Early Pregnancy and Childbirth
23.04.2018
An early pregnancy is typically classified as any pregnancy occurring in teenagers and adolescents, usually between the ages of thirteen and nineteen (13 and 19). Girls at this age are too young, unprepared and uniformed to manage their situation and progress towards safe delivery. Furthermore, their emotional, psychological and social needs are greater, and more delicate than those of older women. Early pregnancy is a global problem present in all social classes, and in many countries including high, middle, and low income countries. Worldwide, majority of teenage and adolescent pregnancies occur in developing countries, rural areas and marginalized communities. This is mostly caused by poverty, lack of education, early marriage, lack of employment and absence of relevant public health information. Over 20 million girls, below the age of 19 years, become pregnant and give birth in developing regions annually.
Many teenage and adolescent girls face social pressure to marry and have children; about 15 million girls marry by the age of 19 yearly, and they account for 90% of early pregnancies. For others, pregnancy and childbirth occur out of wedlock, so are neither planned nor wanted. Irrespective of marital status and intentions, the leading cause of death for 15-19-year-old girls globally is complications from pregnancy and childbirth. About 23 million girls in developing countries lack access to modern contraceptive; consequently, half the pregnancies among girls in these countries and regions are estimated to be unintended.
Despite the 0overall progress in the decline of global adolescent birth rate from 65 births per 1000 women in 1990 to 47 births per 1000 women in 2015 due to the growth of global adolescent population, projections show that the number of adolescent pregnancies will go up by 2030- particularly in Africa. More so, there has been unequal progress in reducing adolescent birth rates in various regions as shown below:
- 115 births per 1000 women in West Africa
- 64 births per 1000 women in Latin America and the Caribbean
- 45 births per 1000 women in South-Eastern Asia, to a low of 7 births per 1000 women in Eastern Asia
There are several health, social and economic consequences of early, teenage or adolescent pregnancy. It remains a major cause of maternal and child morbidity and mortality, it also results in intergenerational cycle of ill-health and poverty. Adolescent mothers have higher risks of infections, eclampsia and puerperal endometritis, compared to older women. In addition, about 3.9 million unsafe abortions occur among them each year, contributing to maternal mortality and long-term health problems. Babies born to adolescent mothers may have higher risks of low birth-weight, premature delivery and serious neonatal conditions. Adolescent pregnancies also have negative social and economic effects on girls, their families and communities at large. Single pregnant adolescent girls may experience stigma and rejection by their families and friends leading to school drop-out and limited opportunities for employment and self-development, often perpetuating cycles of poverty. Similarly, their married counterparts are more likely to experience domestic violence compared to older women.
The following can reduce early pregnancies and corresponding consequences:
- Delaying marriage until after the age of 18 years; it is estimated that about 10% reduction in child marriage could contribute to a 70% reduction in a country’s maternal mortality rate
- Creating awareness and providing support to reduce pregnancy in females less than 20 years
- Promoting abstinence or the accessibility and use of contraception by adolescents at risk of unintended pregnancy; this could avert a total of 2.1 million unplanned births, 3.2 million abortions, and 5600 maternal deaths annually
- Reducing forced sex and unsafe abortions among adolescents
- Increasing the use of skilled antenatal, childbirth and postnatal care among adolescents
- Introducing stern punishments for rape