancy and childbirth.
Though many countries forbid early marriage, the violation of the law is usually the rule. For example, in Ethiopia, the law of the country allows marriage only when a girl is 18, but about half of the adolescent girls get married before age 15.
Yet, we need to know that pregnancy is an issue that calls for more education and support, if only to encourage girls to delay motherhood until they are ready.
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