The World Health Organization provides international recommendations for pregnancy prevention and support for pregnant adolescent mothers. These include accessibility to “youth-friendly” health services for antenatal and postnatal care and skilled birth attendance; provision of comprehensive information on contraception use; social support to reduce sex coercion and sexual violence; access to and retaining of girls in the education system; post abortion care and information on dangers of unsafe abortions.
In Kenya, measures to actualize these recommendations, for example guidelines for setting up youth-friendly services are in place. However, implementation has been marred by several challenges. These include, but are not limited to, socio-cultural attitudes towards access to sexual and reproductive health information for this demographic; the cost involved in setting up youth- friendly services; the poor uptake of health services by adolescents, as well as the stigma and societal pressure that often comes with teen pregnancy.
Adolescent mothers’ perspectives on available support systems
In a bid to understand the lived experience of adolescent mothers, a brief data collection exercise was conducted in 2018 across four informal settlements in Nairobi. The study explored the perspectives on support adolescent mothers received at home, school, health facilities, from the father of their children and the community. The support referred to included financial, psychological, educational, physical and social support.
A significant number of the girls interviewed indicated that they hardly receive any form of support from their partners, largely because they refuse to acknowledge their role in the pregnancy. Some of them are kicked out by their parents, and being sidelined by their communities, friends and relatives is often a common occurrence. Ridicule by teachers and fellow students often push many to drop out of school.
The same is replicated at public health facilities where information and psychosocial support for adolescents is often lacking. Many pregnant teens prefer visiting private facilities for antenatal care as they are deemed friendlier and offer better quality services. However, owing to the stifling poverty that is a feature of many homes in the slums, most of these girls are unable to receive the financial backing they need from their families. As a result, those who cannot afford often start their clinic visits much later into their pregnancies. It also means that they have to find menial jobs to support themselves and their babies before, and soon after birth.
Despite that, the situation is not all bleak as a few organizations are providing the girls with much-needed support through mentoring, small stipends, and agency for those who want to go to school. Although there is still need for information on birth preparedness, confidence- building and problem- solving skills.
Looking to the future
For pregnant adolescent mothers, support at all levels (economic, social, physical, educational, and emotional) is key not only for the prevention of further teenage pregnancies but also in safeguarding the lives of both mothers and their children, physically, emotionally and mentally.
To achieve this, a multidimensional approach needs to be effected involving all key people around the girl (parents, family, friends, school, community, and health facilities). As per WHO recommendations, this should include youth-friendly services incorporated into health facilities tailored to meet the need of this population; a conducive and supportive environment for re-entry of adolescent mothers to schools and peer support groups as avenues for social interactions, acceptability and support for girls in similar situations. This approach will be also useful in reaching out to other young girls in an aim to reduce the number of adolescent pregnancies. It would also give existing teen mothers a chance to dream again; to raise well-adjusted members of society and break the cycle of poverty.
Most people, almost everyone, knows of a teen mom. Teen pregnancy rates are growing, and we need to bring awareness to that.