The College of Obstetricians and Gynaecologists has noted with concern the media reports and the National Department of Health’s media statement, of teenagers giving birth over the Christmas and New Year’s Day period.
It is reported that 145 of the 1 708 babies born on Christmas Day were born to teenage mothers. On New Year’s Day, 190 teenagers gave birth, two of whom are reported to be 14 year olds from KwaZulu-Natal and the Eastern Cape provinces.
What the statistics do not show are the complications associated with teenage pregnancy and childbirth, which are: Caesarean sections; pre-term labour, resulting in babies admitted to neonatal ICU; hypertension in pregnancy, with all of its complications; postpartum haemorrhage, which can sometimes result in a hysterectomy; maternal and perinatal mortality.
According to the World Health Organization (WHO) fact sheet on adolescent pregnancy, there has been a decrease globally in the adolescent (15–19 years) birth rate from 64.5 to 41.3 births per 1 000 women between the year 2000 to 2023.
However, the adolescent birth rate for South Africa, continues to increase every year.
Preventing adolescent pregnancy is one of the Sustainable Development Goals’ (SDG) agenda and commitment, where the indicator 3.7.2 is the reduction by 2030 of the “Adolescent birth rate (aged 10-14 years; aged 15-19 years) per 1 000 women in that age group”. Six years away from the target year, we are far from reaching this goal.
Teenage pregnancy in our country has very serious implications. In a report by the Department of Basic Education to the portfolio committee on basic education in 2021, it was reported that, “One in three girls aged between 10 and 19 years in South Africa fall pregnant and do not return to school”.
As a country and a society, what we have done is to create a generation of girls who will most likely never participate in the economic productivity of the country, and who will most likely never take up leadership positions.
We have created a cycle of poverty and dependency on government subsidy, without increasing the workforce and contributing to the economic growth of the country. We have perpetuated gender disparity by allowing girls to drop out of school, while the male partner is not held accountable.
We call on all South Africans to protect our children and the future of the nation by making a commitment to finding sustainable solutions to this pandemic of teenage pregnancy. Possible solutions include:
- Empowering teenagers with comprehensive sexuality education.
- Equipping teenagers with skills and support to advocate for themselves.
- Providing knowledge and information so that they can make an informed choice about their reproductive needs.
- Ensuring that there are functional and accessible adolescent and youth friendly services.
- Practising respectful, patient-centred care and creating an enabling, friendly environment at our health facilities.
- Increasing the uptake of self-care interventions as recommended by the WHO, to make sexual and reproductive health (SRH) services accessible. These are over-the-counter emergency contraception, over-the-counter contraceptives, self-testing for pregnancy, self-administration of medical termination of pregnancy, and consistent, correct use of male and female condoms.
- Highly skilled health-care workers, who will give counselling in a rights-based approach and manage side-effects and adverse events.
- Community engagement and involvement of religious groups.
- Stakeholder ownership of the programmes, which align with the needs of the youth.
- Involving men in strategies to prevent unintended fatherhood or early fatherhood.
- Using the power of social media to our advantage, to disseminate information and programmes.
- The Department of Basic Education to put programmes in place to retain scholars.
- The legal and justice system to be efficient where crimes of statutory rape and GBV have been proven.
As custodians of women’s health, the College of Obstetricians and Gynaecologists of the Colleges of Medicine of South Africa commits to working hand-in-hand with all who seek to address this scourge head-on.
We can no longer sit idly by while children are having children. As such, we will embark on programmes in 2024, in partnership with various stakeholders, to tackle teenage pregnancy in South Africa.
Teenagers and adolescents are a vulnerable group. They are vulnerable because of their stage of emotional and cognitive development, their economic dependence, and their stigmatisation by healthcare providers, parents, the community, and religious groups. We should ensure that we address the barriers to access sexual reproductive health services.
As a country, we cannot afford to ignore this problem. As a society, it is imperative that we protect our children. As obstetricians and gynaecologists, it is our duty to provide holistic care to the vulnerable.
Teenage pregnancy is everyone’s responsibility.
Prof Zozo Nene is President of the College of Obstetricians & Gynaecologists (CMSA).