Wednesday, December 7, 2022

Oops! It’s accidental pregnancy

According to Botswana Family Welfare Association (BOFWA) represantative Kesaobaka Dikgole bemoans that, “many Botswana adolescent girls  get pregnant, and have children before they are physically, emotionally, and socially mature enough to be mothers.

Dikgole is not just blowing hot air. As a big shot inside BOFWA he should know better. BOFWA is a nationally recognized leader in Sexual and Reproductive Health (SRH) that ensures reproductive health including Family Planning (FP) as a human right to all individuals and families.

Dikgole’s lament should not be taken lightly. The ability to decide whether to have children, how many and with whom, is fundamental to the reproductive rights of girls and women. When this right is ignored or compromised – by social constraints or abuse or lack of health services, the consequences snowball. Unintended pregnancy impacts individual lives and whole societies, impeding progress in health, education and gender equality, increasing poverty and lack of opportunity.

Dikgole explained that, ” married or unmarried, adolescent girls become pregnant for different reasons. For some, pregnancy is accidental and the results of experimenting with sexuality or of lack of knowledge about how to prevent conception. Others seek pregnancy and motherhood to achieve adult status or fill an emotional void. But most adolescent pregnancies have little to do with choice or mistake. Globally, the majority of adolescent girls who become pregnant are married and pressured to have a child. For others, pregnancy often results from abusive, forced, or coerced sex.”For a woman, an unplanned pregnancy can be the source of great stress, and sometimes of negative feelings. Women can have more initial adverse reactions to unintended pregnancies because they tend to have a tough time dealing with things that “Aren’t supposed to happen.” The truth is, unplanned pregnancies happen – and quite often. On average, women want to have two children. To accomplish that goal, a woman will spend close to three years pregnant, postpartum or attempting to become pregnant, and about three decades more than three-quarters of her reproductive life—trying to avoid pregnancy. For the women affected, the most life-altering reproductive choice- whether or not to become pregnant is no choice at all. By putting the power to make this most fundamental decision squarley in the hands of women and girls,  motherhood could be an aspiration not an inevitability.

Social Work senior lecturer at the University of Botswana says, “an unintended pregnancy will lead to miscarriage or abortion, low birth weight, and premature birth. This of course also has an impact on increasing the risk of maternal and child mortality. Unwanted pregnancy has serious and detrimental impacts on the health, social, and economic sectors. It is hoped that the use of contraception can prevent unwanted pregnancies and reduce the number of births. Unwanted pregnancies can be caused by unhealthy behavior and conditions at the time before or during pregnancy such as rape, lack of knowledge about contraception, too many children, health reasons, fetal defects, young age or not ready to have children and an irresponsible partner. In addition, the incidence of unwanted pregnancy is closely related to various aspects such as the socio-demographic condition of the family, culture, and beliefs in society.”

An unintended pregnancy by definition is unplanned, but it may be wanted or unwanted or anywhere in between. This includes pregnancies that occurred earlier than desired. Over 60% of unintended pregnancies end in abortion and 45% of all abortions performed are unsafe. A lot of women a year are hospitalised as a result. It can happen to any person of reproductive age who can get pregnant -young or old, rich or poor, partnered or unpartnered.Some women who want to avoid pregnancy are not using safe, modern contraception methods. About a quarter of all women are not able to say no to sex. At the individual level, poverty, lack of autonomy and low education attainment limit women and girls’ access to accurate contraceptive information and services. Some women and girls simply cannot afford to pay for contraceptives. In places where contraceptives are freely available, some women lack accurate knowledge of them and how they work.

Clinical psychologist, Dr Sophie Moagi says,”Mothers reporting unplanned pregnancy may also experience poorer quality relationships with partners, and may receive lower levels of social support relative to those who planned their pregnancy. Higher levels of marital conflict and lower participation of the child’s father in childcare.Furthermore, lack of support from family and friends also acts as a link between stressful life events and depression/anxiety postpartum. It could thus be said that poorer relationship quality and lower levels of social support will influence the relationship between unplanned pregnancy. An unintended pregnancy is a risk factor for poor maternal mental health including perinatal depression, stress, and lower levels of psychological well-being and life satisfaction. An unintended pregnancy increases the risk of maternal depression  and parenting stress.”

At household level, parents seldom communicate well about methods of preventing pregnancy. Where they do talk about it, they focus on abstinence rather than contraceptives, and they sometimes use fear tactics. Another household driver is insufficient financial support from the family, pushing girls into transactional relationships. The COVID-19 pandemic also disrupted the supply of contraceptives and services.Unintended pregnancies are far higher in gender unequal communities compared to more gender equal ones. Sociocultural norms sometimes discourage women and girls from exercising their choice to use contraceptives, including condoms. Unintended pregnancy, especially among young people, can be dis-empowering. It can prevent girls and young women from getting the education and skills they need to improve their economic prospects and productivity.

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