A 17-year-old female student enters either with her friend or boyfriend, looking scared and confused. She reveals that her period is late or that she is pregnant and in need of advice.
Or, she could be quite advanced in her pregnancy, even up to five or six months.
Most of the time, she doesn’t know how she got pregnant although she will admit to having had sex. Most times she will not have used any contraceptives as she was assured by her boyfriend that he wouldn’t get her pregnant or that he was using the withdrawal method. This is backed by the 2017 national health and morbidity survey which shows that only 12.7% of sexually active teenagers 13 to 17 years old actually used a condom in their last sexual encounter.
Often, she does not suspect that she is pregnant despite her period being delayed for many months. She may put it all down to stress or assume that her period is naturally delayed. Although biology textbooks do teach how pregnancy can occur, signs and symptoms of pregnancy are rarely taught.
The statistics
About 15 million girls aged 15 to 19 give birth each year in developing countries. Adolescent mothers are significantly more likely to suffer complications during pregnancy and childbirth.
In Malaysia, teenage births hit an all-time high of 18,000 in 2012 to the latest of 7,700 in 2018.
Baby dumping statistics recorded by the Malaysian police average about one baby dumped every three days for the last decade.
Sex among teens is on the rise with a national survey in 2017 showing that 7.3% of teenagers aged between 13 and 17 are sexually active.
Teenage pregnancies are the summation of teenage births, abortions and miscarriages. Malaysia does not have data on teenage abortions or miscarriages.
The consequences
Some girls never visit a clinic, naively denying the possibility of pregnancy, and end up dumping their babies after giving birth to them.
Others tried online abortion pills or those from illegal sources bought by their boyfriends or themselves. Some visit clinics for abortions, while others have no choice but to carry on with their pregnancy in secret and in shame, with or without family support.
Some actually go online to find someone who wants to adopt their babies.
Most have to stop schooling, inevitably affecting their future prospects.
The solutions
Different groups of people will have different solutions to the same problem. Some want more religious teaching, others want to have strict supervision, including limiting internet access or imposing a curfew.
Others propose that we don’t talk about sex as it will encourage teenagers to have more sex! Again, not only are there different groups of people with different ideas, there are also different groups of people from those with first-hand experience of providing care and counselling for pregnant teenagers to those who are far removed from the problem and only hear and read about it in the media yet have lots of ideas about how to tackle the problem.
No one is absolutely wrong or right, but what we should do is to go by facts and proven evidence on what works and what doesn’t.
The facts
The people who constantly care for and work with teenage mothers would have greater in-depth knowledge of the gap and what is needed, thus their feedback should be the basis on which we propose solutions rather than that of those who make policies but have no inkling of what’s going on.
It’s also clear from the evidence that abstinence-based methods of preventing teenage pregnancies don’t reduce the numbers.
On the other hand, sex education doesn’t lead to an increase in sexual activities but, in fact, delays sexual initiation and decreases risky behaviour.
It’s also a well-researched fact that for teenagers who are already sexually active, allowing them to use and access contraceptives decreases teenage pregnancies.
We should face the facts, like it or not, grab the bull by the horns so to speak, and implement solutions that have proven to be effective rather than indulge in whimsical idealistic notions that have not shown to be effective scientifically. It’s time we lifted the lid of secrecy when it comes to teenage sexuality and reduce the harm from ignorance over what rightfully is life-saving information.
Let’s talk about sex and save our teenagers from unplanned pregnancies.
Dr John Teo is a consultant obstetrician and gynaecologist.
The views expressed are those of the author and do not necessarily reflect those of FMT.