Teenage pregnancy - a public-health issue in Jamaica
Patricia Watson, Contributor
ADOLESCENT PREGNANCY continues to be a major public-health challenge in Jamaica. Coupled with this, is the related trend of adolescent girls who are infected with HIV. Anecdotal evidence points to an increasing number of adolescents who are not only getting pregnant, but also contracting HIV.
Teenage mothers are more likely to face maternal mortality as their bodies are not mature enough to have children. Approximately 18 per cent of children born in Jamaica are attributed to adolescent girls. They are also more likely to have premature babies, complications during labour, babies with low birth weight and low use of antenatal health care (Reproductive Health Survey (RHS) Jamaica 2008, UNICEF).
Sexual Activity and teens
The 2008 RHS reports that the mean age at first intercourse for females 15-17 is 14.4 and for those aged 18-19, the average age is 15.8, and that the percentage of women aged 15-19 who have ever had sexual intercourse, is 43.6 per cent.
The 2008 Knowledge Attitude and Practices Survey, Jamaica, points to a high level of sexual risk-taking among young girls aged 15-24 years. Just over 20 per cent (21.4 per cent) of females aged 15-24 years old reported having more than one sexual partner within a 12-month period.
Lifetime incidence of STIs increased by more than 50 per cent among women aged 15 to 24 years old, moving from 8.2 per cent in 2004 to 14.4 per cent in 2008.
A socioeconomic problem
More than 60 of every 100 pregnancies (66.2 per cent) among adolescent girls in the age group 15-19 years were unplanned in 2008. However, a more sobering trend that is noticeable in the statistics is that more adolescents are planning pregnancies. Data from the RHS indicate that the percentage of planned birth in the above-mentioned age group was 18.8 per cent in 2008, an increase of 9.4 percentage points over the last survey in 2002. .
A look at the Registrar General's Department statistics on births in 2008 also gives an insight into the public health and development challenges faced by Jamaica as it relates to teenage pregnancy. The data show that in 2008:
"Mothers below the age of 15 gave birth for the first time to 225 children, and an additional three were recorded as second birth for mothers under 15 years old.
"Of the 42,161 babies born in Jamaica, 6,138 were the firstborn for teenagers aged 15-19 years. For the same age group, 1178 were recorded as second births, 121 as third births, 10 as fourth birth and one each for fifth and sixth birth.
A similar trend is seen in those aged 20-24 years old. There were 5,575 firstborn to adolescent women in this age range; 3,857 second births; 1,498 third births; 411 fourth births; 72 fifth births; 13 sixth births; four seventh births; one-eighth birth and one 10th birth.
Adolescents aged 15 to 24 years old account for the 44.75 per cent of all births in Jamaica for 2008. The implications of this are clear. Oftentimes, the teenage mother is excluded from school and thus professional opportunities to provide for themselves and the babies. Since the mothers are not in a position to care for themselves and their children, the burden of care rests with civil society and the government. It also speaks to the present gaps in parenting, child rearing, sexual and reproductive health education and the financial burden the country faces.
A focus group discussion (FGD) conducted by EVE for Life with eight HIV-positive and eight HIV-negative teenage mothers around teenage pregnancy produced some interesting information.
None of the participants in the FGD thought they would have got pregnant the first time they had sex. According to them, they were thinking only about the pleasure.
"I see other girls having sex and not getting pregnant, so I thought it would be the same for me."
A key point made by participants is the way men see pregnant adolescent girls. According to the participants, men see them as clean and less likely to become pregnant again, and so, proposition them for sex. They explain how it makes them feel cold the way the men look at them and the things they say to them.
"Is a whole heap of man out there want young pregnant girls. They tell us that they will mind the baby if we give them a piece." "They tell us that when a young girl pregnant we are tighter."
"Dem ask wi if we nuh want dem wash the baby head with the sperm - they claim it will make it easier to have the baby if the head wash."
"Dem sey dem like to have sex with pregnant teenagers, because they want to have unprotected sex and come inna yu. You won't get pregnant again cause yu already pregnant."
"Some of them think we are safer - they want to have sex with us because they don't want to get disease."
The average age of first pregnancy for HIV-negative participants in the FGD is 15 years old, and 17 years for HIV-positive participants. The experience for the participants was varied with some receiving reassurance from parents, others being abused physically, and others being put out of their homes. The emotional impact of pregnancy was also experienced by parents.
"I got pregnant when I was 16 years old. My mother cried every day. She was very disappointed."
"My mother hit me with a machete. My mother told me to come out of the house. My mother told me she felt she would just walk in front of a truck and let it hit her."
"My mother was pregnant at the time and she got upset and lost the baby. My mother was a teen mother herself and was disappointed."
Almost all the participants told their friends they were pregnant before they told their parents. Some wrote it in their diaries. None of the pregnancies were planned, and 12 of 16 participants contemplated abortion.
The FGD participants overwhelmingly felt that parents played a role in their getting pregnant.
"Some of the parents are careless. I told my mother I had a boyfriend and she didn't give me any advice. I told her I was having sex and she didn't tell me to stop or how to protect myself."
"Once you start seeing your period, some mothers tell you, you can start having sex.
At the clinic and hospital, the young mothers also noted that their treatment by health-care workers was bad. They explained that they were treated as if they had no rights. One participant summed up the treatment:
"They disgraced me bad. They classed me in a way - 'whey yu a do yah? Yuh shoulda inna school!'"
Starting today, EVE for Life in partnership with The Gleaner will begin the series 'Diary of Teen Mom". The series is expected to generate public discussion around this public-health issue with a view to developing innovative programmes to prevent teenage pregnancies and to assist teenagers who have already given birth to return to school and complete their education. Many teenagers who get pregnant did not intend to do so and some are forced to have sex resulting in pregnancies. Some teenagers also get pregnant and contract HIV. It is important that in our discussion of teenage pregnancies that these nuances are considered and appropriate policies and programmes are developed to address this growing socio-economic problem.
We welcome stories from other teenage mothers. You can send your stories to firstname.lastname@example.org.
Patricia Watson is the executive director of EVE for Life, a non-governmental organisation that targets women and children living with HIV and AIDS.