After reports of a 10-year-old girl in Ohio crossing state lines to have an abortion gained national attention last week, some prominent abortion opponents argued that the child should have should be pregnant at full term.
However, midwives and doctors working in countries where teen pregnancy is common, say those pushing very young girls into full-term pregnancies may not understand get the devastating consequences of pregnancy and birth on a child’s body.
“Their bodies are not ready for this,” says Marie Bass Gomez, a midwife and senior nursing staff at the reproductive and child health clinic at Bundung Maternal and Child Health Hospital in Gambia. childbirth and very vulnerable to injury.
Dr Ashok Dyalchand, who has worked with pregnant teenage girls in low-income communities in India for more than 40 years, said the key issue is that a child’s pelvis is too small. to allow the passage of the fetus.
“They go into labor for a long time, labor is hindered, the fetus presses on the bladder and urethra,” sometimes causing Dr Dyalchand, head of an organization called the Pachod Institute for Health Management, a public health organization serving disadvantaged communities in central India, said pelvic inflammatory disease and tissue between the vagina and the bladder and rectum.
“It’s a pathetic state especially for girls under the age of 15,” he added. “Complications, morbidity and mortality are much higher for girls under 15 years of age than for girls aged 16 to 19, even though 16 to 19 years of age has twice the mortality rate for women. female 20 years and older.
The phenomenon of young girls giving birth is relatively rare in the United States. According to the Guttmacher Institute, the last year data were available, there were 4,460 pregnancies in girls under the age of 15, with just under half ending in abortions, according to the Guttmacher Institute, which supports abortion rights and surveys. regular clinics.
But globally, pregnancy and childbirth-related complications are the leading cause of death for girls aged 15-19 years, according to the World Health Organization.
According to a 2014 review published in the Journal of Neonatal-Perinatal Medicine, maternal age is associated with an increased risk of maternal anemia, infection, eclampsia and preeclampsia, and cesarean section. emergency and postpartum depression.
Willibald Zeck, the United Nations Population Fund’s maternal and newborn health coordinator, who often delivered births to young mothers while working as a gynecologist in Tanzania and later as a supervisor, said Dr. : maternal health programs in Nepal and the Philippines.
While a pregnant 10-year-old in Ohio could receive antenatal care and a cesarean section to lessen the effects of an obstructed labor, the pregnancy experience of a young girl in India Degrees are the same as in the United States, Dr. Dyalchand said. “Girls will more or less experience the same kind of complications: The only difference is that because of access to better health care, they may not experience such dire outcomes. But that doesn’t mean that girl’s body and life are scarless.”
Dr. Shershah Syed, a gynecologist and maternal mortality specialist in Pakistan, regularly cares for pregnant girls 11 years of age and younger. He says good prenatal care can prevent the development of a hole between the bladder or rectum wall and the vagina – called fistula – the site of a leaky urine or stool that is not only painful (leaky urine causes burning sores) but is also a source of immense shame and humiliation.
But even good prenatal care cannot prevent hypertension or urinary tract infections common in very young mothers, he said.
“Physiologically, a 10-year-old child is not considered pregnant. The point is, she’s a child and the child can’t have a baby, she’s not ready,” Dr Syed said, adding: “And the mental torture she’s going to go through, it’s not measurable”.
In the cases he has seen, early pregnancy stunts the very young mother’s physical development, and often the child’s mental development as well, as many girls drop out of school and lose social contact. casual association with friends, he said. But while an anemic mother struggles to get pregnant, the fetus will carry the proper nutrients and continue to grow, until they get past what a mother’s pelvis can handle. children can bring.
“They go into labor for three days, four days, five days, and after that labor, usually the baby is dead. And then when the head falls, the baby will be born,” said Dr Syed, one of South Asia’s leading experts in obstetric fistula repair, a common result of obstructed labor. in pregnant girls.
In most of these cases, the girl developed a vaginal fistula, a hole between the bladder wall and the vagina. In a quarter of cases, the prolonged labor process will also cause a rectal fistula, causing the girl to constantly leak both urine and stool.
If people with fistulas know there is a treatment and find their way to his clinic, Dr Syed says he can correct the condition. But the process requires a long recovery time: a bladder fistula takes about five weeks to heal, while a rectal fistula takes four or five months.
In 1978, Dr. Dyalchand began his career in public health at a small district hospital in rural Maharashtra, on the west coast of India. During his first week, two pregnant young girls bled – one during labor, the other at the hospital entrance, before she went inside. It began his long career working with communities to persuade them to delay the age of marriage and first conception in girls.
That intervention has shown considerable success, and, Dr. Dyalchand notes, India is also slowly expanding access to abortion. This procedure is legal until 24 weeks of pregnancy.
In Gambia, Bass Gomez says her clinic can provide good prenatal care for pregnant girls, but that doesn’t alleviate the larger trauma of the experience. Her clinic is designed to serve adults, she said. “But when you have a baby with you, it really hurts the child,” she said. “It’s not comfortable, that environment, it’s not set up for them. You can tell they are having a hard time. There is a lot of shame and disgrace. “
