What Pregnancy and Birth Do to Young Girls' Bodies?
Some
famous abortion opponents argued the 10-year-old Ohio girl should have carried
her pregnancy to term after the story of her crossing state lines to have an
abortion last week captured the nation's attention.
However,
those campaigning for extremely young girls to bring pregnancies to term claim
that they may not grasp the terrible toll that pregnancy and delivery take on a
child's body. This is according to midwives and doctors who practise in nations
where young adolescent girls frequently become pregnant.
According
to Marie Bass Gomez, a midwife and senior nursing officer at the reproductive
and child health clinic at Bundung Maternal and Child Health Hospital in the
Gambia, "Their bodies are not ready for labour and it's really
stressful."
The
crucial problem, according to Dr. Ashok Dyalchand, who has worked with pregnant
adolescent girls in low-income communities in India for more than 40 years, is
that a child's pelvis is too narrow to allow passage of even a small foetus.
According
to Dr. Dyalchand, who is the director of the Institute of Health Management
Pachod, a public health organisation that works with underserved communities in
central India, "They have long, obstructed labour, the foetus bears down
on the bladder and on the urethra," occasionally leading to pelvic
inflammatory disease and the rupture of tissue between the vagina and the
bladder and rectum.
He
continued, "It is a pitiful state, especially for girls under the age of
15." "Girls under 15 had substantially higher complications,
morbidity, and mortality than girls 16 to 19, despite the fact that women 20
and more have mortality rates twice as high as those in the 16 to 19 age
group."
In
the United States, the phenomenon of young females becoming mothers is
relatively uncommon. According to the Guttmacher Institute, which advocates
abortion rights and routinely polls clinics, there were 4,460 pregnancies among
girls under 15 in 2017, the most recent year for which data were available,
with just under half of those pregnancies ending in abortion.
However,
the World Health Organization reports that worldwide, problems related to
pregnancy and childbirth are the number one killer of girls between the ages of
15 and 19.
According
to a 2014 analysis that was published in the Journal of Neonatal-Perinatal
Medicine, young maternal age is linked to a higher risk of maternal anaemia,
infections, eclampsia and pre-eclampsia, emergency caesarean delivery, and
postpartum depression.
Dr.
Willibald Zeck, the maternal and newborn health coordinator for the United
Nations Population Fund, who frequently delivered babies for young mothers
while working as a gynaecologist in Tanzania and later oversaw maternal health
programmes in Nepal and the Philippines, said that babies born to girls are
more frequently premature and have low birth weight.
The
experience of pregnancy for a young girl is the same in India as it is in the
United States, according to Dr. Dyalchand, despite the fact that a pregnant
10-year-old in Ohio might have access to prenatal care and a caesarean section
that would mitigate the effects of obstructed labour. The only difference is
that because the girls had access to better medical treatment, they might not
experience the same kinds of catastrophic results. The girls would experience a
more-or-less identical type of issue. But that doesn't mean the girl's life and
body aren't left with scars.
Gynecologist
and maternal mortality specialist Dr. Shershah Syed regularly treats pregnant
girls as young as 11 years old in Pakistan. According to him, proper prenatal
care can prevent the formation of a fistula, which results in the leakage of
urine or faeces and is not only unpleasant (the leaking urine creates burning
sores) but also a great source of embarrassment and humiliation.
The
hypertension or urinary tract infections that are frequent in very young moms,
however, cannot be avoided, he added, not even with appropriate prenatal care.
A
10-year-old child is not meant to be pregnant according to normal physiology.
She's a child, and children cannot give birth; they are not ready, Dr. Syed
stated, adding that the emotional anguish she would experience is
indescribable.
He
claimed that in the cases he has observed, an early pregnancy halts the very
young mother's physical development as well as frequently her cerebral
development because many girls drop out of school and lose access to regular
social interactions with peers. But even though an anaemic mother strains to
carry the pregnancy, the foetus receives the right nutrition and grows until it
is much beyond what the pelvis of a young mother can support.
They
go into labour for three, four, or five days, and frequently the baby is
already dead by the end of that labour. The infant is then delivered when the
head collapses, according to Dr. Syed, one of South Asia's foremost authorities
on the treatment of obstetric fistula, a common complication of obstructed
labour in expectant girls.
A
vesicovaginal fistula, or hole between the bladder wall and the vagina, has
formed in almost all of these cases in the girl. A rectal fistula that results
in continual urination and faeces leakage is caused by prolonged labour in 25%
of cases.
Dr.
Syed claimed he can close fistulas if patients who are aware that therapy is
available find their way to his clinic. However, the procedure necessitates a
lengthy recovery period: a rectal fistula takes four to five months to repair,
whereas a bladder fistula takes roughly five weeks.
Dr.
Dyalchand started his public health career in 1978 in a modest district
hospital in rural Maharashtra, on India's west coast. Two young pregnant girls
bled to death in his first week; one while in labour and the other at the
hospital's entrance before she ever entered. It was the beginning of a long
career in which he worked with communities to persuade them to put off the age
at which girls can get married and have their first child.
Dr.
Dyalchand said that India has likewise been progressively increasing access to
abortion, and that the intervention has demonstrated significant success. Up to
24 weeks of pregnancy, the technique is acceptable.
Ms.
Bass Gomez stated that although her clinic in the Gambia is able to provide
pregnant girls with quality prenatal care, this does little to lessen the
overall trauma of the experience. She said that her clinic is geared on
treating grownups. However, she added, "it's incredibly distressing for
the child when you have another youngster walk in who is also pregnant."
"That setting isn't built up for them, and it's not comfortable. You can
tell they're having trouble. There is a great deal of humiliation.