When a carefree toddler reaches adolescence, she puts her footsteps to a completely new world. Though the usual age is 10-14 years, it varies from country to country, race and geographical distributions. But, there is no doubt that her known world suddenly changes — a drastic change occurs in her physical, mental and social aspect.
She becomes excited with sudden growth spurt (suddenly becoming taller than her counterparts) as well as emotionally unstable or frightened with menarche (the first menstrual bleeding) and thelarche (onset of breast development).
By the time, all these unusual changes may lead these adolescents to miss their classes — they become either euphoric, depressed or may experience other mood swings.
Different studies show that both in developing and developed countries, adolescents get involved in sexual activities which they are not able to distinguish between the acceptance or deviance in the society as their body and mind is still young, soft and tender.
So, willingly or unwillingly they become victims of sexual harassment, get involved in sexual relationships or become victims of women trafficking. As a consequence, they become high risk pregnant before the age of 18 which exposes them to the greatest threat to their life as well as to their families. The risks of adolescence pregnancy are:
• Miscarriage, as their whole body, including the reproductive system, is not fully developed. They are not capable enough to carry on with pregnancy. Also chances of having normal vaginal delivery is less.
• Susceptibility to various types of sexually transmitted diseases (STDs) like syphilis, gonorrhoea and HIV etc. can cripple their and the newborn babys’ lives.
• They might suffer from anaemia (deficiency of haemoglobin in blood), pre-eclampsia and eclampsia (high blood pressure with oedema and convulsions), preterm births, low birth weight babies, obstructed labour, intrauterine or infant death etc. Eventually, maternal mortality increases to a greater extent.
• After delivery, they may suffer from mental imbalance, get addicted to drugs and sex stimulating pills. Chances of developing various psychological problems ranging from postpartum blue, neurosis, psychosis and suicidal tendency increases exponentially.
• Long term complications of early sexual activity before cervical (mouth of uterus) maturation is the precursor of cervical cancer, worst candidate of Pelvic Inflammatory Disease (PID), repeated miscarriage, ectopic pregnancy, infertility and lastly pelvic organ prolapse/descent.
Some youngsters, especially workers in factories, restaurants and even high school students think that they are mature enough to have sexual relations or marriage without permission of parents/guardians.
In Bangladesh, an estimated 2.5 million births (17% of total births) were attributed to adolescents between the age 15 and 19 years between 2005 and 2010. The adolescent fertility rate is 118 births per 1,000 women younger than 20 years.
Although the adolescent pregnancy rate is declining, the reduction is only 18% during a period of 12 years. To reduce infant and teen mortality, wedding before the age of 20 should never be considered.
The social elites (school teachers, social consultants, religious leaders etc.) can play an effective determining role in preventing this dangerous situation. The parents/guardians should prioritise not to put obstacles on the growing girl’s mind and body. Also, parents should be open with their young children especially when they are facing a crisis.
The writer is a Gynaecologist and Obstetrician working at Widad University College, Malaysia.