Avoiding Averages

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By: Anna Dion, Young Champion of Maternal Health

This blog post was contributed by Anna Dion, one of the fifteen Young Champions of Maternal Health chosen by Ashoka and the Maternal Health Task Force at EngenderHealth. She will be blogging about her experience every month, and you can learn more about her, the other Young Champions, and the program here.

“Teenage pregnancy is one of the biggest problems we face here,” says Maria, a nurse that has worked for over 20 years in a small health centre in a poor neighborhood about 2 hours north of Buenos Aires. “Most teenage pregnancies aren’t planned or wanted, so we spend a lot of time working with them throughout their pregnancy to accept and love their newborn.”

I had the chance to speak with Maria in the context of the project I am working on as part of my Young Champions project – to develop a companion program for women with high-risk pregnancies, with a particular focus on adolescents. Together with my mentor, Ashoka Fellow Alberto Vasquez and the municipal Health Secretariat, we are developing a training program for volunteer companions, who will support and counsel adolescents before, during, and after their pregnancy. We are working towards piloting the program in Maria’s health centre in the new year.

Since I have been here, many health professionals have voiced their concerns about adolescent pregnancy— that it is an epidemic and that despite education campaigns and heroic efforts by the health centre staff to engage young people in discussing reproductive health issues, things don’t seem to change.

This perspective of adolescent pregnancy contrasts with that of a group of early 20-something women that SAHDES has trained as health promoters in a small, rural community, not far from Maria’s health centre. Most of the women in this ‘Club de Madres’ had children between 16-18 years, some have finished high school and some still plan to, while others are focused solely on raising their young families. About half of the group had planned to get pregnant while still in high school—they saw it as a natural part of becoming an adult and, for them, a more practical option than staying in school. All were in stable relationships, and most still are. Those that didn’t plan their pregnancies struggled with the idea at first, however, reached a point with their partners and families where they have been able to raise their children while still finding time to continue with their own life plans.

I realize that this group likely represents exceptions in their communities. All of these women have had the support of their families and/or their child’s father. They have been able to control when and if they have another child. They also share many stories of their peers who have not been so fortunate, who are now pregnant with their 5th child, of women who have to hide buying and taking birth control pills from their husbands, and of children raising children as their mother leaves home to earn their household’s only income.

The opportunity that I have to work across different sectors continually reminds me that there isn’t an average experience of a pregnant teenager. This is key to the development of the training curriculum for our birth companion program. I hope that all of the women we work with will feel as confident and supported as the women in the ‘Club de Madres,’ and that we can prepare these companions to work with women where they find themselves—building on their strengths and working together through their challenges, as varied and difficult as they may be.