Despite the enormous work by health educators, the Anguilla Family Planning Association and others, the rates of teenage pregnancies in Anguilla show no significant decline in recent years.

Risks for pregnant teenagers
Teenage pregnancy is technically defined as occurring when a female under the age of 20 becomes pregnant. The vast majority of teenage pregnancies in Anguilla is unplanned and in some instances occurs as a result of sexual abuse, especially those occurring under the age of 15 years.

Many teenagers when they become pregnant fail to tell anyone and often seek medical attention very late in their pregnancy.

This often leads to an increased risk of medical complications. Pregnant teens are more at risk for certain health problems such as high blood pressure and anaemia. They are more likely to go into labour too early. Risks are even greater for teens younger than 15 years and those who do not get prenatal care.

Pregnant teens also have many emotional reactions. Some may want a baby to have someone to love, but do not recognize the amount of care the baby needs. Others become overwhelmed by guilt, anxiety and fears about the future. Depression is also very common in teenagers who become pregnant. Pregnant teenagers require special medical care, understanding and counseling and all should have medical care beginning early in their pregnancy.

Prevention of teenage pregnancies
Many strategies have been undertaken to help prevent teenage pregnancies. In some countries there has been some success. Parents have a crucial role to play in helping to prevent teenage pregnancies, but health educators, teachers and others in the community also play important roles.

Sex education in schools is a very controversial topic, but there is general consensus that a comprehensive sex education curriculum based on values, attitudes, communication and negotiation skills, as well as biological aspects of reproduction can be successful in reducing teenage pregnancies.

Some parents often ask what they can do to help prevent teenage pregnancies. The following might prove helpful:

• Talk with your children early and often about sex and answer their questions. If you do not know the answers seek professional help.

• Supervise and monitor your children.

• Know your children’s friends and their families

• Encourage children to take school seriously and value education highly

• Know what your children are reading, watching on TV and on the computer

• Have a strong and close relationship with your children.

Parents, by having good communications with their teenagers, can provide guidance to their teenagers about sexuality, contraception and the risks and responsibilities of intimate relationships and pregnancy.

Prenatal care
Many teenagers who become pregnant are often scared and do not like seeing a doctor, but it is very important that they see a doctor very early in their pregnancy. Education about aspects of pregnancy is important to all pregnant women, especially teenagers who often need special advice on a wide range of topics such as nutrition, sexually transmitted infections and other health conditions.

Postnatal care
Teenagers who become parents often need the care and support of family members and friends, especially in the first few weeks following delivery. It is important the teen mother see a doctor for her six week check up following delivery. This is an ideal time for the health care provider to discuss a wide range of topics. Birth control should be discussed. Not having sex – abstinence - is a sure way to avoid becoming pregnant again or getting a sexually transmitted infection. If the teenager choose to have sex she should wait until her doctor tells her it is safe and the doctor or health educator should discuss with her the matter birth control.

Conclusion
Unplanned teenage pregnancies continue to occur at alarming high rates in Anguilla despite the introduction of sex education in schools and the tremendous work being done by the Anguilla Family Planning Association, and others in the community. There is need to reassess our strategies and to develop a more comprehensive national preventative programme to prevent teenage pregnancies especially for those teens under the age of 16 years. Anguilla cannot continue to have so many children have children at such an early age.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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