As per the NGO ‘Stop Child Abuse Now’ (SCAN), 12 odd cases of teenage pregnancies have been reported in Goa in the last three months, all these being police cases. NT NETWORK delves deeper
Danuska Da Gama | NT NETWORK
A pregnancy during teenage years can have devastating effects, be it on physical health , mental health, and even society’s perception of the youngster.
And while such an instance could be perceived to occur among youngsters who have little or no knowledge of sex education, and especially belonging to the lower strata of society, it is disturbing to note that such cases have and continue to occur among the elite and well educated classes as well.
The Goa scene
According to a social worker, through cases studies in Goa, she has realised that teenage pregnancy isn’t just limited to the lower socio- economic class, where lack of education and awareness seem to be the major factors for such cases, after abuse. “With the elite class, teenage pregnancies happen due to carelessness, and youngsters wanting to live life on their own terms,” she says.
Today, several girls in college are aware of the consequences of pre marital sex, but are still not worried. “I accompanied my friend to the gynaecologist who got her a termination done. No one at home got to know about it because it was a matter of few hours,” says a young girl.
While there are some girls who are cautious about getting into a relationship, because of such incidents, there are girls who believe that a sexual relationship fosters a better bond, and if by chance there is a pregnancy, it is done away with, and it doesn’t affect the relationship.
A hospital in North Goa is especially a go-to place for college girls in distress due to pregnancy to get a termination done as the hospital is within close proximity of a college. A nurse tells us: “It is common to have such girls come in. While some are scared and nervous there are some who’ve come in before and have no remorse. They either come with their friend, alone, or with their boyfriend.” Rarely, she adds, does a parent or a family member accompany them.
Cases rising in Goa
In fact, according to lawyer Emidio Pinho who is part of the NGO, Stop Child Abuse Now (SCAN), there has been a rise in teenage pregnancy cases in the state.
SCAN works on child abuse cases with a team of experts from different professions. Protection of children and creating awareness, disseminating information on laws related to children is what the teams focus is on.The organisation works with children who come in contact with the police, those who are in difficult circumstances, as well as those in conflict with the law. The organisation also deals with cases of teenage pregnancies. While some go unreported, the NGO states that 12 odd cases of teenage pregnancies have been reported in the last three months, all these being police cases.
The medical perspective
Gynaecologist Kedar Padte tells us that the first case of teenage pregnancy that he dealt with was in 1981 when he was pursuing his MD when a 12-year-old girl was brought in to Goa Medical College (Ribandar) by her parents after she complained of stomach pain. Upon examination they realised that she was going through labour pains. “It was a shock for the child as well as her parents. In those days, things used to get hushed up a lot. But the case was registered with the police” he recalls.
His first case after he started private practice was when a 16-year-old girl from Panaji was brought in by her father to the hospital as she was in pain. The girl however, knew about her pregnancy but was afraid to accept it and tell others. Because she was overweight, and wore loose clothes, it had been easy to conceal her pregnancy.
“She was admitted at 10 p.m. and by 11:30 p.m. she delivered her baby. By 4 a.m. she was going back home. At that time there was an orphanage nearby so the child was sent there,” says Padte.
According to him, teenage pregnancies have decreased compared to about three decades ago. But, what has changed is that youngsters drink alcohol, party, and get into sexual relationships at a younger age. And because of the awareness of the availability of contraceptives, they consume pills to terminate the pregnancy.
“RU486 or Misoprostol is a popular drug for termination which is used before 20 week of pregnancy. We don’t allow termination of pregnancy after 20 weeks as per law, but people choose to go to rural hospitals,” points out Padte. He adds that on an average more than 100 teenagers terminate their pregnancy in the state every year.
Padte categorises teenagers into five categories. The first category comprises of about 20 per cent who aren’t ready to indulge in any kind of a sexual relation.
The second category comprising of around 25 per cent are those who are exposed to certain sexual activities, but not enough to produce pregnancy. If they do end up getting pregnant, they are smart enough to use contraceptives.
The third category of about 25 per cent includes those who are pretty sure of what they are doing and have their partners consent. They take regular contraceptives and indulge in sexual activities and don’t easily get pregnant. If by chance they get pregnant, they terminate it.
The fourth category also comprises of about 25 per cent. These indulge in alcohol and drugs and end up having sexual relationships although they are not sure they want it to begin with, and then end up getting pregnant. They are generally in denial, thinking that they have a delayed period and land up to terminate their pregnancy when they are in an advanced stage. A sub category here are those who are delicately placed and want to hide their pregnancy which goes over 20 weeks and then deliver the baby and give it for adoption.
The fifth type is a small group of about five per cent who totally throw caution to the air as they don’t know about contraceptives and have repetitive miscarriages or look for termination of pregnancy. “This category exists and I have seen them on a regular basis. These teenage girls have gone under repetitive termination, even four – five terminations. However, they are unapologetic about it and don’t want to take contraceptives,” says Padte.
The reason why most girls don’t believe or get to know that they are pregnant is largely due to their irregular menstrual cycle. Due to lifestyle and eating habits, girls today have irregular periods, and missing periods is common. Thus if they miss a period they believe it is a hormone problem and don’t think beyond that.
Indeed, most of the recent reported cases came to light when the children visited a local hospital with complaints of pain and fever. The same was reported to the local police by the doctors on duty, says Pinho.
How teen pregnancy is dealt with
Teenage pregnancy cases are dealt with differently for a major and minor girl. If the girl is below 18 years an offence is registered under the provisions of Protection of Children from Sexual offences (POCSO) and the Indian Penal Code (IPC). If she is above 18 years, and if she desires, an FIR (First Information Report) is registered.
Speaking about the options that the girl has after coming to know that she is pregnant, Pinho says that the first important step is to inform an adult, either their parents or any person they trust which could include school counsellors, teachers, etc. “No local medication should be tried to get rid of the pregnancy as it could be dangerous to the child,” he stresses.
Secondly, visiting the nearest police station or the hospital for assistance is necessary. “If the child goes to the hospital the doctor on duty is bound to report the matter to the nearest police station after giving necessary treatment to the victim. If the child is below 18 years old, it is mandatory to register an FIR,” Pinho explains.
If the girl has the support of her family and wishes to continue with the pregnancy, after the delivery, the child remains with the victim. But in cases where she does not have family support, she along with the baby is produced before the Child Welfare Committee where both are provided necessary care and protection.
If there is a case of sexual abuse where the victim does not want the baby, the infant needs to be produced before the Child Welfare Committee in North or South Goa.
Pinho doesn’t deny that the stigma attached to such cases dissuades most families from disclosing the incident. “Many times the families do not wish to file a police complaint. After due counselling being given to the family and an explanation on the need for mandatory registration of FIR, they come forward to report the offence,” he says. However, Pinho warns, that the act of concealing a child sexual abuse case can amount to penal action which includes imprisonment
Lack of sex education
Pinho also explains that the problem of teenage pregnancies boils down to lack of basic sex education. “In some cases which came to us, the children were not even aware of the correct terminology used for the parts of the body. These children were students of Class 8 and 9,” he reveals.
Thus, he believes that with the prevailing scenario, knowing the law is not as important as the need to give children knowledge of basic sex education.
“There is a need for a review and standardisation of the sex education content given by the Education Department which includes specialised training of the educators so that they are first familiarised with the terminology and contents when imparting sex education,” he states.
He says that sex education must be implemented in schools right from the age of 11 years, keeping in the mind the level of understanding of the child. Programmes should be standardised for better implementation.
He goes on to say that his organisation has been instrumental in drafting a module on child and law for the Goa State Commission for Protection of Child Rights (GSCPCR) during the tenure of Sushma Kirtani, the then chairperson, wherein most of the laws were written in a simplified manner. The GSCPCR had assured that the module would be implemented and the same has been sent to the Education Department.
Change in mindset about sex
However, what worries Padte is the current trend in society where girls from elite society who are well aware of the consequences of sexual relations come in for abortions.
“These children are very intelligent and know what sex education is. But they not longer consider having sex before marriage or committing to somebody permanently, a taboo. As a doctor I would say we are heading towards a major problem, and the girls end up with many problems in the later stage of life,” he says.
Effects on health
Teenage pregnancy problems are several, he says, and these can hamper the life of a girl thereafter. Given the stigma attached, the girl may not disclose that she has terminated a pregnancy to her family. This is especially true in a traditional setup. And this may haunt her later. If she marries, she has to carry the burden of keeping this a secret from her husband as well. This, he says, can create a lot of mental stress.
“Sometimes if you hide something it can create a problem. While sometimes there’s the risk of being open with the current partner but the relationship then becoming bitter,” he says.
The other medical problem associated with having sexual relationships with multiple partners is contracting sexually transmitted diseases and being prone to infertility with infection in the uterine cavity.
Padte agrees that children today do confide in their parents, but children still don’t obey their parents. “It’s a tricky situation being a parent to an adolescent. You have to be friendly yet firm. However, a sibling of the same age helps in indirectly tacking a situation,” Padte explains.
He says that handling a child’s sexual relationship or teenage pregnancy requires sensitivity as the child’s emotions have to be understood along with the guilt. “Children today face pressure from all sides, be it sports, studies, competition. And that is when a girl might end up in a sexual relationship which is an outburst of emotions. So the parent has to be careful in handling the child, and managing both, the sexual and emotional part,” Padte explains.
Teenage pregnancy could also be the result of child abuse and Pinho’s advice to parents is not to shy away from telling kids about their body parts especially when the child seeks an explanation. “Most parents are uncomfortable talking to their children. Thus left to inform themselves children resort to friends or the internet for advice which is mostly incomplete and incorrect. Further limited availability of sex education leads to several myths about pregnancy and sex,” he explains.
In fact, Pinho believes that awareness drives should also be conducted for parents in rural areas especially during Parent Teacher Association meetings. “We have identified certain areas and have started working with the child village committees. Awareness programmes in schools are also being conducted,” Pinho informs.
He however believes that parents should take the onus and monitor when electronic devices like mobiles, tabs, laptops, and computers are being accessed by children.
A family safety plan ensures that the entire family is aware of what is healthy sexual development. The parents should teach the child proper names of body parts and what to do if someone tries to touch them in a sexual way. “The moment you see warning signs that a child is being sexually abused don’t wait for proof of child sexual abuse,” he says.