SINCE its establishment at the Linden Hospital Complex (LHC) on March 14, 2017, the teenage pregnancy clinic has seen a significant increase in young mothers joining the facility in a bid to benefit from the specialised services offered.
The antenatal clinic monitors young mothers, ranging from ages 13 to 19.
Realising that there was an increase in teenage pregnancies in the mining town, a decision was made to establish the clinic. In 2016, 18 per cent of total deliveries at the LHC were teenage mothers.

Read more: https://guyanachronicle.com/2017/02/15/alarming-number-of-teenage-pregnancies-in-linden

Therefore, out of the 998 live births, 179 were delivered to teenage mothers, giving an approximation of 14 teenage deliveries per month.
As a result of this alarming number, the teenage clinic was introduced and on the first day of admission, four teenage mothers joined. To date, there are now 61 teenagers who are now members.
Melanie Norwick, a midwife attached to the LHC and who plays an integral role in the functioning of the teenage antenatal clinic, told the Guyana Chronicle that the teenagers were formerly members of the high-risk clinic which is held on Thursdays, but the management of the hospital had noticed a decrease in their attendance while the delivery rate was up.
It was concluded that the teenagers may have been affected by stigma and discrimination. As a result of this, many of them were reluctant to attend. If this was not remedied, serious medical, physiological and social consequences could have been attached.
Graph showing increase attendance

CLINICAL MOTIVE
Chief Executive Officer of the LHC, Dr. Mohammed Riyasat, who is also an obstetrician, explained that the introduction of the clinic was essential for the effective and early monitoring of the teenagers, since they are special high-risk cases.
In teenage pregnancies, Riyasat said there are three very important risks that the teenagers are exposed to. As a result of most of the pregnancies being spontaneous, Riyasat explained that teenagers are at risks of anaemia.

“A lot of these teenagers would have been anaemic, their eating patterns would not have been in a way to prepare them for pregnancy…so we want to capture that early and give them their nutrition to build them up to go through the pregnancy also.”
High blood pressure (HPB) is another risk, he explained, that needs to be tackled early, since it is more prevalent in teenage mothers and can lead to pre-eclampsia and eclampsia.
“We have seen it several times, 15 and 16 years old coming with really high blood pressure, these are pregnancy-induced blood pressure.” Such complications can lead to haemorrhaging in the head, stroke and even kidney failure.
Pre-term delivery is the third risk that the obstetrician explained is associated with teenage pregnancies. These babies are normally underweight and are more susceptible to infections since their lungs, brains, nervous systems and other vital organs may not be as developed as it should.

SOCIAL MOTIVE
Because of the stigma attached to teenage pregnancies, the medical practitioners related that many of the young mothers were hesitant to attend the regular high-risk clinic and this led to absenteeism from their monthly visits. The mothers were therefore not being monitored effectively and the introduction of the clinic remedied this situation.
Midwife Norwick explained that the teenagers felt more comfortable among their cohorts and attendance began to increase.

“We wanted to give them more attention and we have seen great improvement in responses, in them opening up, they open up more, they respond more, we have a better rapport with them, they come to us with any problem,” the experienced midwife posited.
Dr Riyasat echoed similar sentiments in saying, “We are able to focus our energies more on them, have that one-to-one rap … we know with teenage pregnancy, there is a lot of stigma behind it, so we have to assist them, they may be rejected by their parents, by their neighbours and friends and if they are not getting the kind of support from society, somebody has to step in and that is us, the health workers, we have to step in and fill that grey area, and if we don’t, then there can be more complications,” he said.

MORE COMFORTABLE
Shequita (not real name), a 17-year-old mother who attends the clinic, explained that she feels more comfortable at the teenage clinic than at the regular one.
“You know I would feel kind of shame when people stare at me, even some of the nurses would be whispering and talking and I was hesitant to stay away, but then I realise that I needed to put shame aside but then not everyone would be strong like me so I think the teenage clinic is a good thing because you feel more comfortable, you realise you are not alone in this situation,” the young mother shared.
One of those complications includes repeated pregnancies, and according to the social worker Laurette Grey-Smith, there are cases where the teenagers would have repeated pregnancies before becoming adults and therefore family planning, as well as counselling, is essential to curbing this phenomenon.

The health workers revealed that in one case there was a 19-year-old with three children. She highlighted that many of the teenagers would be school dropouts and situations such as poverty and dependency on another partner who would then demand a child of their own, would cause the teenager to become impregnated again. Judy (not real name), a repeated teenage mother, said that she entered another relationship when her first daughter was six months, and that is how she got pregnant again.

insert Judy (My Baby Father)

“My baby father went back with his first child mother and I wasn’t working, so I decided to enter into another relationship with this carpenter boy who was supporting us and for first he used condom and then he didn’t want to use it anymore and I didn’t want to talk up because I was scared he would leave and I end up getting pregnant again before my daughter was 1,” Judy revealed.

While there were no cases of the teenagers being infected with HIV for 2017, Midwife Norwick revealed that there were noticeable cases of Human Papillomavirus (HPV) infection.

Read More: https://guyanachronicle.com/2017/09/06/36000-girls-targeted-hpv-campaign

The schools welfare officer is responsible for channelling the teens back into the education system. While some of them would go back to school, some would choose to learn a life skill at a tertiary institution.
As a social worker, Smith-Grey plays the role of counselling the teenagers as well as referring the cases to the Child Care and Protection Agency, when the mothers are below 16 years old, since they would have been victims of statutory rape.
“They have not reached the age of consent, so they cannot consent to sex so even though they are in a relationship and they agree to have sex, according to the law they still cannot agree to have sex… all such cases have been referred to the child care agency because they are still considered minors,” Smith-Grey said

While the law makes provision for the fathers, if they are over the age of 16, to be prosecuted, the social worker related that in many cases, this is not done.
And according to Smith-Grey: “It comes down to what the family would accept…if the relatives come and say that they don’t want any police story, then everything seems to lie low but according to law, they are supposed to be prosecuted.”
The teenage pregnancy clinic at LHC is also part of the hospital’s maternal health strategy which aims at maintaining the record of no maternal death which has not occurred since 2011.