Contraceptive choice for teenagers
Old generation POP is best in special situations as it does not cause break though bleeding i.e. bleeding at middle part of the cycle. This oral contraceptive is the best suited for teenagers as it does not cause nausea, vomiting, giddiness and what is most importantly no intermenstraul bleeding or spotting,. We call it BTB (break through bleeding). drug is to be taken daily. In India this is available as the brand name of Minikare (Lynesrol-500 mg): cot about Rs. 210/- for 28 tabs to be taken daily without any gap. Following are the indications where we tithe contraceptive prescribers hesitate to advocate COC but may be prescribed POP in some special situations:
A) Prevention & complications of teenage Pregancy-Prime indications in adolescents”:-Role of POP in Adolescent girls:
Contraceptive choice for teenagers. It may be a lesser evil to provide the adolescents with the knowledge and technology of contraception along with teaching them the ethical, religious and moral values than leaving them to the risk of sexually transmitted diseases and unwanted pregnancies and running their life. Sociomedically this is a difficult issue as maters are seldom distressed in this age group particularly if she is unmarried but sexually achieve. HCP should remember that the ovulation rate is high in this age group and the frequency of intercourse is also frequent especially f she is married. As such fecundity (pregnancy rate) is also high amongst then. So thus a reliable i.e. a near 100% effective contraceptive has to be suggested.
Teenage pregnancy is not rare:
One night think that in India teenage pregnancy must be a rare event today because we know that Indian load prohibits teenage marriage. It permanents marriage only when the age of girl is 18 years or beyond. But author continuous to se thousands of teenage pregnancy even in 2009. The complication of pregnancy and puerperium are profound in this tender age. Septic abortion is by far too common in this age group particularly in rural setting. Young mothers lack in breast feeding smiles. What then is the exact scenario? What the statistician report on teenage marriage and pregnancy? Do they affirm author’s observations?
Age at first marriage in India:
Marriage occurs relatively early in India. More than one quarter (27 percent) of Indian women age 20-49 married before age 15; over half (58 percent) married before the legal minimum marriage age of 18, and three quarters (74 percent) married before reaching age 20. But there has been a steady rise in age at first marriage, which is reflected in the gradual decline in the proportion of women married by ages 15, 18 and 20 years. The median age at first marriage among women age 20-49 is 17.2 and the median age at the over 13 million women are married below the legal age of 18 years. BMRU (Bihar, MP, Rajasthan and UP) contribute 75 percent of total married women in the age group 15-19 who have begun childbearing is highest in Jharkhand (28 percent), West Bengal (25 percent), and Bihar (25 percent), all in the East Region. First cohabitation is 17.7 years. Wealth has a positive association with the median age at first mirage. Women age 25-49 in the highest wealth quintile marry over four years later than women in the lowest wealth quintile. There is a steady increase in age at marriage with increasing education, resulting in a seven year difference in the median age at marriage between women age 25-49 with no education and women with at least 12 years of education. Urban women marry more than two years later than rural women on average (Source: NFHS-3).
Age at first pregnancy:
World wide 15 million (1/5) of all births are in the teenage group. Teenage abortion number approximates 4.4 million in developing countries. Most of them are clandestine abortions. The marriage of girls at young ages in India leads to teenage pregnancy and motherhood. Overall, 12 percent of women age 15-19 have become mothers and 4 percent of women age 15-19 are currently pregnant with their rest child. This means that one in six women age 15-19 have begun childbearing. The percentage of women who have begun child bearing increases sharply with age, from 3 percent at age 15 to 36 percent at age 19. (Source: NFHS-3).
Teenage Abortion:
In India, the incidence of induced abortion in women less than 15 years in 1990-91 was 0.5 percent and between 15 and 19 it was 6.6 percent (Dept. of family welfare, Ministry of Health and Family Welfare). Ministry of Health figures from Maharashtra in 1997 show that girls younger than 15 accounted for 21.7 percent of all abortions.
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