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Agony of teenage mothers dying to give Life

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With the increasing rate of teenage pregnancies in Nigeria, Rebecca Ejifoma, who spoke to four teenage mothers, chronicles their anguish and the urgent need for sexuality education and reproductive health communication for the girl child

Teenage pregnancy is fast becoming a way of life. Although not a glorified topic in the Nigerian society and globally, many teenage girls have botched their dreams in life with early age pregnancies. While some mended the shredded pieces of their lives again, others relapsed in their unmet life potentials.

Undoubtedly, teenage pregnancy has continuously plagued the wellbeing of the Nigerian society. The Nigeria Demographic and Health Survey (NDHS) 2013 seconds this. An estimated 23 percent of women aged 15 to 19 years have begun childbearing, of which 17 percent have had their first child and five percent are pregnant with their first child. From the NDHS data,  32 percent of teenagers in rural areas have begun childbearing compared to 10 percent in the urban areas.

One of the most common factors driving the incidence of teenage pregnancy in the Nigerian society is family dysfunction which has an enduring and unfavourable health consequences for women during adolescence, childbearing years and beyond.

This reporter gathered that teenage girls from poor background families have the highest rated sexual activity that lead to early pregnancy. Poor parenting, poverty, dating, violence, age discrepancy are among the major causes that lead to the consequences of teenage pregnancy. Others include voluntary early sex and peer pressure, sexual abuse or forced early marriage.

Most  teenage mothers drop out of school and suffer psychological, economical, psychosocial and vocational consequences.

The incidence of teenage pregnancies is unacceptably high despite attempts to prove contrary. Further, the NDHS revealed  that only three in 10 women reported to first have had sexual intercourse at the age of 20 or later, while 54 percent had been sexually active before turning 18 even as 24 percent had had sex before they were 15.

Worse still, according to the NDHS, two percent of sexually active girls between 15 and 19 use contraceptives mainly because of a lack of access. So, it is hardly surprising that 23 percent of girls in this age group are already mothers.

The impact of teenage pregnancy usually ruins the girls’ lives – health wise and socially. They drop out of school and do not acquire any skills that would help them earn money or end up in a bad marriage to their child’s father who often is too young to be a father. The girls end up with Vesico Vaginal Fistula (VVF), and hight maternal and infant mortality rates.

Estimates by the National Population Commission (NPC) has it that the number of teenage mothers in Nigeria may exceed 60 million by 2020, saying that good sex education could make a difference.

Unfortunately in Nigeria, sexual issues are not discussed freely and  teenage pregnancy is more prevalent in rural areas where poverty and illiteracy are worse. But even in the city a teenage girl is unlikely to obtain family planning services. Teenagers who get pregnant either arrange illegal abortions or are forced to marry the boy that impregnated them, and be denied education and professional opportunities while struggling with health issues.

Ngozi’s story
The lack of awareness has earned many girls early pregnancies. One of such girls is Ngozi Philips, an indigene of Rivers State. She is aged 18 going on 19. She lives in a rickety room in Badagry area of Lagos with the family of the boy who got her pregnant.

“I was living with my family in Port Harcourt. In 2017, my mother and I had a disagreement.  I ran away from home to Benin where I stayed with my grandmother. But my uncle planned to return me to Port Harcourt. I ran to Lagos with the little money {N14,000} I earned for two months in Edo”.

“When I arrived Lagos, I lived with a girl I met at the park in Edo. We were underage. She took me to the night club in Lagos, where I met Victor Fred, 22, a prospective secular music dancer. He told me he was a dancer and he liked me very much.

Ngozi

“We started a relationship. When I told Victor I had housing issues, he brought me to his mother and I began to live with her and her three mature children in one room. Soon I discovered I was pregnant.”

As a result of her escapades, Ngozi’s parents severed all ties with her. “I tried to terminate the pregnancy to avoid shame. My father was really disappointed and to-date doesn’t want to see me. I am ashamed,” she lamented.

The young mother recounted her ordeal almost in tears. “I would stay from morning till 2pm without eating. I begged for food on the streets. One lady introduced me to a Pentecostal Church and I explained to them what I was going through, they really encouraged me with food, money and baby items until child birth.

“Victor didn’t help much. As a dancer, he earns very little – N1,000 or N1,500 at least once in a month. The mother, who sells electronics,feeds the family for the night only. She would go to Alaba International where she sells until night before I eat.”

For a whole month, Ngozi didn’t go for antenatal. “I started when my pregnancy was six months. The antenatal was every Thursday. But I didn’t go always. There was no transport money to go and return. When I had my baby she was okay but I didn’t feed well. And took no medications. The only time I have money is when my people send me N2,000.

“Baby food is N1,400. if I buy baby food for that amount and pampers N500 the money is  finished. So, when I’m left with N100, I would stay until 12.00 before I eat breakfast.

“I wish to go back to school. I wanted to study Business Administration at Imo State University. If I get the opportunity to go to school, I will be very happy.”

Chioma’s story

At barely 20, Chioma Okafor who hails from Imo State is a single mother of twins. A twin herself, she and her twin sister are the last children of the family. An orphan, she was under the care of her older siblings until it was discovered she was 5 months pregnant while in her aunt’s home at Egbeda.

“I began working as a sales person at Egbeda after my WASC exams last year then went to School of Nursing in Imo State. But while I worked to save some money, I met this guy called Emeka aged 33. We had sex. He promised to marry me, but things changed as soon as I got pregnant.”

Chioma was regretful. “When I told him I was pregnant, he warned me not to try such with him. He ordered me to abort it immediately or never contact him again. I felt ashamed to say it (she covered her face with her hands). So, I wore a girdle to hide the pregnancy until the fifth month when I knew abortion was no longer possible.

Chioma

“It was a terrible experience. My brothers were disappointed and accused me of shaming the family. It was terrible. I could not contain the trauma and even contemplated suicide.”

Chioma had hoped to be married with all the fanfare typical of wedlock in her community, but all her hopes were dashed. “I was raised in a Christian home. I know it is wrong to have a baby out of wedlock. My elder brother said no illegitimate child would come into our family; hence, he provided enough money for abortion. Because I was scared of death and hell, I refused”.

Emeka rejected and blocked her calls. “I thought he wanted to marry me because he is 33 years old. I never knew he was a professional womaniser. Even right now, another girl is pregnant for him”.

Many teenagers have lost their lives while giving birth, a factor contributing to maternal death ratio of 115 deaths per 1000 live births in West Africa.  Chioma almost lost her life at the sixth month.

“Every time I fainted, my elder ones rushed me to the hospital for check and the doctors said the baby and I were okay. But I knew I was not. Until one day, I slumped. All the expenses were taken care of by my elder brothers,” she narrated.

For the young mother of two, how she woke up from coma is still a mystery. “At the ninth month, I had twins.” Chioma giggled: “It has not been easy. My siblings have been feeding my twins and I”.

Today, with her three months old twins, she lives with her siblings in an apartment in Ketu area of Lagos. “There were times we had no food to eat. I would start crying. But on this third month of their birth, the babies’ father sent me some money to buy milk.”

She, however, complained: “I can’t give them breastmilk exclusively. I give them water and infant formula. The baby boy suckles me dry and weak. I can’t do it. I don’t have the strength.”

 Owinte gets pregnant following peer influence

Pregnant at 15, Owinte Andrew became a mother as a teenager. She told Africa Health Times. how it all happened: “I am 19 now and I have a 4-year-old boy but he doesn’t know I am his mother. Only my parents know the truth.”

Owinte who hails from Cross River State met Tony on Facebook. She had just completed her secondary school education. He was 17.  The first time she visited Tony was in the company of her siblings.

“His parents were not home. My friends excused themselves on the pretex of going out to buy something. He offered me a bottle of soft drink. I drank it and became weak. I felt so weak that I could not resist him when he came close. He slept with me.”

Owinte was too young and naïve to cope with pregnancy. “I felt so ashamed and contemplated suicide but in the end the decision to run to my grandmother prevailed. My friends who deceived me even spread the information that I was pregnant.”

“My pregnancy was a nightmare. It was nine painful months of shame and disgrace. I carried the pregnancy in my slim body. I could not care for myself much less a baby. I fainted everyday, it is thanks to my grandmother that I survived.  She stood by me all the way.

Owinte’s father desired the best for his only daughter after her mother dragged her back home. “He was angry I got pregnant but insisted I would go to the university. He bought my JAMB form saying my mother would take care of the child while I went to school and started my life afresh. He hoped I had learnt my lessons the bitter way”.

Today, Owinte is a student of Cross River State Polytechnic. She is in her final year studying Mass Communication. She told Africa Health Times she is over it.

“My son knows me as his elder sister. He calls me auntie and calls my mum, mummy. I’m not sad anymore and I’m not foolish either”.

SS 2 student, Mabel, sets for abortion

Mabel

The case of 18-year-old Mabel Adebayo comes into focus.  She was a 2nd year Senior Secondary School student in Amuwo-Odofin before she got pregnant. Her pregnancy is just over a month old now.

“The boy responsible is older but also a teenager. We slept together twice and I got pregnant. When my parents found out they urged us to get married, but he refused and even denied responsibility. He stopped talking to me.”

Mabel’s dream is to become a lawyer. “I am ready for abortion. If I had money, I would keep the pregnancy, but I’m not comfortable with it. I don’t feed well. I’m jobless and stay home daily. I’m not ready to be a mother.”

Mabel’s advice for young girls is instructive. “Stay focused on your studies. Don’t follow boys. When time comes you will get married. But right now as a girl you don’t need a man in your life.”

WHO, UNICEF Statistics

The experiences of the girls above say a lot about the proliferation of teenage pregnancy.  According to the World Health Organisation (WHO) and United Nations Children’s Fund (UNICEF), approximately 16 million girls aged 15-19 and 2.5 million girls under 16  give birth each year in developing countries.

Complications during pregnancy and childbirth are the leading cause of death for the adolescents globally. Every year, some 3.9 million girls aged 15 to 19 years undergo unsafe abortions.

Although the trend keeps gaining ground daily, medical experts have said that lack of sexuality education at early stage among the girl child and use of contraceptives are reasons teenage pregnancies thrive in Nigeria.

Solutions from experts

Olalekan Azeez, Executive Director for AIDs and Pregnancy prevention for adolescents (Am Pregnant) sensitising young people to be pregnant with information that will help them scale through the adolescent age having realised that that is the most difficult age in one’s life.

“These teenagers and adolescents need information to scale through that age. We use mobile theatre to educate young people in schools and we need to inform them about their sexual reproductive health at early stage from primary schools.

“We need to open the communication gap and let adolescents know that their reproductive health organs should not be joked with. We have different methods for the different ages. and we have been very successful.”

Further,  he stated : “Adolescent and teenage pregnancy is a societal issue. But these days, it tends to be socioeconomic issue. Most of the time, you can see the way most Nigerians are falling into abject poverty. When you move to Ojo Road in Ajegunle, you will see that aming every 10 houses there is a hotel. Who occupies those hotels? They are youngsters from different neighborhoods. You have them across Festac.

“Most single mothers want socioeconomic complements. It is from the girl child. This is affecting the fabric of the family.

Social factor was based on the fact that  those child did not open up on child communication earlier. Some are from broken homes and no one to back them up with the necessary information.

“Every month, we receive between 10 and 15 pregnant adolescents especially from Ajegunle. This thing is happening. We empower them for a second chance opportunity.”

He said  there used to be access to information, but these days, there is funds scarcity.

“Even if you give out the funds donors are putting into our system, it is not up to one percent of our total budget. The Nigerian government needs to take out at least  three per cent to spark the awareness.”

It was also noted that adolescents generally lack sexuality information. “They are making new friends daily, coming into schools and having boyfriends. Funds are no longer available to continue with  information, education and communication activities. That can change life.”

In the view of Isaac Moses, Chief and Executive Director, Society for Information and Human Administrative Issues,  a youth-focused organisation in Ajeromi/Ifelodu LGA, specialising on sexual and reproductive health for young people in Nigeria, there are emerging issues that are cross cutting.

“Currently, we have seven pregnant adolescents we are managing. Many people think adolescent pregnancies have to do with upbringing. There are factors like social pressure, experimenting out of curiosity, poverty and more.

“When you tell them to say no to juvenile delinquencies and vices, no to unplanned pregnancies, no to early sex and abortion, what should they say yes to? That is where we bring in multichannel approach that can help them to position and focus in life.”

According to UNICEF, teenage deaths comprise the bulk of maternal death in Nigeria. Family physicians and medical experts however say use of contraceptives can reduce the rate of pregnancies among adolescents  by 50 per cent.

More solutions from family planning experts

According to the State Team Leader for NURHI Project for Centre for Communication Programme, Dr. Edun Omatsanjuwa, pregnancy among teenage girls aged 13 to 19 is significant regardless of whether they are married or not.

“In some cultures in the northern part of the country,  early sexual debut and early sexual exposure are common practices. Teenagers like to explore and are exposed to sexual content on social media and on TV earlier than what it used to be. These days, the average sexual debut is about 12 years, and if not properly educated there could be teenage pregnancy.

“Biologically, once a girl begins menstruation, it is assumed she is ready to carry a child. but that does not necessarily mean that the body is ready to carry pregnancy. I do not agree with the misconception that the best time to have a baby is as a teen.

“Early 20s to early 30s is the best time. At this stage, the body is mature and healthy enough to carry pregnancy. Maternal mortality is highest among teenage pregnant women. The risk is higher in terms of hemorrhage.”

Times are changing. Then mothers were full-time housewives. But now people are on the move. People want to achieve more. Feeding the child and yourself is challenging. Lack of money plus environmental effect will cause depression.”

Qualitative basic education

On the way forward,  Omatsajunwa proposed provision of qualitative basic education. The more enlightened, the less likely she is to fall into the category of teenage mothers. Provide quality sexuality education. Let them begin to understand the consequences of sexual relationship. Talk about sex with the children, use the right terminology. Incorporate sexuality education into the school educational system.

“We need to stop playing the ostrich. Once you identify that you have a problem, you have solved half of it. But we are still in denial that we have a problem. The education should involve boys too.

“We have to start taking about Family planning to our children from are 14. If you are exposed to pregnancies, you can be exposed to STDs, HIV and so much risk involved in unprotected sex.

“There has to be healthcare providers trained to provide counselling services as well as counselling services in our educational facilities to adequately counsel our children in schools.

“Truly, these teenage mothers have had their dreams robbed, but medical experts have said that collective efforts from government at all levels, communities, parents and peers can arrest the factors responsible to help the girl child achieve her full potentials in life.”

Information sharing

Also speaking,  a Resident doctor at the University of Lagos, Dr. Olufunke Olamigoke, noted: “At 14.6, the CPR is low. If it can be increased to 36 per cent, then the death rate of women dying of pregnancy related causes will reduce by 50 per cent in Nigeria,” she said.nalyst have said that if the use of contraceptives is increased in Nigeria, the alarming maternal death rate of 576 per 100,000 live births will reduce by 50 per cent.”

“From research, Nigeria is among countries with high maternal deaths with 576 deaths per 100,000 live births. The benefits of using contraceptives is a measure that reduces the incidence of unplanned and unwanted pregnancies and reduces vulnerability to abortion risk, which accounts for 60 per cent of maternal mortality.

“Abstinence is good. We preach it. But those who can not abstain should use contraceptives. It reduces the hazard of frailty from high parity pregnancies. So, increase CPR and the mortality will reduce,” Olamigoke added.

“Family planning reduces maternal deaths directly giving that Sustainable Development Goal aims to reduce such deaths to 70 per 100, 000 live births. We can achieve this goal by use of contraceptives.”

With about 25.2 per cent of adolescents contributing to the high rate of abortion recorded annually in Nigeria, experts have called on parents and guardians to expose their children to sexuality education not sex education, a preventive measure against maternal mortality.

These experts in Psychology and family health said this at theMaternal and Child Health focusing on Life Planning for Adolescents and Youths and Family Planning, adding that as a result of unplanned pregnancies, more adolescents tend to procure abortion, a major contributor to maternal death in the country.

“From the Department of Reproductive Health, University of Ibadan, 55 per cent of abortion rate reported yearly of every 1,000 women, half is adolescent as a result of unsafe  sex which brings about unplanned pregnancies,” Youth Empowerment Foundation (YEF) Programme Manager, Tolulope Osoba.

A call to action

In their call for immediate action, besides sexuality education, and access to reproductive health information, these experts lent their voices further. The bottom line is that tackling health issues is important, but ultimately Nigeria must accept that, in spite of religious and cultural teachings, sexuality is part of adolescence. Teenagers must be adequately informed and empowered to navigate this period successfully by avoiding unwanted and unintended pregnancy.

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