SEATED in the gynaecologist's clinic and sticking out like a sore thumb, is a 13-year-old girl. As many expectant mothers there break into little conversations with other soon-to-be-mothers, the young teen sits sullen, with an older woman, who seems to have accompanied her there. They sit there, incommunicado, each adrift in their own thoughts. Once in a while, the girl tugs at her blouse to reveal the outline of a little blooming tummy. Still a child herself, shockingly, this girl is pregnant. Even for Professor Jamiyah Hassan, a consultant obstetrician and gynaecologist at the University Malaya Medical Centre, who has counselled a number of underage pregnant girls over the past few years, this girl’s age comes as a shocker. Sadly, she tells me, the young girl’s predicament is not a result of rape, but of consensual sex.
“Most of the time when I get such young patients, it's already too late to do anything. Had this girl known about sexual and reproductive health and been armed with the right knowledge, she could have avoided this unwanted pregnancy,” says Jamiyah who has, in the past 10 years, been actively educating both health care providers and the public on the need for sexual and reproductive health to be discussed openly.
The 13-year-old is just one of the hundreds of teens in the country who’re sexually active and perhaps pregnant.
The Cabinet was recently informed that there were 21 recorded cases of students who got pregnant out of wedlock between 2006 and now. Statistics from the Welfare Department found that this year alone, from January to April, 111 young girls were pregnant. The figure, however, is just the tip of the iceberg as many cases go unreported and pregnancies terminated. A two-year survey done by the National Family Planning Development Board by end 1996 showed that more and more teens were having sex at a younger age. With no help from the family, and no means to support oneself and the baby financially, baby dumping becomes an easy option out of fear of admonishment from family and the emotional and physical responsibilities that come with raising a child.
“When young adolescents are empowered with the knowledge of sexual and reproductive health, they stand a better chance of making the right decisions when faced with passion-fuelled situations,” adds Jamiyah, who is also a council member of the Asia Pacific Council of Contraception.
She believes that it’s imperative that sexual and reproductive health education be taught at home first, before continuing it in schools and colleges. So how should parents go about discussing a topic that turns many a face scarlet red? “Start them young. When they’re five or six, they learn that boys and girls’ private parts are different. This is when parents should tell boys that they cannot touch a girl’s private part and girls be told that they shouldn’t touch the boys’ too. That’s all you need to tell them at that age,” she says.
When the child starts school, and learns a little bit more about his body, he may be curious about where babies come from. It is then, she adds, that parents should talk about reproductive organs, and their differences between boys and girls. But there is no need to go into details about the birds and the bees. Children at this age, agree psychologists and authors of parenting books, need not be given in-depth details as they take in only the information they are capable of processing. “It’s when they reach puberty, when their hormones make them feel more feminine or masculine and they develop sensual feelings and attraction for the opposite sex that a discussion about what’s right and what’s not should be had,” says Jamiyah, who’s also a faculty member in Universiti Malaya. She adds they should be told about health issues too, such as sexually-transmitted infections (STIs), sexually transmitted-diseases (STDs), and HIV/AIDS . Most teenagers, she adds, don’t need lessons on sexual intercourse per se as they would have heard about it from friends, seen enough of it on TV, in movies and music videos as well as from all the graphic details available freely on the Internet. Datuk Nor Ashikin Mokhtar, a senior obstetrician and gynaecologist, and founder of PrimaNora Medical Centre, can’t agree more. “Research shows that today's teenager is exposed to some 20,000 sex scenes annually. Even flashing lights, as one would see in music videos, or in pubs and discos, for example, can turn on the hormones,” she says, adding that with all these stimuli, it may seem impossible to keep teens away from sex. She recalls a recent incident when a caring teacher brought in a pregnant schoolgirl who was at a loss of what to do about her unwanted pregnancy. “Without an option of what to do with her baby, and the emotional support, she would have just hidden the pregnancy. Eventually, it would be one more abandoned baby making the headlines in newspapers.” Jamiyah and Nor Ashikin know that education on sexual and reproductive health can help deter unwanted pregnancies among teens. What’s most important, they say, is to teach abstinence. “Most girls are fooled into thinking that the only way they can prove their love for a boy is to sleep with him. That’s not love. Love is when you are mature enough, financially independent and have found the right partner to enter the sacred institution of marriage and start a family. So until you satisfy these conditions, abstinence is the way to go,” adds Jamiyah. Contraceptive methods are not the solution as teenagers should be taught the consequences of their actions and the responsibilities that come with pregnancy.
Welfare Department figures show that since 2005, there have been 407 abandoned babies in the country.
All parties — from parents, teachers and healthcare providers to society at large — will need to eventually, openly discuss sexual health and reproduction. The subject of an unwanted pregnancy is not just someone’s skeleton in the closet.
“It costs taxpayers. In the United States, for example, the teen pregnancy crisis costs taxpayers an estimated US$6.9 billion (RM21.7 billion) in lost tax revenues and increased spending on public assistance, health care, foster care and the criminal justice system. As a nation, we cannot afford the consequences of teen pregnancy. The costs are staggering. Teen mothers are less likely to complete their schooling or get married," explains Nor Ashikin. Furthermore, she adds, the odds are stacked against children of teen parents from birth. “Their health is poorer, their cognitive development slower, and their behavioural problems worse than their peers. Teen pregnancy robs youngsters of their childhood and their future as productive adults. It also robs their children, and their children’s children,” she stresses.
Jamiyah says if a teenager asks about contraception, parents should not assume that their child wants to start a sexual relationship. “Teenagers have curious minds and a rebellious streak. They may have heard about contraceptives and are just curious. Explain to them what these are,” she says. However, she is also quick to point out that many parents themselves are not equipped with all the right information to openly discuss sexual and reproductive health with their children. She suggests that spouses talk to each other first to find out if one knows more than the other and to learn from each other to make the communication with the child easier. Should they really lack the knowledge, then they should turn to doctors who can provide the answers. As fingers are usually pointed at young girls who get pregnant out of wedlock, it’s unfair that boys can get away with it. “Most of the time, the boys run away from their responsibilities once the girl gets pregnant. As much as we educate the girls, boys should also be told of the consequences,” stresses Nor Ashikin. Dr Mohamad Farouk Abdullah agrees. The consultant obstetrician and gynaecologist and the president of the Obstetrical and Gynaecological Society of Malaysia, says boys should be always included in any sexual and reproductive health education campaign. “Ignorance is not a crime. Perpetuating ignorance is the crime. As such, awareness, acceptance and access is important,” he says.
Jamiyah explains: “Just as parents would like to see their daughter ‘safe’, they should also teach boys to respect girls and not do anything irresponsible. They should tell the boys to treat a girl right, just as they would want their sister to be treated.” Jamiyah, who has spoken at over 50 conferences and seminars as well as on TV and radio, will be one of the medical professionals in the recently launched Yes, I Can campaign roadshow travelling to key universities and colleges in the Klang Valley. The campaign seeks to empower women of every age to make informed and inspired choices about their sexual health and contraceptive options, address and tackle the issues of unplanned pregnancies and abandoned babies, as well as facilitate open conversations between young women and their healthcare providers on the role of contraception in reducing unplanned pregnancies.
Oh yes, you can TODAY, you can, with just a click of a button and a scroll of the mouse, learn all about sex and sexual health issues. However, with easy access to such information, ignorance is still rampant among young girls about protecting themselves against unwanted pregnancies. To help educate more young people on ways to prevent an unwanted pregnancy, the Yes, I Can campaign was launched recently by the The Asia Pacific Council of Contraception (Apcoc), the Obstetrical and Gynaecological Society of Malaysia (OGSM), Health Associations Malaysia (FRHAM) and Bayer Schering Pharma Malaysia. Its main objective is to curb unplanned pregnancies and abandoned babies in the nation by creating awareness and education. The campaign was recently launched by Datuk Aminah Abdul Rahman, the director general of the National Population and Family Development Board of the Ministry of Women, Family and Community Development. First and foremost, a specially designed campaign (website — www.yesican.com.my) with links to Twitter and Facebook will provide a conducive online platform for young women to discuss topics related to family, love and relationship. Lending their expert opinions are healthcare professionals who will provide advice on the various topics online. The website will also be a source of information on topics such as women’s health issues, modern contraception and up-to-date information on campaign initiatives.
Second, a campus roadshow will bring the campaign to young women through visits to key universities and colleges in the Klang Valley. Each campus visit will feature talks on sexual health and contraception by healthcare professionals, sharing sessions by Deborah Henry (one of the three campaign ambassadors identified for the campaign) on unplanned pregnancies. There will also be educational games and leaflets on the campaign and on unplanned pregnancies and contraception methods distributed. Third, Malaysians nationwide can channel their creativity toward addressing a good cause and stand to win RM10,000 in cash through the Yes, I Can Challenge. The challenge calls on Malaysian adults aged 18 and above to support and be advocates for the challenge. The challenge comprises a team or individual proposal (in 1,000 words or less) on how the issue of unplanned pregnancies can be resolved and a poster designed to accompanying the proposal.
Participants can submit their proposal and design via the Yes, I Can website by 4pm on Oct 24.
The panel of judges for the challenge comprises representatives of Apoc, OGSM and FRHAM. Six proposals will be shortlisted and put up for public voting. The selected participants will then be given a chance to present their ideas at the campaign finals in November. Further details are available at www.yesican.com.my.
Yes, I Can will call for young people to make a pledge to take responsibility for their sexual health. A mobile Yes, I Can pledge board will travel with the campaign campus roadshow to encourage young people to support the cause and pledge to do their part to help reduce the incidence of unplanned pregnancies. Online pledges can also be made at the campaign website. Finally, there’s the Spot The Sticker contest. The campaign also seeks to engage the media to shed light on these issues through educational articles in key publications.
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