BackThe burden of teenage mothers
Most adolescent mothers are hardly equipped to deal with the unforgiving circle of child marriage, domestic violence and teenage pregnancy
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New Delhi: She had planned meticulously, going over every little detail through the night, for one last time. She’d wait for her parents to leave the house and prepare lunch. She decided to feed the hungry child first and then drink up the rest. If it went as planned, it would solve all problems.
It was fleetingly exciting, she said. “It was also a big mistake," the skinny teenager says about the morning, nearly a month ago, when she force fed her baby girl All Out, a brand of insect repellent and a common household poison, before consuming it herself.
At 18, she has anaemia, iron deficiency, dangerously low haemoglobin levels, an 18-month-old baby girl, a hostile, physically abusive family and a failed marriage under her belt. Circumstances that she says pushed her towards the decision to commit suicide.
“I ran away from home with a Hindu boy and got married. We were in love. A month later, I was pregnant," she says. At that time she was 14 years old. “I decided to come back home when things (beatings) became unbearable but my family does not accept my daughter," she adds.
She is an adolescent mother, one of India’s 1.8 million teenagers who have children annually, many of whom are hardly equipped to deal with the unforgiving circle of child marriage, domestic violence, teenage pregnancy and substance abuse.
Living with her family for the past two years hasn’t helped the teenager’s case, says Mithilesh Kumari, an activist with Mamta Health Institute for Mother and Child in West Delhi’s Nangloi district.
Kumari’s job is to equip teenagers cope with the consequences of child marriage, drug abuse and focus on nutrition.
“Usually, in extreme cases where there is a risk of suicide, we get the families involved but she has not allowed us to meet her family so far. They have not accepted the baby girl (who survived taking the insect repellent) but seem to have come to an arrangement. The family provides her a roof but food and clothing for both of them is not their responsibility," said Mithilesh.
So, through Mamta, the teenage girl gets two meals a day from the district’s Anganwadi (child care) centre. The non-government organization is also teaching her sewing. The amount she earns from tailoring, about ₹ 500 a month, goes mainly in feeding the baby and buying Gul Manjan—a form of smokeless tobacco. “Nashe se neend aa jati hai," (it helps me sleep) she justifies, cutting Mithilesh short.
The nutritional status of young mothers in India has become a public health priority, says Anuradha Gupta additional secretary, mission director, National Health Mission, health ministry. Empowering adolescent girls to use contraception, reduce unintended pregnancies and associated risk to maternal health is at the core of the Indian health ministry’s RMNCH+A approach (for reproductive, maternal, new born, child and adolescent health). This is the country’s first policy targeting adolescent health.
India has a youth population of 253 million—more than the total of Western Asia in absolute numbers. According to the health ministry, 1.8 million women give birth every year. Further, 60% of these adolescent pregnancies are not adequately spaced, aggravating risk to maternal and child health. A shocking 43% of Indian girls are married before the age of 18 years. As per the National Rural Health Mission data, more than 25,000 young mothers die annually, 9% of them aged between 15 and 19 years. The economic burden of teen pregnancies and child marriage— measured by the mother’s foregone annual income during lifetime—is 12% of annual gross domestic product, according to health ministry.
“Most of the girls in the 16 blocks I cover in West Delhi do not go to school. Majority of them face domestic violence and few of them are aware of the nutritional challenges that come with child marriage and teen pregnancies. Our biggest challenge is to keep them healthy while they deal with their crisis," Mithilesh added.
The health ministry recently changed its strategic approach to child marriage and teen pregnancies in the country and launched a campaign focusing on continuum of care with integrated health services, importantly for adolescents, mothers and children. The change in policy came after health surveys showed that over 33% of the disease burden and almost 60% of premature deaths among adults can be associated with behaviour during adolescence.
“Community-based interventions for adolescents depend on stakeholders, parents, teachers, etc., coming on board. ‘Rights’ is not a word well-received by Indian parents when speaking about children. We try not to use that word and work around that fact that the choices children are making affect their health adversely," said Sunil Mehra, a paediatrician and executive director of Mamta.
“Once we get children in a common, safe space, we start with building life skills and majority of them open up. We then ensure they have access to appropriate services, depending on what interventions they require. Our hope at that point is that they take advantage of the services available. The trick in dealing with this age group is that you have to wait till they are ready to accept your help and guidance," Mehra added.
Meanwhile, the teenager from Nangloi is sitting at Mamta’s office surrounded by girls with similar stories. The 18-year old advises two girls who were listening to her story.
“Don’t make the same mistake I did. I have no control over my life—except for when to end it." Asked what she’ll do next, without batting an eyelid she says, “I’ll try to die again."
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