Written by: Catherine Packer, Research Associate, FHI 360, and Co-Chair of the Youth-Friendly PAC Task Force
The following originally appeared on the K4Health blog. It is reposted here with permission.
Each year about 18 million adolescent girls under the age of 19 give birth, and about three million adolescents ages 15 to 19 undergo unsafe abortions worldwide. Childbirth and pregnancy-related complications are the number one cause of death among girls ages 15 to 19 in low- and middle-income countries. Early pregnancy increases the risk of anemia, postpartum hemorrhage, prolonged obstructed labor, obstetric fistula, and malnutrition for young mothers. Adolescents are more likely than women over the age of 20 to have stillbirths and give birth to infants with low birth weight. A girl who becomes pregnant also faces numerous societal consequences. She may be forced to drop out of school and confront discrimination in her community, and she is more likely to have a lower income and more children at shorter intervals over the course of her lifetime.
Healthy timing and spacing of pregnancy is critically important for adolescents’ health, education, and wellbeing; however, youth face many barriers to avoiding or delaying pregnancy. Social pressure to marry early and have children and lack of access to contraception impede adolescents’ ability to avoid pregnancies, which puts their lives and health at risk.
In countries where abortion is illegal, many adolescents and women end unwanted pregnancies by undergoing unsafe abortions and can die or become severely injured as a result. In some of these countries, women can obtain postabortion care (PAC) services, which, ideally, include treatment of abortion complications and provision of contraceptive counseling and methods. When adolescents access PAC services, it is sometimes their first interaction with the health care system. Thus, PAC services offer an opportunity to reach young people with information and contraception to help them avoid future unintended pregnancies and to achieve healthy timing and spacing of desired pregnancies.
Youth voices on postabortion care
To find out what youth think about access to contraception and postabortion care, the PAC Consortium’s Youth-Friendly Task Force recently produced a video of young people discussing these topics. Public health colleagues from Kenya, Nepal, Nigeria, Senegal, and Zambia used smart phones and video cameras to record interviews with young people, who brought up the following key issues:
- If young people try to obtain contraceptive methods, health care providers, parents, and communities judge them.
- Young women experiencing unwanted pregnancies often go to “quacks” or traditional healers who use unsafe methods to terminate the pregnancy. If they seek follow-up services in a health facility, health care providers treat them badly and are judgmental.
- Many young people knew someone who had been injured or who had died from complications of unsafe abortion.
- There is a lack of discussion about sexuality in homes, schools, and communities.
In the 14-minute video, young people express a desire for nonjudgmental services and access to quality reproductive health care and information. Unfortunately, because of stigma around youth sexuality, adolescents are often treated harshly by judgmental providers and community members. Therefore, we should advocate for increased access to youth-friendly, nonjudgmental reproductive health information and services.