In 2012, an in-depth study was conducted on the risk factors for unwanted teenage pregnancies in Huai Rat District. It was found that teenagers getting pregnant while in the education system was due to external factors such as communication tools, which facilitate quick and easy contact, as well as economic and social conditions. Internal factors included interest in the opposite sex, curiosity, wanting to have a boyfriend due to trends, changing behaviors and values, and lack of access to sex education and reproductive health services for teenagers, leading to unplanned pregnancies and becoming teenage mothers unpreparedly.
In May 2013, I had the opportunity to attend a training on caring for teenagers and women with unplanned pregnancies to prevent unsafe abortions, organized by Health Center 5 in collaboration with the Foundation for Reproductive Health and Rights of Thailand at Kwan Ruen Hotel, Nakhon Ratchasima Province. I reflected the issues to the speakers and consulted for solutions, receiving guidance which I considered as another option for the network of care and referral for teenagers with unwanted pregnancies to prevent unsafe abortions in Health Service Area 9. The hospital director, who is the chairman of the adolescent clinic, and the team considered adjusting the service model to improve access and use of health and reproductive health services for teenagers and youth. They volunteered for the TEEN UP CARE project to prevent and solve health and reproductive health issues, covering all four aspects: Safe Virgin, Safe Sex, Safe MCH, Safe Abortion.
On June 20, 2013, I continued the approach by organizing a district-level meeting to plan the development of network partners by integrating and strengthening local organizations in adolescent and youth health work, including health service facilities, educational institutions, families, communities, and local government organizations. It was an exchange of learning to stimulate and push teenagers to have appropriate reproductive health behaviors. We developed a proactive working model with integrated network partners to create knowledge, understanding, attitudes, and life skills for teenagers according to the curriculum and learning process through experience, such as training teachers to use a comprehensive sex education curriculum, conducting workshops on communication between parents and children to promote sexual health in youth. There are counseling services outside office hours 24/7 via Hot line–Phone in counseling, Facebook: Huai Rat Adolescent Clinic, and Line. The clinic provides ONE STOP SERVICE to ensure teenagers can access and use reproductive health services comprehensively and according to their needs, in line with the problems of teenagers, easily, quickly, privately, warmly, and safely. We coordinate care and assistance in cases of unplanned pregnancies through a network of volunteer doctors for Safe abortion, safe termination of pregnancy, both within and outside Nakhon Chai Burin area.
The results of operations in 2014 showed that the rate of access and use of health and reproductive health services at the adolescent clinic increased nearly fourfold, from 108 cases in 2013 to 401 cases in 2014. The number of consultations for unplanned pregnancy issues increased tenfold, from 18 cases in 2013 to 190 cases in 2014. After counseling, over 90% of service recipients decided to terminate the pregnancy, with 69% being teenagers and youth. Of these, 59% were service recipients under 20 years old, with 95% being residents of Nakhon Chai Burin area, and 60% being residents of Buriram Province, of which 69% came from other districts outside Huai Rat. After terminating the pregnancy, 40% of service recipients chose to use contraceptive implants, 33% did not use contraception due to separation, and another 27% chose other contraceptive methods.
Following up on the pregnancy rate of teenagers under 20 years old in Huai Rat District shows a decreasing trend, but repeat pregnancies are on the rise. The birth rate by mothers aged 15-19 per 1,000 female population aged 15-19 shows a decreasing trend, from 54.75 in 2013 to 39.97 in 2014.
I don’t know about the life of a nurse. Some have morning shifts followed by afternoon shifts, some have afternoon shifts followed by night shifts. Personally, I don’t have any shifts… I just know that I have to answer calls and provide information and counseling every time… she calls. There were 100 more consultations on unplanned pregnancies in the first four months of 2015. I feel exhausted at times due to the surrounding obstacles, from patients, from society, and my own health issues, along with the guilt that still arises within me…
Fortunately, there is a group of volunteers working together to solve the big and complex problems without personal gain. The doers may be criticized by those who disagree, except perhaps by patients and relatives who praise them. Therefore, a strong network must be built to encourage each other both locally and broadly, promoting the presence of alternative counseling personnel in every hospital. There should be at least four facilities in the province that can provide Safe Abortion services, safe termination of pregnancy, along with providing semi-permanent contraceptive services, such as contraceptive implants, to prevent repeat pregnancies.
Implementing the sex education curriculum in educational institutions is still a challenge. It requires clear policy support from central government agencies and cooperation from educational institutions to increase youth knowledge and life skills, leading to a reduction in Teen Moms and a quality population in the future.
Anyone??… Please help cure the “unplanned pregnancy disease” at… TEEN UP CARE….
Story by Khun Wijitra Waliprakon
Professional Nurse, Huai Rat Hospital, Buriram Province