Eva Muigai was in her final trimester when her family discovered she was pregnant. Ms. Muigai, 17, lives with her family in Gachie, Central Kenya. She spent her pregnancy wearing clothing she hoped would hide her growing baby bump.
She says, “The plan was to have an abortion but I was too scared. My classmate had an abortion last year and she almost died, so I kept postponing the abortion.”
She explains that at five months, she gathered the courage to visit a man at the shopping centre, but he refused to perform the abortion because she was beyond three months pregnant.
Her mother found out when she fainted one day, at seven months pregnant.
In April, two weeks before her due date, she was rushed to hospital with severe abdominal cramps. She had an emergency Caesarian section but her baby did not survive. In mid-May, Ms. Muigai was re-admitted to hospital after experiencing swelling in her stomach, and then in her entire body.
Researchers and advocates are pushing for better access to modern contraceptives for adolescents. They also want adequate care for pregnant teens and their newborns to reduce the risk that youth like Ms. Muigai will end up in hospital.
Angela Nguku is the executive director of the White Ribbon Alliance for Safe Motherhood in Kenya. She says, “Complications of pregnancy and childbirth are a leading cause of preventable deaths and ill health among adolescent women, aged 15 to 19 years, in Kenya.”
According to the World Health Organization, adolescent mothers face higher risks of eclampsia (convulsions during pregnancy or childbirth), uterine infection, and systemic infections than mothers aged 20 to 24. Babies of adolescent mothers face a higher risk of low birth weight, premature delivery, and severe post-birth conditions.
The Guttmacher Institute is a leading global research organization that studied teen pregnancies in Kenya. The institute’s research shows that providing adolescents with easier access to contraceptives would result in a 73% drop in unintended pregnancies. It also shows that improved access to modern contraceptives and adequate care for pregnant adolescents and their newborns could reduce adolescent maternal deaths by 76%. On average, 450 Kenyan women die in childbirth each year.
Contraceptive use has increased in Kenya over the last decade. Currently, 61% of women in Kenya use contraception. But amongst youth, the figure is just 40%. As a result, nearly one in every five teenage girls has either given birth or is pregnant with their first child, according to the Ministry of Health.
To address the risk of stigma and discrimination against adolescent women, Mrs. Nyambura urges the government and the health sector to re-evaluate the manner in which teens access government services, including information on sexuality.
But the coronavirus pandemic is expected to hinder progress. The government implemented a nationwide lockdown in April with a nighttime curfew. Schools and religious centres closed.
Grace Kanini is a nurse at one of the country’s referral hospitals. She says: “A health pandemic such as COVID-19 will only widen the existing gap between adolescent women and all the [sexual and reproductive health] services that they need. Human and financial resources have now been directed into fighting this health crisis.”
She adds that people are only coming to the hospital for life-or-death emergencies, which could mean more risk for pregnant teens who avoid the hospital and regular check-ups. Already, many teens miss important prenatal care visits.
For the first seven months of her pregnancy, Ms. Muigai did not have a single prenatal care check-up. And she is not alone. According to the Ministry of Health, 51% of pregnant adolescents attend fewer than the four essential prenatal care visits, a number recommended by the World Health Organization. One-third do not visit a health facility for the birth.
While the cost of contraception and health care for mothers and babies is high, not meeting their needs costs more. This is reflected to Ms. Muigai’s situation—an “A” student with dreams of becoming a neurosurgeon who lies in a referral hospital receiving medical treatment.
This story was adapted from an article written by Miriam Gathigah for InterPress Service, titled “Kenya’s Adolescent Women Left Behind as More Married Women Access Contraception.” To read the full story, go to: http://www.ipsnews.net/2020/05/kenyas_adolescent_women_left_behind/ 
Photo credit: Miriam Gathigah / IPS