MANGADAI, Nov 13 - “Recently, a senior official in the district administration rang me up and told me that she is sending a girl child whom I should offer shelter for the night in our child home. The girl child arrived at our centre with her mother. But I was shocked to know that the adolescent unmarried girl of around 16 years of age was eight months pregnant. The mother, an illiterate village woman least knowing any consequences took her daughter to Mangaldai for abortion of the pregnancy for fear that if her father or any male member of the family came to know about it, the girl will be killed,” narrated Rashmi Rekha Sarma, the director of ‘Kasturi Sishu Griha’, Mangaldai and a child activist. “We have come across as many as four cases of pregnant unmarried adolescent girls in recent times and most of the cases are from Sipajhar revenue circle area, ” she added. She pointed out illiteracy, poverty and lack of necessary awareness as major factors of such rising cases of adolescent pregnancy in Darrang district.
According to a field work conducted on 924 households by Nielsen (India) Private Ltd from November 6, 2015 to March 31, 2016 and published in the National Family Health Survey (NFHS)-4, 31.5 % of the total population of the district are adolescents below 15 years of age whereas 37.9% of women got married at an adolescent age before attaining the minimum legal age of 18 years. The survey also revealed that 16.5% of the women in between the age of 15- 19 years are already mothers or pregnant. The survey has also brought to light the poor rate of schooling of girl children and use of new scientific methods of family planning. It says that 29.5% girls have never attended school while only 44.4% married women use modern family planning methods.
Adolescent pregnancy as observed by the medical experts has also contributed in increase in the Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) of the district . “Pregnancy during adolescence i.e., below 20 years of age is always very risky for both the mother and the baby. At this stage, the girl does not get necessary reproductive growth and as such we often found major complications like anemia caused from malnutrition and pregnancy-induced hypertension (PIH) which ultimately develops eclampsia, the direct major cause of maternal death,” said Dr Samsul Haque, a prominent consultant gynaecologist and a Senior Medical Officer at Mangaldai Civil Hospital.
Similarly Dr Gautam Bora, a renowned consultant paediatrician of Mangaldai observed that adolescent pregnancy has a direct impact on increase of Infant Mortality Rate (IMR) of the district. “An adolescent pregnant woman is often very prone to iron deficiency anemia, deficiency of folic acid and calcium and such disorders carry high risk of premature onset of deliveries. The premature onset of deliveries lead to the increase in incidents of pre-term, very low weight babies and still births that are directly connected to the rise in IMR”, he said. On the other hand Kangkan Kr Saikia, Programme Associate of MAMTA-HIMC, a community and system focused initiative related mainly to maternal and child health, highlighted one psychological factor linked to an adolescent expecting mother which also helps in increasing MMR and IMR . “Our baseline survey in as many as 33 villages across the district has helped to find out that 40% of the rural women in between the age group 20-24 years get married before 18 years of age and majority of them were not mentally prepared for pregnancy and do not know anything about pre-conceive care which later leads to rise in MMR and IMR,” he said.
The above views of the experts in this relevant field clearly indicate that adolescent pregnancy is directly linked to the rise of MMR and IMR and if MMR and IMR are be checked, proper intervention for prevention of adolescent pregnancies is need of the hour. But the question is how effective intervention in this regard could be materialised. According to Purnima Goswami, a senior sub teacher in the Department of Economics of a private junior college, “natural changes that occur both in mental and physical health in an adolescent while growing from a child is very delicate and it needs to be dealt very carefully by the elders especially parents and teachers. We should give them proper health education and mothers have the best role to play as the regular counsellors,” she opined. In a State like Assam in general and district Darrang in particular, where a large section of people live below the poverty line, literacy rate is still very poor, social stigma and superstitions even rule the literate section, modern health care service is yet to touch the rural masses. Whether the responsibility should be confined only to the limited number of Government medical practitioners and other health staff? Definitely not! No doubt , the Government has to play the key role in this regard but medical practitioners, health workers, public leaders, parents and guardians, teachers, social activists, media persons and all the stakeholders in the society have their own role to play for an adolescent pregnancy free future.