UM Specialist Centre (UMSC) obstetrician and gynaecologist Associate Professor Dr Aizura Syafinaz Ahmad Adlan (right) and her younger sister UMSC psychiatrist Dr Aida Syarinaz during a joint interview on teenage pregnancy at UMSC recently.
--fotoBERNAMA (2019) ALL RIGHTS RESERVED
(First of a Two-Part Interview)
By Salbiah Said
PETALING JAYA, Dec 27 (Bernama) -- Research has shown that an average of 18,000 teenage girls in Malaysia get pregnant each year, 25 per cent or about 4,500 cases involved out-of-wedlock pregnancy.
Citing the statistics from the Ministry of Health in 2015, experts from UM Specialist Centre (UMSC) shared that while the latest figures (2018) have not been released, they believe teenage pregnancy is on the rise.
"These numbers could be the tip of the iceberg as many cases are likely unreported," UMSC obstetrician and gynaecologist, Associate Professor Dr Aizura Syafinaz Ahmad Adlan told Bernama in a joint interview with her younger sister, UMSC psychiatrist, Dr Aida Syarinaz Ahmad Adlan recently.
The data also showed that around 14 in every 1,000 underage girls in Malaysia fall pregnant every year, which add up to an average of 18,000 girls per year. In comparison, Singapore’s rate is 4 pregnancies for every 1,000 underage girls, and Hong Kong is at 3 out of every 1,000.
Dr Aizura Syafinaz said social acceptance in Malaysia on teenage pregnancy was still poor, restricted, secluded and regarded as taboo due to premarital sex, incest, rape, sexual abuse and teen marriage being its precursor.
Statutory rape in the Penal Code in Malaysia is defined as sexual activity with a girl under the age of 16 as she is unable to understand the nature and consequence of giving consent. According to the World Health Organisation (WHO), teenage pregnancy is one in which the mother’s age is between 13 to 19.
The Age of Consent in Malaysia is 16 years old. The age of consent is the minimum age at which an individual is considered legally able to give consent to sexual activity. Individuals aged 15 or younger in Malaysia are not legally able to give consent to sexual activity, and such activity may result in prosecution for statutory rape or the equivalent local law.
"Therefore, I question parents who allow teenage marriages; should they be “charged” for consenting statutory rape?," said Dr Aizura Syafinaz.
She expressed that studies also showed that most cases in Malaysia were from urban poor, that is the lower socio-economic income group - single mothers with children, parents working double shifts or having two jobs with their children left unsupervised at home.
"Sadly, these sectors are large groups where their teenage daughters end up pregnant. Predominantly, these young girls lack attention and are left alone having lots of free time in their hands. It's like a vicious cycle. As it stands, they hail from a low socio income group and regrettably end up with pregnancy," added Dr Aizura Syafinaz.
Citing a Malay proverb, 'Biar mati anak, jangan mati adat,' she said that these parents would be bursting with anger after realising that their daughter had lost her innocence. Instead of resolving the issue, the mindset is more of how to handle the embarrassment caused by this affected daughter.
"In many cases, the girl would be sent to a half-way house to deliver the child. Some parents would only want their daughter to come home alone without the baby, as they believe that an illegitimate child would bring shame to the family," said Dr Aizura Syafinaz.
More often than not, unwed mothers are not accepted by their own parents. Hence, unwanted or an illegitimate pregnancy results in baby dumping or abandonment of babies. Data has shown that an average of 100 babies are dumped nationwide in Malaysia every year.
She said the idea of using condoms or oral contraceptives was still a taboo among the conservative society as it was often seen as promoting "free sex" and encouraging promiscuity.
"For instance, I wanted to regulate a teenager's period by recommending oral contraceptives, but her mother was against the idea for fear that people might think her daughter was sexually active.
"While information on teenage pregnancy is available on the health ministry's 'myHEALTH' portal since 2012, it only saw 34 visitors as end-November this year, reflecting the poor outreach among youths," she added.
Dr Aizura Syafinaz opined that there was a need for a review in sex education in secondary schools, which only emphasised on basic biology of the human body's reproductive system.
"The approach to sex education is too academic and still indirect as most people shy away from discussing the topic of ‘sexuality’. Schools are teaching the usage of intrauterine contraceptive device (IUCD) at Form 1 level. IUCD is something that we teach our medical students in our medical school curriculum.
"When statistics showed that teenage pregnancy was higher within 15 year olds, we simply decided to educate students earlier, in Form 1 at 13 years of age. How is this thoroughly thought? Schools don't teach about the sex act per se and highlighting the pros and cons. The eventuality of not knowing the consequences of having unsafe sex deceives the girl into pregnancy, and enduring the problems thereafter," she added.
She noted that there was a lack of sexual reproductive health knowledge among Malaysians. According to a 2015 survey backed by the Health Ministry, 35 per cent of Malaysian female youths believe that having sex for the first time does not lead to pregnancy, and one in five Malaysians believe that sexually transmitted infections (STIs) could be transmitted by mosquitoes - an alarming interpretation!
Dr Aizura Syafinaz said parents are the ones to blame for not filling the gaps in their children's understanding of the birds and the bees, noting that cultural taboos and upbringing prevented them from doing so.
Studies have shown that many teenagers below 16 become pregnant as a result of premarital consensual sex activity.
Dr Aida Syarinaz shared that Attachment theory affirms that the bond between the child and the caregiver would determine their future relationship.
"Attachment is an emotional bond with another person. The earliest bonds formed by children with their caregivers have a tremendous impact that continues throughout life.
"Children who are securely attached tend to develop better self-esteem and self-reliance as they grow older. Usually they are more independent, have successful social relationship and experience less depression and anxiety. Failure to form secure attachment in early life can have a negative impact in their adult life, " she said.
Dr Aida Syarinaz said in situations where their daughter is pregnant, parents need to learn to accept the fact and address the problem in the best possible way. Being in denial does not help in dealing with the pregnancy.
"Parents tend to get uncomfortable discussing sexual issues with their teenage children, leaving them to seek such information from the media and peers,” she added.
Dr Aida Syarinaz cited a case of a 14-year old girl who comes from a chaotic family - her father an alcoholic, while the mother is the main breadwinner.
"Her parents were hardly at home and the girl spends a lot of time with her then boyfriend who gave her lots of attention. She was not well informed about sexual intercourse and did not realise that she was repeatedly being raped by her boyfriend, who described the intercourse as “act of love”.
"She was scared if she did not follow what the boyfriend wanted, she will lose his love, even though the intercourse was painful for her. She is still getting treatment as she was very much traumatised by it," said Dr Aida Syarinaz.
Dr Aizura Syafinaz added that in many cases and especially with the low-income groups, adolescents come home and what greets them are packed “tapau” food on the dining table instead of a home-cooked meal and dinner with the family. What is there to say, as parents are probably working and doing double-shifts. Unattended, the girl may feel lonely and ends up spending her free time with her boyfriend, who will be waiting within the vicinity with his motorbike.
Dr Aida Syarinaz said youths today were exposed to negative sex exposure through pornographic materials. Without effective and comprehensive sex education, youths tend to learn and understand the distorted versions of sex, and some upload nude photos of themselves via social media platform such as WeChat.
"Should the girl decide to indulge in sexual activities, then she must practice ‘safe sex’ to protect herself, that is, the harm reduction approach. The consequences of prohibited sexual affairs can lead to pregnancy. Remember, you have the right to say, ‘ No to Sex’!” she stressed.
While sex abstinence should be promoted to avoid teenage pregnancy, she highlighted that proper parental supervision with a safe environment at home, staying in school and having a healthy relationship with family and peers may reduce the risks of unwanted pregnancy.
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