Reproductive Health Issues and Use of Family Planning Methods among Married Adolescent Mothers
Introduction: Adolescent pregnancy is a major public health concern in low- and middle-income countries. Nepal ranks among the twenty countries with the highest child marriage rates in the world. Adolescent mothers are at higher risk for poorer maternal and neonatal outcomes. This study intended to find the reproductive health issues and use of family planning methods among married adolescent mothers at a tertiary care center in a western part of Nepal. Methods: This was a cross-sectional study conducted among adolescent mothers who attended the family planning counseling session at Community Medicine Out-patient Department at a tertiary care center. Pre-tested semi-structured questionnaire was used for data collection and variables were entered in SPSSTM version 16. Descriptive statistics were presented in terms of mean and percentage. Results: Among 235 adolescent mothers, the mean age of adolescent mothers was 18.02 years (SD = 1.13). Almost 93.2% had not used any kind of contraceptive methods previously. Limited knowledge, uncomfortable talking about contraception and spousal denial were common reasons for not using contraception. Obstetric related complications were observed in 13.6% and one in ten neonates required neonatal intensive care unit admission during the study period. After the counseling session, six out of ten expressed current choice of long-acting reversible contraceptives method in which Jadelle implant was preferred. Conclusion: Our study among the adolescent mothers showed that use of family planning methods before pregnancy had been very low. Policies need to focus on meeting the unmet need for family planning among married adolescent girls.
Rosen JE. Position Paper on Mainstreaming Adolescent Pregnancy in Efforts to Make Pregnancy Safer. Department of Making Pregnancy Safer. Geneva: World Health Organization; 2010. Available from: https://www.gfmer.ch/SRH-Course-2010/adolescent-sexual-reproductive-health/WHO-mainstreaming-adoles-cent-pregnancy-efforts-MPS-2010.html
Nepal Demographic Health Survey 2016. Min¬istry of Health, Ramshah Path, Kathmandu; Nov 2017. Available from: https://www.dhsprogram.com/pubs/pdf/fr336/fr336.pdf (accessed 2 Sept 2020).
UNFPA. Marrying too Young: End Child Marriage. Available from: https://www.unfpa.org/sites/default/files/pub-pdf/MarryingTooYoung.pdf (accessed 2 Sep 2020).
Maharjan B, Rishal P, Svanemyr J. Factors influencing the use of reproductive health care services among married adolescent girls in Dang District, Nepal: a qualitative study. BMC Pregnancy Childbirth. 2019;19(1):152. DOI: https://doi.org/10.1186/s12884-019-2298-3 PMID: 31053108 PMCID: PMC6500073.
WHO. Adolescent pregnancy. Factsheet in https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy (accessed 8 Sept 2020).
Aguilar AM, Cortez R. Family Planning: The Hidden Need of Married Adolescents in Nepal. The World Bank; 2015. Available from: https://openknowledge.worldbank.org/handle/10986/21464
Rinehart W, Rudy S, Drennan M. GATHER guide to counseling. Popul Rep J. 1998;(48):1-31. PMID: 10096107.
Devkota HR, Clarke A, Shrish S, Bhatta DN. Does women’s caste make a significant contribution to adolescent pregnancy in Nepal? A study of Dalit and non-Dalit adolescents and young adults in Rupandehi district. BMC Womens Health. 2018;18(1):23. DOI: https://doi.org/10.1186/s12905-018-0513-4 PMID: 29357853 PMCID: PMC5778648.
Regmi PR, van Teijlingen E, Simkhada P, Acharya DR. Barriers to sexual health services for young people in Nepal. J Health Popul Nutr. 2010;28(6):619-27. DOI: https://doi.org/10.3329/jhpn.v28i6.6611 PMID: 21261208 PMCID: PMC2995031.
Pandey PL, Seale H, Razee H. Exploring the factors impacting on access and acceptance of sexual and reproductive health services provided by adolescent-friendly health services in Nepal. PLoS One. 2019;14(8):e0220855. DOI: https://doi.org/10.1371/journal.pone.0220855 PMID: 31393927 PMCID: PMC6687105.
WHO. Adolescent Pregnancy: Issues in Adolescent Health and Development. World Health Organization, Geneva; 2004. Available from: https://apps.who.int/iris/bitstream/handle/10665/42903/9241591455_eng.pdf (accessed 2 Sept 2020).
Napit K, Shrestha KB, Magar SA, Paudel R, Thapa B, Dhakal BR, et al. Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal. J Health Popul Nutr. 2020;39(1):2. DOI: https://doi.org/10.1186/s41043-020-0212-2 PMID: 32041664 PMCID: PMC7011236.
Mahato PK, Sheppard ZA, van Teijlingen E, De Souza N. Factors associated with contraceptive use in rural Nepal: Gender and decision-making. Sex Reprod Healthc. 2020;24:100507. DOI: https://doi.org/10.1016/j.srhc.2020.100507 PMID: 32200229.
Kumar A, Singh T, Basu S, Pandey S, Bhargava V. Outcome of teenage pregnancy. Indian J Pediatr. 2007;74(10):927-931. doi:10.1007/s12098-007-0171-2
Rexhepi M, Besimi F, Rufati N, Alili A, Bajra¬mi S, Ismaili H. Hospital-Based Study of Ma¬ternal, Perinatal and Neonatal Outcomes in Adolescent Pregnancy Compared to Adult Women Pregnancy. Open Access Maced J Med Sci. 2019;7(5):760-6. DOI: https://doi.org/10.3889/oamjms.2019.210 PMID: 30962834 PMCID: PMC6447330.
Committee on Adolescent Health Care. Committee Opinion No 699: Adolescent Pregnancy, Contraception, and Sexual Activity. Obstet Gynecol. 2017;129(5):e142-e149. DOI: https://doi.org/10.1097/aog.0000000000002045 PMID: 28426620.
Rigsby DC, Macones GA, Driscoll DA. Risk factors for rapid repeat pregnancy among adolescent mothers: a review of the literature. J Pediatr Adolesc Gynecol. 1998;11(3):115-26. DOI: https://doi.org/10.1016/s1083-3188(98)70130-5 PMID: 9704301.
Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, et al. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012;366(21):1998-2007. DOI: https://doi.org/10.1056/nejmoa1110855 PMID: 22621627.
Copyright (c) 2020 Samata Nepal, Shreyashi Aryal
This work is licensed under a Creative Commons Attribution 4.0 International License.
- The Journal of Lumbini Medical College (JLMC) publishes open access articles under the terms of the Creative Commons Attribution (CC BY) License which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- JLMC requires an exclusive licence to publish the article first in its journal in print and online.
- The corresponding author should read and agree to the following statement before submission of the manuscript for publication,
- License agreement
- In submitting an article to Journal of Lumbini Medical College (JLMC) I certify that:
- I am authorized by my co-authors to enter into these arrangements.
- I warrant, on behalf of myself and my co-authors, that:
- the article is original, has not been formally published in any other peer-reviewed journal, is not under consideration by any other journal and does not infringe any existing copyright or any other third party rights;
- I am/we are the sole author(s) of the article and have full authority to enter into this agreement and in granting rights to JLMC are not in breach of any other obligation;
- the article contains nothing that is unlawful, libellous, or which would, if published, constitute a breach of contract or of confidence or of commitment given to secrecy;
- I/we have taken due care to ensure the integrity of the article. To my/our - and currently accepted scientific - knowledge all statements contained in it purporting to be facts are true and any formula or instruction contained in the article will not, if followed accurately, cause any injury, illness or damage to the user.
- I, and all co-authors, agree that the article, if editorially accepted for publication, shall be licensed under the Creative Commons Attribution License 4.0. If the law requires that the article be published in the public domain, I/we will notify JLMC at the time of submission, and in such cases the article shall be released under the Creative Commons 1.0 Public Domain Dedication waiver. For the avoidance of doubt it is stated that sections 1 and 2 of this license agreement shall apply and prevail regardless of whether the article is published under Creative Commons Attribution License 4.0 or the Creative Commons 1.0 Public Domain Dedication waiver.
- I, and all co-authors, agree that, if the article is editorially accepted for publication in JLMC, data included in the article shall be made available under the Creative Commons 1.0 Public Domain Dedication waiver, unless otherwise stated. For the avoidance of doubt it is stated that sections 1, 2, and 3 of this license agreement shall apply and prevail.
Please visit Creative Commons web page for details of the terms.