Reducing early pregnancy key to safe motherhood

Though the  Covid-19 pandemic has hit hard celebrations of festivals and important commemorative days, women’s health day calls for recognition of the important contribution of mothers holed up at home during the lockdown which had not only deprived them of their freedom but also in most cases reduced them to 24x7 housemaids, catering to children, husbands, and in-laws in joint families.

"It has been very tough and we do not know when this dark phase would get over and there would be light at the end of the tunnel," rued school teacher Seema Gupta, drained out of all energy balancing domestic duties and work from home pressure.

Women working from home are reporting all kinds of mental problems and fatigue, pressured by demands at home and responding to official deadlines, said Mukta, an IT professional.

Once the pandemic gets over or controlled, society will need to reboot and redefine new social parameters.

"Girls of marriageable age are under tremendous pressure as match-making has become difficult. Marriages are being postponed," noted social activist Naresh Paras.

Another big problem is the disruption of reproductive health services. Girls have to be protected from early pregnancy which poses severe physical and mental issues, according to health workers in rural areas. While popular culture glorifies motherhood, it fails to consider the struggles of adolescent mothers who have yet to reach physical or mental maturity.

The UNFPA’s State of World Population Report, 2021, says that nearly half the women in 57 developing countries do not have the right to bodily autonomy, including making contraceptive choices, seeking health care, or even regarding their sexuality. India is already home to one-third of the world's child brides. With the pandemic causing school closures this problem has further compounded.

Early pregnancy has long-term effects on the health and well-being of young mothers and their babies. Available data suggest that maternal mortality rates for married adolescents, between 15 and 19 years of age, are higher than women in their twenties and early thirties.

Adolescent mothers aged 10–19 years also face higher risks of birth-related complications like eclampsia, puerperal endometritis (uterine infection), and other systemic infections than women of higher age groups.

Further, babies born to adolescent mothers face a higher risk of low birth weight, prematurity, birth injuries, stillbirth, and infant mortality. Health problems, lack of education, and the responsibilities of parenthood combine to further restrict adolescent’s future economic opportunities and career choices.

According to the fourth National Family Health Survey (NFHS-4), 35 percent of women aged 20-24 years in Rajasthan were married before they turned 18. This is significantly higher than the national average of 27 percent. Among adolescent girls age 15 – 19 years in the state, six percent have already begun childbearing (NFHS–4), leaving them vulnerable to being denied access to education and health care. 

Divya Santhanam, Senior State Program Manager, Rajasthan at Population Foundation of India says, "In India, child marriage is illegal and yet if we were to go by NFHS-4 data, in Rajasthan alone, one-third of all adolescent girls are married before they turn 18. It goes without saying that preventing such early and unplanned pregnancies is critical to their overall wellbeing. Further, only a healthy mother can give birth to and raise a healthy child and can break the vicious cycle of intergenerational malnutrition.”

“To invest in young people’s health today is to ensure a healthy next generation,” she adds.