Pregnant girls face higher risk of losing babies to complications

Adolescent mothers aged 10 to 19 years have a higher risk of eclampsia, puerperal endometritis, and systemic infections than women aged 20 to 24 years, according to the World Health Organization. [Kipsang Joseph, Standard]

Fatuma*, a 17-year-old from Merti, Isiolo, has seen it all.

She was married off as a third wife at the age of 13 to a wealthy businessman in the area in exchange for 12 cows and 25 goats.

Fatuma was in Standard Five when she was married off.

"When I got home from school in the evening, I found my mother crying. When I asked her about it, she told me that my father had decided that I would be the wife of a wealthy businessman starting that evening," she says.

"Before I could digest the news, my father came to the kitchen where we were and ordered me to accompany him," she says.

"I became terrified and followed him. There were two cars that had just arrived at the compound, and he handed me over to the strangers."

Fatuma says when she arrived at her matrimonial home, she was greeted by one of the businessman's wives, who informed her that she would be performing wifely duties to the husband that day.

"The man would sexually assault me and with no time, I became pregnant. Given my age, I had a stillbirth five months into my pregnancy. I almost died."

"I was pregnant again after six months," she continued.

"I carried the pregnancy to term this time, but when labour pains began, I was taken to a Manyatta to deliver, but I was unable to push the baby out. As a last resort, I was taken to the hospital, where tests revealed that the baby had already died in my womb."

She said they operated on her and she was able to give birth via caesarean section, but that after a while, the wound was not healing and when she returned to the hospital, she was told that her uterus needed to be removed in order for her life to be saved.

"One evening, I used the money the man had left in the house as transportation. I ran away and went to Marsabit County to seek medication, where the uterus was removed and I stayed in a rented house until I healed," Fatuma says.

"I lost my womanhood and will never have my own baby," she added tearfully. I'm not interested in having a man in my life. I can support myself through the menial jobs I do, but I will never return home."

Fatuma is one of the girls in Isiolo county who were married off at a young age against their will.

Early marriage is the norm in the county of Isiolo. Parents marry off their children at a young age to gain prestige and income.

The move is also intended to prevent the girls from becoming pregnant out of wedlock while visiting their fathers' homes, which would reduce their marriageability and bride price.

According to data from the Kenya Health Information Systems (KHIS) for Isiolo County, 87 girls aged 10-14 years became pregnant between October 2021 and October 2022.

Some 1,873 girls aged 15-19 years became pregnant, and 3,641 girls aged 20-24 years became pregnant.

This data only includes teenage mothers who sought medical care at health facilities, but the majority of residents do not attend antenatal clinics, so the actual number could be much higher.

Marrying a young girl in this community will also earn the family a few cows, camels, and goats compared to those over the age of 18. Families can sell these animals and use the proceeds to care for them.

In the midst of this, teenage girls are left to suffer alone, and no one is prepared to reverse the trend of early marriages. They simply suffer silently. The problem affects not only Isiolo county but the entire country.

Adolescent mothers aged 10 to 19 years have a higher risk of eclampsia, puerperal endometritis, and systemic infections than women aged 20 to 24 years, according to the World Health Organization (WHO).

Eclampsia is a rare but serious condition that occurs in the second half of pregnancy and characterised by high blood pressure, headaches, blurry vision and convulsions.

Postpartum endometritis is a uterine infection typically caused by bacteria ascending from the lower genital or gastrointestinal tract.

WHO further notes that babies of adolescent mothers face higher risks of low birth weight, preterm birth and severe neonatal condition.

In Kenya, one in every five adolescent girls aged between 15-19 years is already a mother or is pregnant with their first, according to the Ministry of Health.

Prof Gordon Nguka, a Nutritional and Dietetics expert from Masinde Muliro University of Science and Technology, says underage girls' reproductive system is not fully developed and therefore not ready to carry a pregnancy.