Look at the real incidence of teen pregnancy

I REFER to the report “Teen pregnancies on the decline” (The Star, Oct 14), in particular the figures given in the “Teen pregnancy ages” graphic. For statistical reports, these are a measure of “teen births”, an important distinction because they exclude a large proportion of teen pregnancies that would have been either aborted or ended in miscarriage (both of which can only be estimated).

Field studies have shown that the ratio of pregnancies leading to live births, induced abortions or miscarriages is about 60:30:15 among pregnant teens. Thus, taking the approximate figure of 10,000 teen births in 2018, it probably means about 5,000 teens have had their pregnancies terminated and another 2,500 ended with miscarriage. Total teen pregnancies could actually then be 17,500 a year.

Although this fall in teen births is encouraging, it is unlikely that it has been brought about by public policies alone. Attempts at introducing comprehensive sex education in schools and improving accessibility to contraceptives for teens and singles have been stigmatised for decades. More likely, this improvement is due to more information being available on the Internet, where Malaysians are forced to obtain the relevant information, both on contraception and abortion.

For those teens continuing their unplanned pregnancy, the government is helping them through Talian Kaseh for support to complete their term. Those are commendable initiatives.

However, there is no policy or programmes addressing the needs of an estimated 5,000 teens who choose to terminate (abort) their pregnancy. Abortion was recognised as a legal procedure in 1989 when the Penal Code stated that an abortion is permitted if endorsed by a doctor who considers the continuing pregnancy to be a “risk to her mental and physical health, greater than if it were terminated”. (Statistics actually show that any full-term pregnancy in the United States has 14 times the mortality rate of a first trimester abortion.)

In any case, most experienced doctors would realise how distressing an unplanned pregnancy would be for teenagers. But this does this not seem to satisfy many doctors to support an abortion based on mental health grounds.

Additionally, these teenagers would be under considerable parental pressure to abort, as few would choose either to impose a forced marriage or allow her to face the prospect of single motherhood as a first choice.

Unfortunately, due to personal prejudices and religious beliefs, most doctors and clinics under the Health Ministry are unaware of or are unwilling to recognise the desperation of pregnant teenagers and do not provide abortions for them on the basis of their mental distress and immaturity. Thus, almost all abortion services are confined to the private sector.

Sadly, difficulties in finding information can lead to pregnant teenagers seeking abortion too late or to be charged exorbitant fees. Social media is also full of scams and many become victims because of lack of official sources of information on abortion.

The Reproductive Rights Advocacy Alliance of Malaysia’s (RRAAM) hotline established via our website to provide abortion information about five years ago now receives almost 300 callers a month. Callers include young persons who have purchased abortion pills off the black market.

Although there are many fake online offers of abortion pills, there are also a few responsible non-profit websites that address this issue by providing genuine medical abortion pills, although these are banned in Malaysia. These suppliers are very ethical in screening potential clients before sending them the pills.

This is now recognised in many countries as a safe back-up solution in remote geographic areas but should not be needed here if these pills are made available locally.

While we consider those who have had a safe abortion as the lucky ones, the conservatives are happier to see them married off although they know “shotgun weddings” are unlikely to be a good start to a long-term partnership. There is limited support and little legal recourse for women and children when such marriages fall apart.

In Asia, the stigma attached to being a single mother is much worse than in Europe. Thus, with her loss of educational opportunities and the stigma attached to being an unwed mother, teenagers will face considerable obstacles to achieving a fulfilling adulthood.

Would the government please start looking at the real incidence of teen pregnancies, consider the needs of the young girls and respect their individual choices in solving their problems?