A pregnant teenager can feel very isolated and vulnerable. She can be plagued by questions of what to do next, whether she should tell anyone, where to get help or advice and how to tell her parents.
Some may even deny the pregnancy and act as if there's nothing wrong with them, thereby denying themselves medical care and advice they need.
Shock, panic and distress – the immediate reactions
Shock, fear, panic, distress is often the immediate reactions to unplanned pregnancy. There are usually tough decisions to make about whether to keep the baby, to have an abortion or to have the baby adopted.
Finding out that a teenage daughter is pregnant comes as a shock to many parents. Some parents know about their daughter's pregnancy from early on. Others have no idea.
Amanda Louw could not bring herself to tell her parents about her pregnancy until she was eights months pregnant.
"I had just turned 18 when I got pregnant and it was my first year at varsity. My parents were very proud, because I was their first child to study at a higher institution. They were expecting a lot from me.
"I couldn’t bring myself to tell them, because I knew I messed up big time. I was scared to death", Amanda said.
She kept the pregnancy a secret after she was rejected by her boyfriend when she told him that she was pregnant.
"When he said he was not the father of my unborn child, I wanted to throw myself in front of a moving train and die. I couldn’t believe he was accusing me of sleeping around," Louw said.
No medical attention
"I had sleepless nights. I cried whenever I was alone. I tried not to stress, which was impossible, but I wanted to have a healthy baby, but it was difficult because I couldn’t go to the clinic by myself, because I couldn’t trust anyone with the secret.
"I could only guess how far I was as I saw my stomach increasing in size and the baby started to move. I couldn’t tell anyone about those moments, I could only imagine how tiny my baby was. I was scared of being treated differently. I still wanted to be my dad's little girl.
"After my final exams, I asked a relative to tell them, because I thought I was about to give birth anytime.
"My father did not talk to me for a while, but my mother was very supportive.
"I almost gave birth at home, because when my water broke, I didn’t know. I gave birth to a baby boy who looks like his father even though he hasn’t come around to see him.
"I'm glad I didn’t have an abortion, because I did consider it," said Amanda.
She said it was not her first sexual encounter without the use of contraceptive or condom.
"I heard that you can get pregnant even if it's not your first, but sometimes you just pray that it does not happen to you", Louw said.
Teenage pregnancy in the Western Cape
1,162 women under the age of 19 got pregnant in different schools in the following areas: Eerste River, Maccasar, Kraaifontein, Bishop Lavis, Michael Maponguana and Vanguard around Western Cape during just seven months in the year 2004.
"Young women, especially under the age of 20 have lots of complications during the delivery of the baby. The pelvic bones in most cases are not yet fully developed and these young women fail to push hard to give birth and this sometimes results in delayed labour, or the decision to do a ceasarean section", said Sister Kholiswa Bangana who is a midwife at Guguletu Maternity Obstetric Unity.
Delayed labour can cause oxygen shortages to the brain of the unborn baby, which can be serious.
Bangana said children born to teenaged mothers are at high risk of premature birth and behavioural problems. They also often do not get immunised and vaccinated, because many young mothers need help in order to take proper care of their babies. This help is not always available.
Adding to these problems, are smoking and drinking habits, and a lack of personal health care during pregnancy. These social issues form barriers in the seeking of medical help for these young women, and this leads to longer hospital stays and poorer health outcomes.
Unprotected intercourse "major cause of pregnancy"
"Young women should be encouraged to practise abstinence or delay their first sexual encounter as far as they are able to, says Department of Health Spokesperson, Maureen McCrea. She added that this would also protect them from getting emotionally hurt.
She spoke of the so-called "double protection" - contraceptives to prevent the unwanted pregnancy and also the use of condoms to prevent Sexually Transmitted Infections (STIs) and HIV/AIDS".
There are still many myths surrounding contraceptives. In many cultures there is a stigma attached to the use of contraceptives among unmarried people. Some people still believe if you start using contraceptives at a young age, you will not be able to bear children or if you do, they will be damaged in some way.
Partner involvement essential
Sister Linda Dyasi who works at the Youth Family Planning Clinic at Uluntu Centre in Guguletu says young women are just plain careless with their lives.
"We educate women about the dangers of not protecting themselves and encourage them to bring their partners when they visit the centre. This is done to educate their partners as well, because they are the first to tell them all sort of myths they heard about contraceptives and discourage using any kind of contraceptive", said Dyasi.
"I think it can be called "unplanned planned pregnancy", because most of these young women are aware of the consequences," said Dyasi.
"I wish parents could come along so that they can understand contraceptives better, because at this age many teenagers are scared that their parents would disapprove of them being sexually active," said Dyasi.
Meeting the contraceptive needs of sexually active young people is one way of lower the incidences of unplanned pregnancy and of abortion.
All young people need to think of the possible consequences of having sex. Talking openly about contraceptives and sex is still difficult for many parents, but avoiding the issue will not stop teenagers from asking questions or experimenting with sex.
(Charmaine Quma, Health24, October 2006)