Health Risks of Child or Teenage Pregnancy. A 10-year-old tribal girl from Colombia gave birth on April 6 to her five-pound daughter by Cesarean section, sparking global outrage for becoming one of the youngest mothers in recorded history.
The unnamed girl, a member of the indigenous Wayuu tribe whose homeland is in northern Columbia’s La Guajira Peninsula, arrived at the hospital crying and in pain. She was 39 weeks pregnant when she underwent a C-section, Univision’s Primer Impacto reported. Most pregnancies are 38 weeks.
The baby was otherwise healthy, despite the fact that the new mom reportedly refused to breastfeed her newborn. The child-mom was also doing fine — even if the first time she saw a doctor during her pregnancy was on the day she gave birth. The pair had to be confined for a few days at the neo-natal unit of an undisclosed Columbia hospital.
Doctors decided to carry out the risky operation because of her age. According to Dr. Kimberly Gecsi, an obstetrician/gynecologist interviewed in Cleveland by ABC News Blogs, a C-section is common in births at such a young age. “The baby’s head needs to come through a bony outlet. But in a young girl, the pelvis may not be ready or big enough to deliver a baby,” she said.
While the Colombian police could prosecute the father for underage sex, the country’s constitution allows the Wayuu tribe to maintain its own sovereignty and certain cultural heritages, which supposedly include very early pregnancies.
“We’ve already seen several cases (of pregnancy) in girls of the Wayuu ethnicity,” Efraín Pacheco Casadiego, director of the hospital where the girl gave birth, told RCN La Radio noticias. “When in fact (the girls) should be playing with dolls, they are having to care for a baby. This is shocking.” The tribe has remained tightlipped about who the father of the newborn is.
Medical risks of early pregnancies
The 10-year-old girl’s plight highlights anew the medical risks of such early pregnancies.
Extremely young mothers have a higher risk of preeclampsia and the babies have a higher risk of fetal growth restriction, Dr. Frederick Gonzalez, a professor of obstetrics and gynecology at the New York University Langone Medical Center points out.
“These girls are not ready to be pregnant. Their bodies are not mature,” says Dr. Gonzalez. “They may be able to get pregnant, but being able to have a baby is a whole other situation.”
The numbers of teenage pregnancies have dropped over the past 30 years in almost all countries, but about 16 million teenage girls still become mothers every year, according to the World Health Organization. These pregnant teens and their unborn babies have unique medical risks.
For one, adolescent pregnancy is associated with higher rates of illness and death for both the mother and infant.
High blood pressure
Compared to pregnant women in their 20s and 30s, pregnant teens have a higher risk of getting high blood pressure — called pregnancy-induced hypertension. They also have a higher risk of preeclampsia — a dangerous medical condition involving high blood pressure combined with excess protein in the urine, swelling of a mother’s hands and face, and organ damage.
To control preeclampsia symptoms, the pregnant teen may need to take medications. But these medications can disrupt the unborn baby’s growth and even lead to pregnancy complications like premature birth.
A full-term pregnancy lasts from 39-40 weeks, and a baby that is delivered before 37 weeks is a premature baby or “preemie.” Teenage mothers are at a higher risk for premature birth, which also puts their baby at risk for many health problems.
While not all premature babies experience complications, being born too early can cause short-term and long-term health problems for preemies. The earlier a baby is born, the more risk there’s for health issues:
• respiratory problems like respiratory distress syndrome, bronchopulmonary dysplasia and apnea
• low blood pressure and an opening in the heart
• bleeding in the brain
• digestive problems like necrotizing enterocolitis
• metabolic problems like hypoglycemia
• blood problems like anemia
• problems in the immune system
Some premature babies will also end up suffering long-term health problems like impaired cognitive skills, vision and hearing problems, behavioral and psychological problems like attention deficit hyperactivity disorder, depression or generalized anxiety, as well as chronic health problems.
Lack of prenatal care
Prenatal care is critical, especially in the first months of pregnancy. Pregnant women should have regular prenatal checkups, where they and their babies can be screened for medical problems so that any pregnancy complications that arise can be addressed quickly. Prenatal vitamins with folic acid — ideally taken before getting pregnant — prevent certain birth defects like neural tube defects. But teenage girls who are pregnant are at risk of not getting adequate prenatal care — especially if they don’t have support from their parents or other adults.
A low-birth-weight baby weighs only 3.3 to 5.5 pounds (1,500 to 2,500 grams). A very-low-birth-weight baby — weighing less than 3.3 pounds — may need to be put on a ventilator in a hospital’s neonatal care unit to help it breath after birth.
Because they’ve had less time to grow in the womb, preemies are more likely to weigh less than newborns should. But even some babies delivered at term still weigh too low. A low-birth-weight baby can face some health problems, such as:
• polycythemia, or too many red blood cells that can make her blood too thick
• breathing problems from inhaling some of her/his first feces (meconium)
• hypoglycaemia or low blood sugar
• difficulty keeping warm
Teen mothers are at higher risk of having low-birth-weight babies.
Sexually transmitted diseases or STDs
Having STDs during pregnancy is critical because these can rise up through the cervix and infect the uterus and growing baby. For teens who have sex during pregnancy, STDs — from chlamydia to HIV are a major risk. Teenagers should be taught how to use a latex condom during intercourse to prevent getting an STD.
Depression during pregnancy
Teens who think they can’t tell their parents they’re pregnant, feel scared, isolated and alone — and this can trigger depression. This will make it less likely that they will eat well, exercise, get plenty of rest or have regular prenatal checkups. Teenage moms need the support of family and friends — or at least one trusted, supportive adult — to help them get the prenatal care and emotional support they need to stay healthy during this time.
Pregnant teens may be at higher risk of postpartum depression, the Centers for Disease and Control warns. Depression can make it difficult to take good care of a newborn — and it will also harm the healthy development of the teenage mom. But it can be treated. Teenage moms who are pregnant should be encouraged to seek help.
Death from violence is the second leading cause of death during pregnancy for teens, and is higher in teens than in any other group.
How do you know if a teenager is pregnant?
Missing one or more menstrual periods is the classic sign of pregnancy — but this can be tricky for teenage girls and their parents.
For one, a teenager may not admit to being involved sexually. Then, their periods aren’t regular yet. Some teenagers may also have cycles that are off as a result of excessive dieting or exercise or low body fat from sports or anorexia.
The full list of pregnancy signs includes:
• a missed menstrual period
• nausea or vomiting — called “morning sickness,” though it can happen throughout the day
• sudden, intense aversion to certain foods, especially meats or fatty, fried foods
• sore nipples or breasts
• unusual fatigue
• frequent urination
• unusual mood swings
Of course, a positive pregnancy test is the best sign of pregnancy — and today’s over-the-counter home pregnancy tests are generally considered accurate.
The outlook for teen mothers is generally bleak — although this doesn’t mean that bad future is cast in stone. With enough support — as well as their own courage and hard work — many teenage moms become good parents. But being a teenage mom puts a girl at many health and social risks such as:
• Discrimination and stigma. Many societies unfairly judge teenage mothers as lazy and irresponsible.
• Dropping out of school. Teen mothers are about two years behind their age group in completing their education.
• Poverty. Women who have a baby during their teen years are more likely to live in poverty.
• Having more children. Teen mothers are more likely than older mothers to have a second child within two years of their first child, and having her first child during adolescence makes a woman more likely to have more children throughout her life.
Babies born to teenage mothers are also at greater risk for problems both in the short and long-term:
• Compared to babies of women in their 20s and 30s, babies of teenage mothers are more likely to die in the first year of life. The risk is highest for babies of mothers under age 15. In 2005, 16.4 out of every 1,000 babies of women under age 15 died, compared to 6.8 per 1,000 for babies of women of all ages.
• Girls born to teen mothers are more likely to become teen mothers themselves.
• Boys born to teen mothers have a higher than average rate of being arrested and jailed.
Pregnant teenagers should be made aware of all options available to them — including abortion, adoption, and raising the child with community or family support. An adult should discuss these in a non-judgmental manner and all efforts to involve the parents or the father of the baby should be made.
A healthy teenage pregnancy
Teenage moms can still have a healthy pregnancy. Here are some ways:
• Get early prenatal care.
• Stay away from alcohol, drugs, and cigarettes.
• Take a prenatal vitamin with at least 0.4 mg of folic acid every day to help prevent birth defects.
• Ask for emotional support.
Preventing teenage pregnancies
There are many different kinds of teen pregnancy prevention programs in the U.S., Canada, Europe and Australia.
• Knowledge-based programs. These focus on teaching adolescents about their bodies, how to use birth control and prevent sexually transmitted infections (STIs).
• Abstinence education programs. These encourage young people to wait to have sex until they are mature enough to handle sexual activity — and pregnancy — in a responsible manner.
• Clinic-focused programs. These give kids easier access to information, counseling by health care providers, and even birth control services.
• Peer counseling programs. These typically involve older teens, who encourage other kids to resist peer and social pressures to have sex or teach teenage girls how to protect themselves from pregnancy and STDs.
The evidence shows that abstinence-only education without information about birth control doesn’t help decrease teen pregnancy rates — but knowledge-based programs do.
“We need to offer adolescents, boys and girls, different options and one important option is dual protection, so they get protected against pregnancy but also get protected against sexually transmitted infections and HIV/AIDS,” says Dr. Vicki Camacho from the WHO department of Adolescent Health and Development in a podcast on the WHO’s website.
In particular, “girls need to be empowered to make the right decisions at the right time,” she says. “If they really decide to have sex, they have to think about what it means and what are the implications of having sex. To do so, they need to have the right information, they need to know where to get services, they need to know what it means having a baby, what are the consequences and the implications.”