According
to the 2005 National Survey on Demography and Health, carried out every five
years by Profamilia, a sexual and reproductive health provider, 42% of the
teenagers expressed a wish to become mothers.
However, this fact does not
change the consequences of teen motherhood in terms of maternal mortality and
poverty cycle reproduction. From
1986 and 1995, the rate of teen motherhood increased from 70 to 89 per 1000
young women, and in 2005 it reached 90 teens per 1000.
Why Early Motherhood?
One of the factors that pushed up teen pregnancy is violence resulting from the armed conflict. Statistics show that the rate of teen motherhood is higher among displaced population.
Profamilia, which runs a program for displaced families, has concluded that teen pregnancy is a way for poor young women to reach objectives other than motherhood. For instance, for such women, getting pregnant by a rich man -- even if he is married to someone else -- is a way to get income for their families and to gain social status among their neighborhood. "For many of these displaced young women, having a baby is a means to solving a lack of affection and income," said Susana Moya, national coordinator of Profamilia's Program for Youth.
In addition, young mothers in poverty can apply for assistance at the Instituto de Bienestar Familiar, a governmental body in charge of social welfare and family care, which offers integrated assistance, including food supplies, training, and housing subsidies. This social welfare is provided only to women who are mothers.
But not only the displaced young women are choosing to become mothers. What could be the causes that push other teenagers to get pregnant?
In addition to the early initiation of sexual relations and the lack of a comprehensive sexual education, there are social and economic factors which push teenagers to motherhood.
Many women are living in aggressive environments where their rights are ignored and violated. Young women are often abused; their opinions are not taken into account within their own families, and sometimes are suffering pressure and mistreatment from their teachers.
"They are running away from the ‘hell' they are living at home," pointed out Germán Salazar, coordinator of the Department for Youth from the Fundación Cardio-Infantil. Various researchers have concluded that for poor women, having a baby accords them more status, and a child can become their source of affection.
Diverging Views on Effective Sexuality Education
Although sexual education at schools has a long history in Colombia, not all the organizations involved have similar approaches. For some organizations the emphasis is on values, duties and responsibilities, encouraging teenagers to avoid sexual relations until they feel certain they're ready to start their sexual life and have the resources to afford protection methods. "Sexual education is not talking about condoms but about values, and is not only a matter of sexual rights but of duties," Germán Salazar said.
Pro-values organizations do not promote abstinence until marriage. They argue that "saying no" is an option for teenagers with enough autonomy, decision-making capacity and self-esteem, whereas it is not for those who are only taught about contraception and safer sex methods.
Others organizations have an approach based on sexual rights combined with the responsible exercising of sexuality and strengthening of autonomy. They argue that interventions have to be done quickly and based on the current reality, including early sexual initiation. According to the survey mentioned above, the percentage of women between 25 and 49 years old that have their first sexual relation before their fifteenth birthday passed from 8% in 2000 to 11% in 2005.
"If we wait until teenagers get high levels of self-esteem, decision-making capacity and autonomy as preconditions to talk them about contraception methods, teen pregnancies will continue to rise," pointed out Susanna Moya.
The organizations that support the pro-rights approach insist that interventions for teen motherhood prevention and STI protection must be done, as well as sexual education programs for self-esteem and autonomy.
However, representatives of both approaches agreed on the opinion that the media - advertisements and entertainment - is playing an important role. The media is sending messages that tend to ignore sexual protection and is promoting sexual relations among young audiences.
Neither the pro-values nor the pro-rights groups support the idea that the only appropriate expression of sexuality is within a heterosexual marriage. Such a position could only be seen within some Catholic groups.
Currently, the Ministry of Education is implementing a pilot pedagogic methodology called Education for Sexuality and Citizenship Building in a number of cities. This curriculum is a transversal program based on civil rights, and covers sexuality, and reproductive and sexual health. Teachers are being trained to develop innovative ways to develop this transversal program. If this innovative program brings successful outcomes, it could be used not only for the rest of Colombia but throughout Latin America.
]]>Editor's Note: With this post we welcome Angela Castellanos, a journalist based in Bogota, to RH Reality Check. Angela will join our Global Perspectives team reporting on reproductive and sexual health and rights issues internationally.
It is hard to imagine a country banning contraceptive methods authorized by the World Health Organization, now in 2008. Believe it or not, that is what is happening in Chile, a country which once was known as one of the Latin American pioneers in contraception policies, and now is rolling the clock back nearly 40 years.
On April 4, the Constitutional Court of Chile banned the free distribution of emergency contraception (EC) in the public health system. The reason: the Court claims that this method is "abortive" and therefore it is against the Constitution, which states the right to life. The argument is based on the presence of the hormone levonorgestrel, contained in various other contraception methods (i.e. pills and cooper intrauterine devices) -- which could also be declared forbidden.
The World Health Organization has unequivocally stated that "Levonorgestrel emergency contraceptive pills have been shown to prevent ovulation and they did not have any detectable effect on the endometrium (uterine lining) or progesterone levels when given after ovulation. Emergency contraception pills are not effective once the process of implantation has begun, and will not cause abortion."
Once again, men determined the rights of women. In fact, nine men of the Constitutional Court snatched away the reproductive rights of nearly five million women of childbearing age. This decision comes in addition to the one that forbade therapeutic abortion, adopted at the end of Augusto Pinochet's dictatorship.
Its consequence are already clear: an increase in clandestine abortions and likely the maternal mortality rate, as many women cannot afford a safe surgical procedure to terminate their pregnancies. Public sector health care staff held protests against the ruling, claiming that the ruling is contrary to women's access to health care.
Women's groups, unions, NGOs, health institutions, and human rights organizations organized demonstrations in the most important Chilean cities, and signed a public declaration rejecting the ruling and appealing the State to observe the reproductive rights.
Informed women think that they will replace EC by a bunch of ordinary contraceptive pills that contain levonorgestrel. However, this alternative does not replace the public recognition of women's rights, and the role the government can play in reducing instances of abortion and teen motherhood.
Actually, abortion and teenage pregnancy were some of the worries at the heart of the reproductive health policy promoted by the current government, led by the female president Michelle Bachelet, which offered low-income women access to EC by reforming the National Norms on Fertility Regulation. According to the new regulations announced in September 2006, the public health services were authorized to prescribe and provide -- free of charge -- traditional contraception methods as well as EC to all women from 14 years old, without their parents' consent.
Soon after, the detractors objected to the reform, so the President declared it a Supreme Act. The legal debate was driven by 36 members of the Low Chamber of Parliament from the rightist Alianza por Chile, with the support of the Catholic authorities and "Pro Vida" (For life), a group against abortion.
It seems very relevant that legal allegations came up when EC became freely distributed within the public health system, while no one protested between 2001 and 2006 when it was sold in pharmacies. For the government and progressive sectors of civil society, this is a "discriminatory" and "non equitable" decision, because it barred access for young and poor women. According to the Fifth National Survey of Youth, in Chile more than 40% of women from the low income levels became mothers between 15 and 24 years old, compared to only 14% of the middle and high levels.
The controversy has involved not only the government, but the whole society. The Catholic Church insists on defending the Constitutional Court decision and call for forbidding EC in private pharmacies. In fact, the Catholic Church put pressure on the Court during the legal debate. "During the allegations, in November 2007, the Monsignor of Santiago was seated in the first row, this is an example of the kind of pressures from ideological forces," stated Lidia Casas, in an interview with this correspondent. Casas, a female lawyer, represented the members of Parliament supporting the free distribution of EC in the public health system.
An economic interest could explain the motivations of the members of Parliament who raised the legal debate. In fact, their political forces represent the powerful economic groups, which are leading the country through an open market model. Some NGOs working for Chilean women, such as DOMOS, raise the question: Is EC a threat for economic power, which needs to ensure a cheap labor force to replace the current generation of workers? This question makes sense, because the active population in Chile and the fertility rate are quite low. In addition, such economic interest could explain the apparent contradiction between the promotion of a modern country and the adoption of regressive measures.
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