Uganda: Post-Delivery Family Planning for Teenage Mothers Crucial

Betty Namusisi, 23, is a mother of four children living in Namayuba village, Wakiso district.

At 17 years old, Namusisi got her first pregnancy and dropped out of school. At the time, there were several myths and misconceptions about the use of family planning and subsequent effects, which prevented her from using them, hence becoming pregnant again, and again.

To date, Namusisi regrets not using family planning because she is not able to take care of her children who are only one and half years apart.

"I was scared to use family planning because I was told it had dangerous side effects; how I wish I got the correct information then," she says.

Namusisi is not alone; Uganda has a high teenage pregnancy rate, estimated at 25% with more than half (56%) having had sexual intercourse before the age of consent (PMA 2020).

The Covid-19 pandemic has exacerbated the situation, thus eroding the gains the country has made in reproductive health care to address this issue. The key driver of teenage pregnancy during this pandemic period is the closure of schools, which usually offer a safety net for children.

Poverty is another contributing factor, closely related to transactional sex, sexual abuse, and exploitation. Furthermore, many teenagers lack access to sexual reproductive health services and information. For instance, some regions are experiencing a rapid increase in the number of teenage pregnancies, (30%) with a likelihood of growing exponentially if serious interventions are not instituted.

Teenage pregnancy remains a major public health concern, with significantly high morbidity and mortality rates, resulting from complications such as obstruction, placental tears, obstruction during delivery, obstetric fistula, anemia, high blood pressure and death, among other complications.

Significantly, available evidence shows that children born to teenage mothers are susceptible to prematurity, birth injuries, and may die during infancy (WHO, 2016).

Further still, early pregnancy results into short birth intervals and more unplanned children. Repeat adolescent births, among women with first birth below 18 years, is high in Uganda with no decline observed in 30 years (Amongin et al., 2020).

It should be noted that teenage mothers are at a higher risk of unintended repeat pregnancy, within one and a half years after childbirth, and this pushes them and their offspring into worse effects than what is experienced following the first birth.

Repeat pregnancy among teenagers is associated with early marriages resulting from poverty. These marriages often deny teenage mothers the power to make decisions about the number of births, and the use of contraception.

Studies have also demonstrated that the reaction of families and communities following the first pregnancy pushes girls to drop out of school, get married and, therefore, set on a vicious cycle of teenage births and poverty.

According to Teopista Namutebi, a peer educator in Wakiso, there is need to engage pregnant teenagers in postpartum family planning especially long-acting reversible contraceptives, as soon as they start antenatal to enable them make informed choices and plan accordingly."

Several organizations, including Marie Stopes Uganda, provide family planning services within hard-to-reach areas through the outreach and public sector strengthening channels.

Strengthening access to postpartum contraceptives can reduce and prevent unplanned repeat pregnancies among teenage mothers and improve their maternal and child well-being.

We commemorated World Population Day on July 11 under the theme "Covid-19 and Beyond: Spotlight on Uganda's Adolescent Reproductive Health."

Going forward, the country needs to invest resources in preventing teenage pregnancy and supporting teenage mothers to avoid repeat teenage pregnancies.

The government, development partners and all stakeholders should enhance capacity building for service providers to deliver postpartum family planning methods and enable teenage mothers to refocus on achieving their future plans, including completing their education.

The author is the communications officer, Marie Stopes Uganda

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