Teenage pregnancy, also called adolescent pregnancy, is a social and medical problem. Our sisters, cousins and nieces have become part of the statistics: 18 in every 100 girls aged between 15-19 years become pregnant in Kenya. 103 pregnancies in every 1000 pregnancies is an adolescent pregnancy, according to the Kenya population situation analysis by UNFPA.
I had a short discussion on this subject with Dr Alex Bosire, a consultant obstetrician and gynaecologist and lecturer at the University of Nairobi School of Medicine.
What are the factors contributing to the high number of teenage pregnancies in the country?
Social factors– There is poor social upbringing with absentee parenting. The teenagers have no role model to guide them on what is right. With the absence of good role models, the teenagers resort to other sources of ‘inspiration’ like social media, poor leaders and politicians and other people in influential positions, radio, TV, and print media. These are misleading to young minds.
Societal pressure also plays a role, as teenagers engage in sexual activities because their friends are also doing it. Unfortunately, because of lack of support and education, these teenagers end up pregnant as knowledge of their reproductive cycles is lacking.
Cultural practices –this is where a society pardons or even encourages child abuse. Where old men are allowed to marry young girls and in some communities where teenage abuse is found, the perpetrators are only fined lightly.
Financial- Due to economic pressures, teenage girls may end up practising sex to get financial favours. Unfortunately, they are not well informed and they end up pregnant.
COVID-19 and the numbers: Has there been an impact on teenage pregnancies by COVID-19, or is it a scapegoat for the numbers witnessed in the recent past?
The COVID-19 pandemic has significantly contributed to social upheavals in that schools have closed, curfews have been implemented, most social functions are limited and thus there is more ‘idleness’ around. Case in point is an article in the local dailies mentioning that many youth were engaging in sexual activity more over the lockdown period, and especially in Nyanza. With this ‘idleness’ in the general population, there is more sexual activity and more teenage pregnancies thus. There is a general lack of discipline, which would not be the case if institutions like schools and churches were still running
What are the medical risks associated with teenage pregnancies?
Teenage pregnancies are associated with complications like preterm labour, preeclampsia- that is high blood pressure in pregnancy, intrauterine growth restriction and maternal death.
Did you know: Pregnancy-related deaths are the leading cause of death for 15-19 year-olds worldwide.
Teenage expectant mothers are also at risk of anaemia, social neglect and stigma as they are commonly ostracized by family and society. They are also at risk of having unsafe abortions.
Teenagers are at risk of prolonged labour because their reproductive organs like the pelvis are not fully developed. This would result in birth trauma and operative deliveries.
Because of ignorance about safe sexual practices, they are also at high risk of HIV and other STI’s. Subsequently, this affects the health of the baby.
Is the idea of contraceptives a symptomatic approach in the prevention of teenage pregnancies?
Contraceptive use is a symptomatic approach; it would prevent pregnancies when used correctly. Education about this is important to avoid overuse of such methods as is the case of morning-after pills. However, opponents to the issue of contraceptives look at the fact that the teenagers may resort to more sexual activity as they now know that they are ‘protected’ from pregnancies.
Is there any medical danger in the use of contraceptives by adolescent girls?
Contraceptives are generally safe to use. However, there are some risks in their continued use. For example, the risk of abnormal blood clotting with use of combined contraceptive pills and that of irregular menses with the injectable contraceptives. Thankfully, the feared risk of cancer is very rare. The other concern is the impact of contraceptive use on fertility which is mitigated by the fact that the most commonly used hormonal contraceptives usually have a quick return to fertility once they stop using them.
What role does education play in the prevention of teenage pregnancies?
Education has a big role to play in curbing or reducing teenage pregnancies. If these girls were taught how to take care of themselves and what measures they can take to avoid pregnancies, then the rates would go down. The society also requires education so that there is a focus in improving safe sex practices and also to provide alternative entertainment for the teenagers so that they do not resort to sex or drug habits that would fuel sexual activity.
One of Kenya’s commitments at the 2019 Nairobi ICPD25 summit (International Conference on Population and Development) was the elimination of teenage pregnancies by the year 2030. The question remains if will we achieve this, and how we will take care of the teenagers that become pregnant.