EARLY MARRIAGE AND TEENAGE PREGNANCY

EARLY MARRIAGE AND TEENAGE PREGNANCY

Early marriage is common – The mean age at marriage for females is 18 years and males 26 years. However, more than half (51 percent) of the illiterate, currently married females are married below the legal age of marriage. Nearly, 20 percent of the 1.5 million girls married under the age of 15 years are already mothers (2001 census). Age at marriage for females is influenced only when the population is matriculate/secondary and above.

Special Needs of a Pregnant Woman
1. Nutritious Food: A pregnant woman needs to eat enough food for herself and for the growing baby. She should eat of available nutritious food eat small quantities at small intervals for good digestion.

* She should avoid spicy food and should eat her dinner at least one hour before retiring to bed.
* A walk after dinner helps her to digest her food and avoid heartburn and uneasiness at night.
* She should not fast or abstain from food through the pregnancy. She need not stop eating any food that she ate when not pregnant, and should not be the last one to eat in the family.
* She should be encouraged to eat when she wants and avoid what she does not want.

Good nutrition during pregnancy helps to initiate good lactation after the birth of the baby. Her daily diet should consist of:

* Bodybuilding food such as milk, curd, cottage cheese, pulses, green peas, lentils, red beans, peanuts, soya­beans, egg, meat and fish.
* Energy-giving food such as rice, potatoes, bread, cereals and jaggery.
* Body-protecting food such as green leafy vegetables, beans, tomatoes, carrots, cabbage and a variety of local fruits such as papaya, mangoes, guavas.
* Some fats, oil, butter or margarine.

2. Exercise during pregnancy helps to stimulate circulation, maintain good posture, strengthen the muscles and increase the ability to relax. Most women do a certain amount of exercise while doing housework, or, by doing some manual labour e.g., working in the fields. The kind and amount of exercise a mother needs depends on the type of work she does. Manual women workers, who do heavy work, should actually lighten their load of work as pregnancy advances. Housewives may need moderate exercise particularly in the open air. Walking or gardening is beneficial. Sedentary women who have very little work should exercise daily.

3. Rest, relaxation and sleep: Extra rest is necessary and relaxation needs practice. Relaxation is a way of conditioning the muscles, to loosen up and help to release tension. The expectant mother should take every opportunity to rest and learn to relax. She could do this by lying on a mat or a firm mattress, close her eyes tightly, and then relax. The expectant mother should aim at eight hours of sleep at night and at least an hour of rest during the day.

4. Emotional support: Certain emotional changes may occur in pregnancy that need to be understood by the expectant mother and her family. The husband should understand her moods and give her the support and assurance that this is a natural happening. When there are social and economic pressures, especially if the pregnancy was not planned, the mother may experience feelings of rejection and depression. Love and care by the family may help to overcome this stressful period. Each family member could contribute in one way or another towards the well being of the mother and the new member.

5. Personal hygiene: It is very important for a pregnant woman to keep her body clean. The daily bath reduces the chances of getting an infection or illness.

6. Clothing: A pregnant woman should wear clean clothes that are loose and comfortable and low-heeled shoes or slippers that support the feet.

7. Regular attendance at antenatal clinic: It is important that mothers attend the antenatal clinic services on a regular basis so as to receive quality care and maintain optimum health for herself and her unborn baby. The normal pregnant mother should visit the clinic at least three times during the pregnancy so as to receive continuous health care and medical supervision.

8. Go for institutional delivery: It is best to have the delivery done in a hospital/nursing home. If this is not possible, due to any reason, a trained birth attendant should carry out the delivery.

9. If the delivery is at home, then it shoule be with the helf of delivery done through a trained birth attendant. Use a disposable delivery kit during childbirth and observe the 'five cleans' during delivery - clean place, clean hands, clean blade, clean thread, clean cord.


Factors contributing to adolescent pregnancy

1. Biological factors in adolescent pregnancy and child birth
* Declining age at menarche
* Early initiation of sex

2. Socio-cultural factors in adolescent pregnancy and child birth

Norms and traditions
* Early marriage is still practiced widely in India despite the fact that there are laws against it. Pregnancy is expected to follow soon after marriage.
* Social pressure from parents, in-laws, other family members for providing proof of fertility soon after marriage.
* Gender discrimination
* Low status of women
* Social barriers to access family planning services.

Changing circumstances of young people
* Exposure to the media results in changes of sexual behaviour patterns
* Pre-marital sexual activity
* The use of alcohol and other drugs can be associated with unprotected sexual activity and therefore possible pregnancy.
* Lack of negotiation skills in adolescents

Vulnerability of young people
* Sexual assaults results in some adolescent pregnancies
* Poverty can lead young girls into sexual exploitation and prostitution, leading to early pregnancy.
3. Service delivery factors in adolescent pregnancy and childbirth
* Most adolescents do not have access to sexual and reproductive health information
* Most adolescents do not have access to contraceptive information and services
* Most adolescents do not have access to safe abortion services.




Adolescent pregnancy: risk and consequences

* Pregnancy and childbirth carry more risks in adolescents than in adults because the adolescent girl is not yet mature physically and emotionally for motherhood. The risks are high throughout the antenatal period, labour, childbirth and the postpartum period. Anemia is very common in pregnant women and is more common in adolescents. Adolescents are at an increased risk of STIs/HIV infection because of biological and social factors.
* Babies born to adolescent mothers have a higher risk of being of low birth weight. This makes them predisposed to higher morbidity and mortality.
* Risk of poor pregnancy outcome is more common in adolescent pregnancy than adults.
* Pregnancy and the responsibility of child rearing could reduce the ability of the girl to continue with her education and with exploring employment opportunities.
* Unwanted pregnancy in unmarried girls may stigmatize them leading to poor self-esteem, guilt and depression.
* Unintended pregnancy in both married/unmarried girls may prompt them to resort to illegal and unsafe abortions.



It is bad to talk about pregnancy because it may attract witches or evil people who will harm the baby.


Pregnancy does not attract witches or evil people. A woman should seek early antenatal care as soon as she suspects pregnancy in order to fulfill her special needs during pregnancy.

A pregnant woman should continue performing heavy physical labour.


Too much heavy work like working in the fields, or picking heavy loads, can cause problems such as miscarriage, premature delivery or underweight babies. Therefore, pregnant women should avoid heavy physical labour.

A pregnant woman should not do any work at all.


A pregnant woman should do normal household work, unless advised by the doctor, as it is a form of daily exercise that keeps her healthy and her muscles toned.

A pregnant woman need not go for antenatal check-up if she does not have any complaint.


Even if she has no complaint, it is very important and beneficial for her to go for antenatal check up so as to receive quality care and remain healthy.

A pregnant woman should remain indoors and should not step out of the house.


Pregnancy is not an illness. Like other people, she can also go out from time to time. In fact, remaining indoors may deprive her from getting fresh air, exercise, recreation, essential antenatal check-ups, etc. However, she should avoid jerks and heavy strain, if travelling by a vehicle. Walking for some distance is a good exercise for her.

A man and his family members can do nothing to help a pregnant woman.


They can give her a lot of emotional support and ensure essential care to her by providing her with nutritious food, sharing her workload, taking her to regular health check-ups, etc.

Small breasts will not produce enough milk.


Being able to breastfeed successfully does not depend on the size of one's breasts. Size of breasts depends upon the fatty tissue layer under the skin. Special glands in the breast that are present in all women produce breast milk. Small breasts also produce adequate milk.

If a woman was not able to breastfeed the first baby, she will not be able to breastfeed successfully any other time.


She can be successful in breastfeeding her next baby even if she was not able to breastfeed the previous one.

Mother's milk comes after 3 days.


You may say that it actually starts flowing freely by the third day but the yellowish milk (colostrum) starts coming out as early as baby starts suckling and it is sufficient for the baby's demands for the first 3 days. Also, colostrum has many benefits for the baby including providing protection from infections.