A teenage pregnancy is one in which the mother’s age is less than 19 years.
The incidence of teenage births in Malaysia has varied from 14,000 to 18,000 annually since the beginning of 2010. This means an average of between 37 and 50 births daily.
By comparison, the incidence in Singapore and Hong Kong is about 20% to 30% that of Malaysia.
There are various factors that increase the likelihood of teenage pregnancies.
Data from the United Nations Children’s Fund (Unicef) Malaysia revealed that teenage pregnancies are strongly associated with poverty, with the mothers either unemployed or in lowly paid employment.
A study of pregnant teenagers at two women’s shelter homes reported lack of or poor parental supervision, with about half reporting poor communication with their parents about personal issues.
Another study in a semi-rural clinic reported that about a third of pregnant teenagers had low educational backgrounds.
Dropping out of school increases the likelihood of insufficient sexual and reproductive health knowledge, and involvement in risky sexual activity.
Various studies have reported low levels of knowledge about sexual and reproductive health, even in university students. The main source of such information were mothers in the Klang Valley and friends in Kelantan.
A study in 1998 reported that 50% of 14–15-year-olds had read pornographic materials and 44% seen pornographic images in magazines and videos.
Peer influence have been reported to have contributed significantly to teenage pregnancies.
Studies have reported that the incidence of consensual premarital sexual intercourse amongst teenagers in the Klang Valley and Negri Sembilan were 13% and 5.3% respectively, with three quarters in the former not using any form of contraception.
Teenagers are biologically not ready for pregnancy, which is reflected in health consequences.
In addition, there are social and economic consequences of teenage pregnancies.
Teenage pregnancy continues to remain a major cause of maternal and infant mortality, as well as inter-generational cycles of illness and poverty. They account for more than 90% of all maternal deaths globally.
Local studies report fewer antenatal care consultations at healthcare facilities, unsureness about date of delivery, maternal anaemia, preterm deliveries and perinatal complications for the newborn.
When there are fewer antenatal consultations, there are decreased opportunities to diagnose and treat maternal conditions such as anaemia; educate the mother-to-be on infant and child care; and planning for the upbringing of the baby.
About one in four teenage mothers have a preterm delivery. This exposes the baby to perinatal complications such as respiratory difficulties and infections.
In addition, the low birth weight of these babies exposes them to long-term health effects.
A study of residents in a local shelter home reported about 93% having emotional problems; 58% sleep problems; and 46% low self-esteem.
The rejection of pregnant teenagers by their families and their use of shelter homes as means to avoid embarrassment and shame exposes the mother to puerperal depression.
Rapid repeat pregnancy exposes mother and baby to further risks.
Studies of teenage pregnancies from other countries report higher risks of fits (“eclampsia”); genital tract and systemic infections; bleeding before and after delivery; frequency of operative delivery; and unsafe abortions, which contribute to maternal mortality and lasting health problems.
Social and economic consequences
The pregnant teenager is likely to drop out of school because of the early pregnancy or marriage.
Subsequent lower educational attainment leads to fewer skills and employment opportunities, which often perpetuate poverty cycles.
It has been found that child marriage reduces future earnings.
The economic impact is that the country will lose out on the annual income that these women would have earned over their lifetimes if they did not have the teenage pregnancy.
According to police statistics, there are about 80 to 100 newborn babies found abandoned annually, with more than 50% found dead.
These numbers could be the tip of the iceberg as many may be buried or thrown away in places where their little bodies can never be found.
The Prime Minister’s instruction to states to increase the minimum age of marriage to 18 years is a positive step.
However, more needs to be done and the measures have to be sustained. For a start, policymakers, parents and society have to acknowledge the following:
• A teenage pregnancy is most probably an unplanned pregnancy; particularly the younger the mother-to-be is.
• The young will increasingly indulge in sexual activity for biological and other reasons.
• Knowledge about sexual and reproductive health in our young is sorely lacking.
• Knowledge and access to contraception have never been reported to increase sexual activity among the young.
• Criminalising the unfortunate end result of human biology cannot stop the natural order of things.
• The government, parents, teachers, and society have to be proactive and not reactive.
As such, there is a need to:
• Implement comprehensive sexual and reproductive health education in all schools.
This means the provision of explicit knowledge about human reproduction and contraception and skills to manage human biology.
• Provide easy and non-judgmental access to contraception to teenagers who are sexually active, including emergency contraception.
• Provide easy and non-judgmental access to antenatal care and delivery.
• Provide social support and acceptance of teenage mothers, particularly single mothers.
• Soften society’s view about teenage and single motherhood.
Some of these measures can be implemented immediately, while others will take time to take effect. However, if there is a will, the time frame can be shortened.
People who have no sympathy for pregnant teenagers would do well to remember not to judge others.
Every teenage pregnancy, particularly if the baby is abandoned, reflects society’s failure to take care of its most vulnerable.
If Malaysia is to be a developed nation, it can and must provide comprehensive sexual and reproductive care for all women, particularly teenagers.