What you need to know:
- During the first six months of 2021, UNFPA registered 196,499 teenage pregnancies from 354,736 in 2020. The report shows that most girls were defiled by family friends and relatives.
Resty Kulabako, a teen from Mbarara was impregnated by a man old enough to be her father. That was after a relative whom she had gone to visit during lockdown married her off because he had got a loan from the said man.
The pregnancy was not a welcome idea to her mother and sisters who taunted her for getting pregnant even when Kulabako explained what had happened to her.
As if that was not enough, apart from failing to give birth normally because her pelvic was not wide enough for the baby to go through, she lost her baby to complications no one bothered to explain to her.
For the next months, Kulabako battled with thoughts of defeat for having lost her baby and was diagnosed with depression. She also often fainted though never got to know the reason behind it.
Uganda has one of the youngest populations in the world, with 75 percent aged below 30 years and its young population faces challenges such as teenage pregnancy.
According to the Uganda Bureau of Statistics UBOS (2018), almost a quarter (one in four or 25 percent) of Ugandan women have given birth by the age of 18, with about two in 10 (18.9 percent) pregnancies in all women attending ﬁrst antenatal care being among teenagers in 2020.
Dr Edson Muhwezi, assistant representative, The United Nations Population Fund (UNFPA) Uganda says the high rates of teenage pregnancy can be attributed to Covid-9 which caused disruption to programmes that support access to sexual reproductive health information and services to schoolgirls.
“Additionally, poverty has led some parents to marrying off their daughters in order to make money to survive,” he says.
Analysis of data on first Antenatal Care visits from District Health Information System (DHIS-2) shows that there was a 17 percent spike in teenage pregnancies between March 2020 and June 2021.
Factors aiding teenage pregnancy
Dr Boniface Ssegujja Otto, a paediatrician at Premier Children's Clinic says the factors associated with teenage pregnancy in Uganda fall under individual, economic, social and physical and physical environmental determinants.
“These include lack of life and social survival skills, lack of knowledge on how to avoid pregnancy, low acceptance/use of contraceptives, neglect by parents, sexual abuse, pressure to contribute to family welfare through early marriage or sexual transactions, lack of community responsibility, media influence, peer pressure, cultural beliefs that promote early marriage/childbearing and lack of role models,” he says.
Dr Otto says other contributing factors include drug abuse among boys, poverty, late work hours, long travel distances such as to school and unsupervised locations (such as sugar plantations).
Effects of teenage pregnancy
According to UNFPA, a total of 354,736 teenage pregnancies were registered in 2020, and 196,499 in the first six months of 2021.
Dr Otto says teenage pregancy is associated with poor maternal and child health outcomes. “Most teenage mothers die during child birth since their bodies are not physiologically ready (immature body) to go through labour,” he says.
One of the complications is obstetric fistula. A research: Fistula -- a disaster for teenage mothers, says this is one of the most severe childbirth-related complications which results from the small size and physical weakness of many young pregnant girls. That makes it very difficult for them to give birth to a child.
“Delivery is thus often prolonged and during this time, the girls' perineum may tear. That leaves holes between the bladder and/or the rectum and the vagina. From then on, the young mothers lose control over their bladder and bowels, are unable to bear more children, and find sexual intercourse painful.” Apart from failing to live a normal life, the urine stench which causes stigma.
While compilations such as preeclampsia (high blood pressure in pregnancy) can happen to any pregnant woman, according to webmd.com, its effects are worse among teens.
“This dangerous medical condition where there is excess protein in one’s urine, swelling of hands and face could also causes organ damage. Additionally, it can disrupt foetal growth and lead to premature birth.”
Dr Otto says that these preterm babies also have low birth weight and when given birth to in a poor state, it may lead to death or lifelong complications such as cerebral palsy.
“Low-birth-weight is between 1.5 and 2.5kgs and these must be put on a ventilator in the neonatal care unit (NICU) for help with breathing after birth. However, the charge that accrues from keeping the baby in the NICU is high, which these mothers may not be able to afford hence possible death and the related mental disturbance to the mother,” he says.
According to World Health Organisation (WHO), babies born to mothers below 20 years face higher risks of low birth weight, preterm delivery and severe neonatal conditions. “In some settings, rapid repeat pregnancy is a concern for young mothers, as it presents further health risks for both the mother and the child,” a report by the body reads in part.
A study: Health effects of adolescent pregnancy: implications for social workers, showed that there is an increased risk of neonatal mortality for the infants of adolescents, possibly owing to higher rates of low birth weight.
Mrs Vivian Kityo, the proprietor of Wakisa Ministries where teenage mothers are rehabilitated says many pregnant teenagers may also face stigma or rejection by parents and peers.
“It is still a social stigma for a pregnant girl to live under the same roof with her parents,” she says. As such, many are sent away from home, the only place where they should have got solace from the harsh treatment of the community.
They are also at a higher risk of experiencing violence in marriage. Dr Otto says many are married off and expected to carry out duties of women yet their bodies are still young. “When they fall short, their husbands and those in the home are likely to treat them with ridicule which could include verbal and physical abuse,” he shares.
Dr Otto adds that adolescent mothers are also at a high risk of poverty since most do not complete school.
“That contributes to reduced potential for gainful employment. Additionally, others lose their employment for various reasons,” he shares.
Owing to more than 300 days out of school, Dr Muhwezi says adolescent girls were deprived of the social protection that school offers and were exposed to risks of sexual violence, exploitation and abuse, child marriages, and teenage pregnancies.