"No!!I Can’t Be Pregnant!"

Posted on 2013-06-30 22:00:39

One of the greatest fear parents in Kenya have today is that of their teenage daughter(s) getting pregnant. The fear is not unfounded; unwanted pregnancies in adolescents have both short-term and long-term implications. Unwanted pregnancies raise many questions; What should be done about the pregnancy? What happens to education and other future plans that may now go unrealized? How will the unborn child be supported? How will the teenage mother cope psychologically and socially? And of course, what will everyone think? These consequences have been drilled into every girl growing up (including being killed by your parents) and yet unwanted pregnancies are still prevalent in Kenya. According to the Kenya Demographic and Health Survey, up to 44% of births in women aged 15years to 49 years are unwanted, and these rates have not changed significantly since 2003. Worldwide, up to one in five girls gets pregnant by the time they turn 18 (WHO, 2012). So why are unwanted pregnancies still prevalent?
  • The obvious and most commonly cited reason for this prevalence is adolescents engaging in behavior that increases the risk of unwanted pregnancy. Premarital sex is now almost a given, and the age of sexual debut keeps getting younger and younger. This is compounded by the use of alcohol and/or drugs, which affect judgment and thus increase the likelihood of engaging in unprotected sex.
  • In recent years, there has also been a shift from outdoor towards indoor social activities for teenagers, fueled by the development in ICT. With this shift, the need for adult supervision has increased, and if this is lacking, there is increased risk of adolescents engaging in sex resulting in unwanted pregnancy.
  • Though there has been increasing awareness, availability and advocacy for the use of contraceptives, teenagers may not have access to these contraceptives. How does one walk into a chemist or a supermarket and purchase condoms? Not many adults are able to do this confidently especially in the presence of others. What is the likelihood then that a teenager will do so? (The assumption here is that once they get them, they will use them correctly).
  • Lack of effective sex education programs has also been identified as a cause of unwanted pregnancy. Sex education has long been misperceived as a cause of increased sexual activity in adolescents. However, this is not the case. Sex education is aimed at equipping young people with knowledge, skills and attitudes to enable decision making that will ultimately result in healthy sexual lives. Effective sex education delays the age of sexual debut, reduces unprotected sex and other risky behavior associated with unwanted pregnancy and STI’s.
  • Let us not forget the cultural practices that support teenage pregnancies such as early marriage. In communities where girls are married off in their teenage years, it is expected that pregnancy will soon follow, and these pregnancies are most likely unwanted.
Unwanted pregnancies have far-reaching consequences;
  • Increase in unsafe abortions - many pregnant teenagers either with or without their parents’ knowledge opt for abortions to avoid the stigma of unwanted pregnancy. Upto 3 million unsafe abortions occur worldwide every year (WHO,2012). These contribute significantly to lasting reproductive health problems and even maternal death.
  • School drop-out - In Kenya, pregnancy is the second most common reason for girls dropping out of school. About 13,000 teenage girls leave school for this reason every year.
  • Maternal complications – complications during pregnancy and delivery are more likely in teenagers, who in many cases are unlikely to receive adequate antenatal care. There are more stillbirths and newborn deaths associated in teenage mothers than in adults.
  • Child development – the children born of teenage mothers also suffer as a consequence. They are more likely to have low birth weight which affects their future health.
  So what can we do? Let’s talk about sex – As much as we may want to lay the prevention of unwanted pregnancies on adolescents, truth is we all have a role to play. This is all centered on sex education, carried out formally or informally by parents or guardians, schools, health care workers, public health programs, friends or peers and media. Formal sex education programs have been introduced in schools to cover a wide range of topics such as reproductive health, family planning, sexual behavior, social and emotional interaction with members of the opposite sex, and so on. These programs help demystify sex, provide young people with accurate information on sex and create a forum to address issues and questions regarding sexuality. These programs where effective have been associated with a reduction in the number of teenagers engaging in unprotected sex, and hence reducing unwanted pregnancies as well as STI’s. However, these programs should not be seen as substitutes for parents discussing sex with their children. An open discussion about sex is encouraged, and this needs to be started at an early age, but only giving age-appropriate information at each stage as the child grows up. A debatable issue is whether parents should provide their teenage children with contraceptives, and what age this should begin. Modern parents are increasingly availing contraceptives to their teenage children, an issue which remains debatable. Campaigns such as the “Nimechill” series advocate for abstinence before marriage. Such messages encourage teenagers to avoid engaging in sex as part of conformance to peer pressures and to be proud of the decision to abstain from sex. The most divergent view comes from the religious leader. Most tend to agree that abortion is not allowed, but they disagree on the use of contraceptives. At the end of the day, it comes down to the individual choice on whether to use contraceptives or not. But if we are to curb the increase in unwanted pregnancy, we may need to explore all options available to us.   Need to know how better to talk to your teenage girl?Contact our psychologist today.