Why teenage pregnancy in Nagaland demands government's attention
Kohima: Rose (name changed), a 21-year-old resident of Kohima, is pregnant with her fourth child. She was just out of high school when a neighbourhood aunt noticed differences in Rose's body and informed her. Unprotected sex with her boyfriend had led to Rose conceiving her first child at the tender age of 18.
"I still don't know how that aunt knew I was pregnant before I knew," Rose tells EastMojo.
Back then, Rose lived with her two younger siblings in a rented house in Kohima, where the three attended school. News of Rose's pregnancy travelled fast, and thanks to the aunt, her parents knew it in no time. But, what had already happened could not be undone.
"First my mother approached me for confirmation. Our families were furious, and decided it was best for us to marry and have the child. We were all scared, but the thought of aborting never crossed any of our minds," she says.
Rose is now a mother of three, expecting her fourth child in March next year. Though the 21-year-old spent her youth parenting, she regrets the unexpected turn her life took. Together with her husband, now a 24-year-old, the couple have no family planning strategies. Despite all, they are grateful for the children they have been blessed with.
The 'reproductive health and family planning clinic' of the the Family Planning Association India (FPAI), Nagaland, while dealing with teenage pregnancies, counsels young clients and refers them to the right institutes for adoption or termination, depending on the desires of the clients.
“There are many cases where the clients do not wish to share the news of pregnancy with their parents. As teenagers fearing reprisal, they helplessly go from one health facility to the other seeking abortion,” FPAI (Nagaland) counsellor Ville Rhetso told EastMojo.
While overall rate of teenage pregnancy in Nagaland has shown a 2% decline since 2015-16, the worrying trend is rate of teenage pregnancy in the state's rural areas, which stands at 4.4%, almost 200 basis points higher than in urban areas (2.5%), recent survey figures indicate.
According to data shared by the National Family Health Survey 2019-20 (NFHS-5), a total of 3.8% of women between 15-19 years of age were already mothers or pregnant in 2019-20, as compared to 5.7% in 2015-16.
Of these, teenage pregnancies were reported at the rate of 2.5% in urban areas of Nagaland, whereas the rural areas saw a rate of 4.4%.
According to Rhetso, lack of sex education and awareness is what keeps the teenage pregnancy figures high in a state like Nagaland.
"Sex education is very important. But unfortunately, our society still considers any talk around sex a taboo. We are still unable to freely discuss these issues either at home or at school," Rhetso said.
Adolescent boys and girls are very uncomfortable in discussing any sex-related matters with either their teachers or their parents. "Female students are able to open up more as compared to boys when they are at school. A lot, however, needs to be done to create awareness on menstrual health-related issues, as well as sex education both at home and in schools," Rhetso said.
While more and more families are paying attention to the need of educating their children in terms of sexual health, Rehtso said pointing to the overall decline in the number of teenage pregnancies from 2015-16, the overall figures are still a cause of worry.
"Parents that got married at an early age are themselves ignorant about sex education and its importance, as well as menstrual health-related problems. They are not very well informed themselves to be able to share the knowledge with their children,” she said.
With rural areas of Nagaland reporting a higher rate of teenage pregnancy as compared to the urban areas, Rhetso reiterated that the knowledge and information gap widens amongst the rural population.
“Those in the urban areas are more open to the problems they face. In rural areas, however, people find it hard to open up in the close-knit communities. They do not like sharing their problems and cases,” she added.
According to the NFHS-5 survey, women aged between 20-24 years but married before the age 18 years is also higher in the rural areas. Nagaland recorded underage marriages at the rate of 2.4% in urban areas as compared to 7.3% in rural areas, at a total rate of 5.6%.
Men between age 25-29 who married before the age of 21 are higher in urban areas. Of the total rate of 5% marriages of underage men in Nagaland in the 2019-20 survey, 8.7% were in urban areas compared to 2.8% in rural areas. Women aged 20-24 years who married before 18 years stood at 5.6%, with 7.3% in rural areas and 2.4% in urban areas.
The sex ratio of Nagaland is 1,007 females per thousand of males: 980 in urban areas and 1,020 in rural areas, according to the NFHS-5 survey for 2019-20. The NFHS-5 fieldwork for Nagaland was conducted from 15 July 2019 to 6 December 2019 by the Research and Development Initiative (RDI) Pvt Ltd, and information was gathered from 10,112 households, covering 9,694 women, and 1,456 men.
Meanwhile, as per the survey, the current use of family planning methods (currently married women age 15–49 years) are: Female sterilisation—13.6% in urban areas and 14.8% in rural areas; Male sterilisation –0%; IUD/PPIUD --20.1% in urban and 19.7% in rural areas; Pill -- 9.1% in urban and 5.1% in rural areas; Condom --4.2% in urban and 2.8% in rural areas; Injectables --0.2% in urban and 0.4% in rural areas.