Shocking statistics revealed recently that over 4,000 girls in the Eastern Cape have given birth in the past four months.
The Eastern Department of Health (DOH) said 97 of these girls were aged between 10 and 14.
The teenage pregnancy pandemic is something the departments of Health, Social Development and Basic Education said they were addressing.
However, other provinces — KwaZulu-Natal, Limpopo and Gauteng — are facing the same challenges.
In the last financial year, statistics provided by the National Department of Health showed that KZN had the highest number of teenage pregnancies — 31,088.
A total of 2,716 girls between the ages of 10 and 14 gave birth between April 2023 and March 2024 around SA.
A staggering 610 girls were from KZN, followed by 395 in the Eastern Cape and Gauteng 430.
A total of 1,226 aged between 10 to 14 years had terminated their pregnancies.
However, experts say there are risks involved with girls becoming mothers at such a young age.
What are the dangers associated with girls giving birth as young as 10?
Professor Ismail Bhorat, president of the South African Society of Obstetricians and Gynaecologists (SASOG) said at the onset, pregnant teens and their unborn babies have unique medical risks.
Lack of prenatal care
“They are at risk of not getting the correct prenatal care, especially if there don’t have family support, which is often the case. The teenager who is pregnant often tends to hide the pregnancy until later in gestation and often misses critical screening periods,” Bhorat said.
“Prenatal care encompasses looking for medical problems in the mother that can impact the pregnancy, diagnose fetal anomalies, diagnose genetic problems and monitor the baby’s growth, dealing quickly with any complications that may arise,” he said.
“Prenatal vitamins, for example, folic acid is ideally taken preconception which is important in preventing certain birth defect such as spina bifida.”
In addition, he said pregnant teens have a higher risk of getting high blood pressure which is called pre-eclampsia.
Bhorat explained that the dangerous medical condition combines high blood pressure with excess protein in the urine, swelling of legs and hands and face (oedema) and organ damage.
“These medical risks affect the pregnant teen herself who may need to take medication to control the symptoms of the condition,” he said.
“This can also lead to disrupting the unborn baby’s growth and could also lead to further complications such as premature birth. The earlier the baby is born, the more risk there is of respiratory, digestive, vision, cognitive and other problems.”
Low birth weight
Bhorat said teenagers are also at a higher risk of having low birth-weight babies.
“This could be part of the placental disruption due to placental mediated disease like growth restriction or pre-eclampsia, or premature labour itself, where the baby has less time to grow in the womb,” said Bhorat.
“Small babies with respiratory problems at birth may need to be put onto a ventilator in a hospital’s neonatal care for help with breathing after birth.”
Birthing options
“Normal vaginal delivery may also prove a challenge in teen pregnancy, especially if the foetus is large for gestational age, and the pelvis may be disproportionately small for the fetal head — this is called cephalon-pelvic disproportion which is common in teens and often leads to a caesarean section.”
He further explained that pregnant teens may be at higher risk for post-partum depression.
“This can interfere with not only taking care of herself, but also the newborn, thus the crucial need for family support,” said Bhorat.
“All efforts by the health authorities should be made to combat teenage pregnancies, as the medical risks these teenage face is very high.”
Social Impact
Echoing similar sentiments was Professor Mergan Naidoo from The University of KwaZulu-Natal’s Department of Family Medicine.
He said teenage pregnancy has multiple risks associated with bio-psycho-social health.
He said, biologically, the impact on the teenager was a difficult labour due to an underdeveloped pelvis.
“There is also an increased risk of operative or assisted deliveries, anaemia, birth complications and hypertensive disorders of pregnancy.”
He said these teenage pregnancies also lead to unplanned deliveries and abortions (both legal and illegal).
Naidoo said the baby risked low birth-weight, pre-term delivery, increased risk of infant death and child malnutrition.
Other factors included psychological trauma from termination of pregnancy, depression, PTSD, sleep disorders and anxiety.
“Then there is a social impact. The impact on the family, like social isolation and the stigma,” said Naidoo.
“Often the teenager leaves school and then becomes a young mother - dependent on family, a boyfriend and social grants. The child is often cared for by the grandmother, and that is associated with many problems.”
Lastly, Naidoo said long-term outcomes are often dependent on pregnancy experiences.
“Hypertensive disorder of pregnancies can lead to intracranial bleeds and a stroke-like syndrome,” he said.
“A traumatic delivery can cause damage to the female genital tract, illegal abortions can cause severe genital tract problems, and psychological trauma can have long-term sequelae (a condition which is the consequence of a previous disease or injury).”
But what interventions are being put in place?
The DOH said it had introduced a number of interventions, including over 1,000 Youth Friendly Zones in primary health facilities or public clinics across the country.
National DOH spokesperson Foster Mohale said this was done to create an enabling environment for young people, girls in particular, to access sexual and reproductive health services without feeling judged.
“These zones are managed by young nurses and doctors to make young people feel open to discuss their health needs without fear of being judged,” Mohale said.
“Some of these young mothers don’t have family support structures to look after the children when they go to school, this contributes to school drop-outs because teen mothers are unable to become caregivers and learners at the same time.”
Mohale said the Department of Social Development had also developed a programme called YOLO, targeting young people aged between 15 and 24, for the reduction of HIV infections and teenage and unplanned pregnancies.
Reasons for teenage pregnancy
In the Eastern Cape, alcohol abuse, a lack of adequate parental care, support and supervision, especially in child-headed families, were some of the reasons for high teenage pregnancy.
The Eastern Cape DOH said youth zones made it easier for the youth to access health facilities without having to wait in queues.
“The youth are seen in dedicated consulting rooms and are seen by younger nurses,” said spokesperson Mkhululi Ndamase.
“They also get an opportunity to discuss their own issues and get more information on sexual reproductive health and rights services.”
He said the department also visited schools to provide integrated health services and education, which includes education and provision of sexual reproductive health and rights information.
This year, the DOH, together with the department of social development and education will provide Integrated School Health Services.
He said they will also be establishing the District Integrated School Health Task Teams in four outstanding districts -Amathole, Chris Hani, Nelson Mandela Metro and Sarah Baartman.
“The department can confirm that there is no shortage of condoms at our facilities. We continuously encourage sexually active people to use condoms whenever they have sex,” said Ndamase.
“It is important to note that teenage pregnancies are not a Department of Health or government issue, but a societal issue,” he said.
“As such, we are calling on everyone to play their respective roles so that we will be able to address this problem.”
Keeping pregnant teenagers in school
The Eastern Cape Department of Education said learners who were pregnant or are mothers, were given a tool kit to keep them in the school system.
“We want them to finish school,” said spokesperson, Mali Mtima.
He said the curriculum also spoke about teenage pregnancy.
KwaZulu-Natal Department of Education spokesperson Muzi Mahlambi said the issue of social ills in our communities “worry us all”.
“Health, social development and education have to deal with these realities,” Mahlambi said.
“These issues don't only disturb us in terms of our programmes, but lead to many of them not finishing school and giving birth to more children, and this becomes a burden to the purse of the government.”
Mahlambi said teenage pregnancies came at a huge financial cost to the State, where it had to disburse funds to these three key departments, saying, “It's a vicious circle”.
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