Wed | Jul 26, 2017

Teen moms lockdown! Victoria Jubilee pushes adolescent mothers to take five-year contraceptive implants

Published:Sunday | September 21, 2014 | 9:00 AM
Dr Orville Morgan, senior medical officer at the Victoria Jubilee Hospital. - File
Dr Sandra Knight - File
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Ryon Jones, Staff Reporter

Teen mothers who give birth at the Victoria Jubilee Hospital (VJH) are being encouraged to accept a long-term contraceptive method to prevent a second pregnancy before they reach adulthood. The strategy seems to be working.

According to senior medical officer at the VJH, Orville Morgan, with the use of Jadelle, a long-acting reversible contraceptive, in 2011 and 2012, there were no repeat pregnancies by the teen moms.

"Last year, we had two repeat pregnancies out of the number of teenagers we had treated, and that was mainly due to the non-availability of a long-active reversible contraceptive," shared Morgan.

"Our long-term hope is that for teenagers who go through our pregnancy clinic, their offspring will not become teenage mothers and … they won't become repeat mothers in their adolescent years, and we have had considerable success because of Jadelle for that."

Added Morgan: "We would prefer abstinence, but that has not been shown to work, so we have to offer them a long-acting reversible contraception."

He warned that the inroads made in reducing repeat pregnancies among teens is being threatened by a shortage of the contraceptive drug of choice at the VJH due to financial constraints.

"It is not being financed properly, so we have to decide that we want to finance these things properly and make sure they are properly in place," argued Morgan, as he pointed to the South East Regional Health Authority (SERHA).

"The funds are just not sufficient to do what
we have to do. SERHA is funded by the Government, but SERHA has to
manage its funds as well. So the Government might say SERHA is not
managing its funds properly, while SERHA might say it is not getting
enough funds. We are at the bottom of the feeding tree, and all we know
is that we are not getting enough funds," added
Morgan.

Jadelle, the long-term contra-ceptive used at
the VJH clinic, is a medication which contains levonorgestrel. Teen
mothers are offered this means of pregnancy prevention, along with
counselling, to ensure their educational and physical development
continues unencumbered by further pregnancy.

LASTS UP
TO FIVE YEARS

The contraceptive, in the form of two
flexible cylindrical implants, is inserted through minor surgery just
beneath the skin on the inside of the upper arm of the teen moms. The
levonorgestrel contained within the implants can last up to five years,
but the teen mothers have the option to remove it at any
time.

According to Dr Rishi Chand, an obstetrician and
gynaecologist, the drug is a type of
progesterone.

"Progesterone is able to suppress the
egg from ovulating. It is the same hormone that is increased during
pregnancy, so it's like telling the brain it's a pseudopregnancy. That
is one mechanism by which it works. It also works by thickening the
mucus in the cervix, making it hard for sperm to get through," Chand
told The Sunday Gleaner.

Teenage
pregnancy can have severe long-term consequences for both teen mom and
child; and the National Family Planning Board (NFPB) believes that with
the breakdown in the family unit and wider community in Jamaica, the use
of contraceptive by teens is a conversation that needs to be
had.

"The whole issue of contra-ceptives to children
is very controversial, because as soon as you mention it, they say you
are encouraging children to have sex," said Dr Sandra Knight, head of
the NFPB.

"But what we are finding out is if we don't
do something about it, then we have a lot of these teenage pregnancies
and a lot of these other issues that we have to deal with, including
sexually transmitted infections and HIV," added
Knight.

The latest official figures show that 270 teen
moms visited the maternity clinic at the VJH in
July.

According to Morgan, on average, 45 adolescents
visit the clinic per week, with almost all the mothers agreeing to use
some form of contraceptive. Well in excess of 50 per cent of these teen
moms opted for the long-term method.

PREFERRED
METHOD

"We prefer when they take a long-acting
contraceptive that requires little input from them. Jadelle falls in
that category, so it is a preferred method," said the senior medical
officer.

"About a year or so ago, before the supplies
were getting short, Jadelle was the contraceptive of choice for
teenagers because it is long-acting and it is reversible. Teenagers are
quite fickle and, therefore, we want to give them something that they
don't really need to worry about; it is just fit and
forget."

Medical authorities agree that there are few
side effects from Jadelle, and according to Chand, the most common
concern is weight gain and a bloated feeling because of the retention of
water.

"Other hormonal effects are headaches,
dizziness; some people have disturbances with their gastrointestinal
system, upset stomach and changes in their menstrual cycle. Sometimes it
can even cause the period to seize permanently while on the
medication," said Chand.

This was supported by the
NFPB, which said it conducted a study last year and proved that Jadelle
is
safe.

ryon.jones@gleanerjm.com