Adolescent birth rates have been declining globally but they remain high in parts of Africa and Asia.8 Adolescent pregnancy is more common in adolescents who live in poverty and in rural areas, and it is more likely to occur among the less educated (Figure 2).
Stillbirths and newborn deaths are 50% higher among infants born to adolescent mothers than among those born to mothers aged 20-29 years In developing countries, complications of pregnancy and childbirth are the leading cause of death in young women aged between 15 and 19 years. About.9 The adverse health effects of adolescent childbearing are reflected in the poor health of their infants: perinatal deaths are 50% higher among babies born to mothers under 20 years of age than among those born to mothers aged 20–29 years. Moreover, babies of adolescent mothers are more likely to have low birth weight, which is a risk factor for ill-health during infancy.10 Because many adolescents face unwanted pregnancy, rates of unsafe abortion among young women are high, especially in Africa where girls aged 15–19 years account for one in every four unsafe abortions.11 Even when they do not result in death, the immediate and long-term health consequences of such interventions – which include haemorrhage, reproductive tract infections and infertility – can be severe. . They showed that many teenage mothers live in poverty, receive no education and end up in either unemployed or in low paid jobs. They often live on welfare in very poor housing conditions, circumstances which may well lead to depression. The child born to a teen mother is more likely to live in poverty, grow up without a father and become a victim of neglect or abuse. They often do less well at school, becoming involved in crime. In many cases, they go on to become a teenage parent themselves and the cycle begins again. The younger sibling of a teen mother can also be affected. Siblings look up to their older sister as a role model and consequently they will often accept sexual initiation and marriage at a younger age, placing less importance on education and employment
Pak, J. (2010) Growing problem of abandoned babies in Malaysia. BBC News Asia-Pacific. 21st August 2010 reference: International Journal of Public Health Research Special Issue 2011, pp (100-102)
-UK has been working for many years to reduce teenage pregnancy rates and to increase healthy outcomes for teenage mothers and their babies. Whilst the two societies are culturally very different, it is possible that strategies that have been used successfully in the United Kingdom could be implemented in Malaysia to help reduce teenage pregnancies and help to make real and meaningful improvement to teenager
2008, the Department of Health (UK) issued the document ‘Teenage Pregnancy Strategy: Beyond 2010’, which clearly illustrated that the strategy was working, with a noted decrease in teenage pregnancy rates and teenage births. In addition there had also been an
Services should be easily accessible, with convenient hours and in convenient locations, and costs need to be low. Perhaps most important of all, the service young people receive should be non-judgmental. They propose comprehensive support services for adolescents, including access to non-judgmental counseling on what options are available to them and also how to engage with family members in disclosing their condition. teenagers might be empowered to make the right choices in difficult and challenging circumstances
After declining substantially between 1995 and 2003, the worldwide abortion rate stalled between 2003 and 2008. [ 1 ] • Between 1995 and 2003, the abortion rate (the number of abortions per 1,000 women of childbearing age—i.e., those aged 15–44) for the world overall dropped from 35 to 29. It remained virtually unchanged, at 28, in 2008. [ 1 ] • Nearly half of all abortions worldwide are unsafe, and nearly all unsafe abortions (98%) occur in developing countries. In the developing world, 56% of all abortions are unsafe, compared with just 6% in the developed world. [ 1 ] • The proportion of abortions worldwide that take place in the developing world increased between 1995 and 2008 from 78% to 86%, in part because the proportion of all women who live in the developing world increased during this period. [ 1 ] • Since 2003, the number of abortions fell by 600,000 in the developed world but increased by 2.8 million in the developing world. In 2008, six million abortions were performed in developed countries and 38 million in developing countries, a disparity that largely reflects population distribution. [ 1 ] • A woman’s likelihood of having an abortion is slightly elevated if she lives in a developing region. In 2008, there were 29 abortions per 1,000 women aged 15–44 years in developing countries, compared with 24 in the developed world. [ 1 ]
From The Economist: More than 60% of the world's 6.5 billion people now live in countries where abortion is generally allowed, and a quarter where it is banned, according to the Center for Reproductive Rights. Mexico city has just decriminalized it, whereas in some countries, such as America and Poland, laws are becoming more restrictive. Some 46m abortions are thought to be carried out annually (more than one in three pregnancies is terminated). Of these, 20m are illegal, resulting in the deaths of some 70,000 women, according to the World Health Organization. From The Economist: More than 60% of the world's 6.5 billion people now live in countries where abortion is generally allowed, and a quarter where it is banned, according to the Center for Reproductive Rights. Mexico city has just decriminalized it, whereas in some countries, such as America and Poland, laws are becoming more restrictive. Some 46m abortions are thought to be carried out annually (more than one in three pregnancies is terminated). Of these, 20m are illegal, resulting in the deaths of some 70,000 women, according to the World Health Organization.
Of the almost 42 million abortions that take place around the world each year, about 20 million are unsafe and virtually all of those occur in developing countries.
The reasons for this include physical inaccessibility and prohibitive costs, but may also be the result of inappropriate sociocultural practices. It is not enough for services to be available; they must also be of high quality and should be provided in a way that is both culturally appropriate and responsive to women’s needs. ** including the need to postpone childbearing or achieve a healthy spacing between births ** poor access to contraceptives and contraceptive failure B **ecause poor and rural women tend to depend on the least safe methods and providers, they are more likely than other women to experience severe complications from unsafe abortion
Teenage pregnancy seminar
Introduction Definition by World Health Organisation (WHO, 2006) :teenaged or underaged girl (usually within the ages of 13–19) becoming pregnant. 3rd National Health and Morbidity Survey in 2006:,1. the mean age at first sexual intercourse for males was 24.8 years old and for females was 22.8 years.2. most Malaysians had their first sex at a much later age; aged 15 to 24 were indeed sexually active3. the percentage young people who were sexually active has increased over the years.
• girls’ first sexual activity occurs during late adolescence – between the ages of 15 and 19 years.• Female adolescents - exposed to unwanted pregnancy, STD and long-term mental and physical health consequences.
Epidemiology In 2006, 750,000 women younger than 20 became pregnant. The pregnancy rate was 71.5 pregnancies per 1,000 women aged 15–19 The teenage birthrate in 2006 was 41.9 births per 1,000 women. This was 32% lower than the peak rate of 61.8, reached in 1991, but 4% higher than in 2005.U.S. Teenage Pregnancies, Births and Abortions:National and State Trends and Trends by Raceand Ethnicity, 2010 by Guttmacher Institute
In MALAYSIA• 92% of the adolescents -unmarried.• Majority :late adolescence -16 to 19 years (73.1%)• urban areas (73.1%)• low income families (53.8%)• Schools dropouts (69.3% )A STUDY ON PREGNANT ADOLESCENTS RESIDING IN AGOVERNMENT HOME: COMMON CHARACTERISTICSAND THEIR VIEWS ON THE PREGNANCYPS Tan et al., by official journal of academy of familyphysicians, Malaysia., 2012.
Reasons why female adolescent end up in unwanted pregnancy1) Few young women use a contraceptive in 1st sexual experience.2) lack of information and skills/Less educated3) access to contraception is limited by their own4) reproductive health-care services for married women of reproductive age (developing countries )5) live in poverty/ rural areas
The EFFECTS of teenage pregnancy15% of total maternal deathsworldwide, and 26% in Africa, International Journal of Public Healthoccur among adolescents Research Special Issue,2011
Abandoned babies• Pak,J (2010): 100 babies being abandoned each year, of which most are deceased by the time they are found. Many young people are lack of education to make safe decisions about sexual health.
Ways to overcome abandoned babies1) prevention, equipping girls with the education, knowledge and skills to prevent pregnancy occurring.2) support, by providing services to support both female and male teenagers who find themselves struggles to cope with an unexpected pregnancy.
How is Malaysia dealing with this issue?• In 2010, first ‘baby hatch’ a place where mothers can safely and anonymously leave their unwanted child.• The state of Malacca opened a school for teenage mothers, ‘Sekolah Harapan, Rumah Harapan’ (school of hope, house of hope).
Recommendations1. life skills based health education- making right decisions2. support services for adolescents, -non-judgmental counseling on what options are available to them.3. engage with family members .
Solutions1) increase access to contraceptive information and services, sex educations2) skilled antenatal and childbirth care3) special sensitivity in dealing with adolescent girls: service providers4) support : well prepared for birth and birth-related emergencies5) cover complications and emergencies during childbirth***Early marriages, adolescent and young pregnancies for the Sixty-fifth World Health Assembly to be held in May 2012
Definition means the end of a pregnancy before the fetus can survive. It may be either spontaneous — when it is also known as miscarriage — or induced, when it is a deliberate termination of pregnancy. illegal abortion may be self-induced, induced by someone who is not a physician or not acting under her or his supervision, or induced by a physician under conditions that violate state laws governing abortions.United States Centersfor Disease Control andPrevention (CDC)
• Abortion Act of 1967:Circumstances under which abortion is allowed under this act: Continuance of pregnancy >> risk of life to pregnant women > than if termination of pregnancy Continuance of pregnancy >> risk of injury to physical or mental health of pregnant women Continuance of pregnancy >> risk of injury to physical/mental health of existing children Substantial risk that if the child were born it would suffer from physical/mental abnormalities as to be seriously handicapped
• In Malaysia, abortion is permitted under The Penal Code Amendment Act (Section 312, 1989)• under Syariah laws and according to the fatwa ,the Department of Islamic Development Malaysia’s website:1. makruh (not encouraged) for up to 40 days,2. harus (permissible) for up to 120 days if there is fetal impairment or is a threat to the woman’s life3. haram (forbidden) beyond 120 days except to save the life of the mother.
Common Grounds on Which Abortion is Permitted Worldwide• To save woman’s life• To preserve physical health• To preserve mental health• Rape or incest• Fetal impairment
Most Important Reason Given for Terminating an Unwanted Pregnancy
Epidemiology• The World Health Organization estimates that in Asia in 2008, :12% of all maternal deaths (17,000) were due to unsafe abortion.• About 2.3 million women in the region are hospitalized annually for treatment of complications from unsafe abortion
CausesBankole A, Singh S, Haas T. Reasons why women have inducedabortions: evidence from 27 countries. Int Fam Plann Perspect 1998;24: 117–27.
modern contraception :- reduced the need for induced abortion- Unmarried, young women >> difficulty in obtaining contraception >> unsafe abortion. Westoff CF. Recent trends in abortion and contraception in 12 countries. DHS Analytical Studies, No 8. Calverton, MD, ORC Macro, 2005.
• 50% of unsafe abortion cases need medical attention .• delay or decide not to seek medical care.• This is because:1) In a lot of countries (illegal abortion) where it is illegal to have abortions performed, the women who go to the hospital for help will be reported to the local law authorities subject to arrest and spending time in jail.2) The medical staff often refuses to help and will even harass women about their botched abortion.
Abortion Statistics, Facts About Abortion I 600,000 maternal deaths occur each year. Seventy thousand (70,000) of those maternal deaths are from the complications of unsafe abortion which represents 12 to 13% percent of maternal deaths
•Quoted from Tun Dr. Siti Hasmah MohdAli : "The best way to prevent unsafeabortions is to prevent unintended orunwanted pregnancies. We have toaddress family planning, provide educationon dangers of unsafe abortions and post-abortion counselling" (source: The Star, 10October 2003).
What are the implementations to overcome this problem?
References• Teenage Pregnancy and Its Health Implications, Greta Hayward, International Journal of Public Health Research Special Issue 2011, pp (100-102)• Women and health : todays evidence tomorrows agenda.• Facts on Abortion in Asia, Guttmacher Institute• Addressing the Unmet need for fAmily PlAnning Among the yoUng PeoPle in mAlAysiA, by Assoc. Prof. Dr. Mary Huang Soo LeeMs L in a government home• Teenage pregnancies and abortions in Malaysia | Malaysian Parenting an• http://www.ijphr.ukm.my/Manuscript/special%20issue%202011_15.pdf www.ijphr.ukm.my• Teenage pregnancies and abortions in Malaysia | Malaysian Parenting and Motherhood advice