Malaysia Teenage Pregnancy Situation

Teenage Pregnancy in Malaysia

Teenage Pregnancy Situation in Malaysia

By eHomemakers, February 2020

Global Situation

According to the World Health Organization (WHO), approximately 12 million girls aged 15 to 19 and at least 770,000 girls give birth each year in developing countries. Of the estimated 5.6 million abortions that occur each year among adolescent girls aged 15–19 years, 3.9 million are unsafe, contributing to maternal mortality, morbidity and chronic health problems. Adolescent women (ages 10 – 19 years) face a higher risk of eclampsia, puerperal endometritis, and systemic infections than women aged 20 to 24 years, and babies of adolescent mothers face higher risks of low birth weight, preterm delivery and severe neonatal conditions.

The Situation in Malaysia

In Malaysia, teenage births hit an all-time high of 18,000 in 2012 to the latest of 7,700 in 2018. Out of this number, 25% or about 4,500 cases involved pregnancy out of wedlock. Around 14 in every 1,000 underage girls in Malaysia get pregnant every year, which adds up to an average of 18,000 girls per year. The cases reported were mostly that of girls from low-income families, unmarried girls, and school drop-outs. Malaysia is ranked 8th among the ASEAN countries in terms of teenage pregnancies with roughly 11.5 pregnancies recorded for every 1000 teenagers aged 15 – 19 years.

Sex among teens is on the rise with a national survey in 2017 showing that 7.3% of teenagers aged between 13 and 17 are sexually active, this trend is an increase of 5% compared to that of 2014 (2.3%).

On average, 1,500 young girls get pregnant each month or 50 a day nationwide, and medical attention is sought mostly at government clinics. Studies have shown that many teenagers below 16 become pregnant as a result of premarital consensual sexual activity.  

UMSC obstetrician and gynaecologist, Dr Aizura Syafinaz Ahmad, an expert from the UM Specialist Centre (UMSC), believes that teenage pregnancy is on the rise. “These numbers could be the tip of the iceberg as many cases are likely unreported.”

Malaysia does not have data on teenage abortions or miscarriages. This means that the situation is likely worse than what the available data shows as teenage pregnancies are a summation of teenage births, abortions and miscarriages.

The Situation in Interior Sarawak

When native girls in rural, secluded villages have to move to towns to take up upper primary and secondary school education at age 10 onwards, they are unprepared for the lure of urban life, economy and sexual grooming by men, who exploit their need for money.

Sarawak has the highest percentage of teenage pregnancies in Malaysia. 

Although the highest number of teenage pregnancies are from Sabah, Sarawak has the highest percentage of teenage pregnancies.

Information Gaps

Surveys on Malaysian adolescent knowledge of reproductive health consistently shows barely adequate levels of knowledge. According to a 2015 survey backed by the Health Ministry, 35% of Malaysian female youths believed that having sex for the first time will not lead to pregnancy, and one in five Malaysians believed that sexually transmitted infections (STIs) could be transmitted by mosquitoes – which is an alarming interpretation. Additionally, the number of teenagers (ages 13 – 17 years) involved in sexual activities has risen dramatically from 2.3% in 2014 to 7.3% in 2017.

Parents were to blame for not filling the gaps in their children’s understanding of the birds and the bees, noting that this was often due to cultural taboos and upbringing.

The Consequences in Malaysia

  • Some girls never visit a clinic, naively denying the possibility of pregnancy, and end up dumping their babies after giving birth to them. Baby dumping statistics recorded by the Malaysian police average about one baby dumped every three days for the last decade.
  • Others try online abortion pills or those from illegal sources bought by their boyfriends or themselves. Some visit clinics for abortions, while others have no choice but to carry on with their pregnancy in secret and in shame, with or without family support. Some actually go online to find people who will adopt their babies.
  • Most have to stop schooling, inevitably affecting their future socio-economic prospects.
  • Adolescent mothers are significantly more likely to suffer complications during pregnancy and childbirth. With little or no prenatal care, the girl is more likely to develop pre-eclampsia – a severe condition associated with high blood pressure, and other maternal diseases.
  • Social acceptance of teenage pregnancy is still poor, restricted and secluded. It is also regarded as a taboo in the society, as premarital sex, incest, rape, sexual abuse and teen marriage come as a precursor.
  • Most teen pregnancy cases in Malaysia involve girls in the urban areas, that is the lower socio-economic income group (comprising single mothers with children, as well as parents who work double shifts or have two jobs and leave their children unsupervised at home). These young girls lack attention and are left alone with a lot of free time on their hands. Lacking proper sexual education, these girls are subject to unsafe sex which usually leads to pregnancy. In the Sarawak teens’ situation, they leave their villages at age 10 to 13 to attend upper primary or lower secondary or upper secondary schools in towns and cities as the schooling opportunity is limited in their remote villages. These teens are unprepared for urban life with a cash economy and materialism. They are also exposed to men who may want to take advantage of them in many ways.
  • More often than not, unwanted pregnancies are not accepted by the girl’s parents hence the practice of dumping or abandoning new-born infants. Data shows that an average of 100 babies are dumped nationwide in Malaysia every year – which is roughly one baby dumping every three days.

The Solutions

Strong evidence globally shows that education on health and contraception significantly reduces the incidence of adolescent unintended pregnancies.

The UNESCO curriculum on Comprehensive Sexuality Education (CSE) is a global model of a curriculum that is effective. The important tenets of its core teachings are based on its cultural relevance, appropriate context, gender equality and human rights. The results of such teaching have clearly shown that it delays the initiation of sexual activity and decreases risky sexual behavior as well as adolescent unintended pregnancies. The CSE hasn’t been attempted fully in Malaysia due to cultural taboos and religious resistance.

To date, different groups of people want different solutions to the same problem:

  • Some insist on more religious teaching to girls, others impose ultra-strict supervision in religious centers or boarding schools including limiting internet access or imposing a curfew.
  • Others recommend that we completely ignore conversations about sex as it will encourage teenagers to have more sex!

A Case for Sex Education

Health professionals with experience of providing care and counselling for pregnant teenagers such as medical experts have greater in-depth knowledge first-hand of what is needed; thus, their feedback should be the basis on which we propose solutions rather than solutions from policies makers have little ideas about the situations on the ground. They recommend that we should follow facts and proven evidence on what works and what doesn’t. They point out these facts:

  • Research evidence shows that comprehensive sexual education is a more effective method than abstinence-only methods when it comes to preventing teenage pregnancies.
  • Sex education doesn’t lead to an increase in sexual activities but, in fact, delays sexual initiation and decreases risky behavior. Spread awareness about sex and save teenagers from unplanned pregnancies.
  • It’s a well-researched fact that for teenagers who are already sexually active, allowing them to be informed about the use of contraceptives and providing them with access to contraceptives decrease teenage pregnancies.
  • Sex education should start at home. If the family is united and open to discussing any issues faced by the persons in the household, it will be easier to discuss sex education and pregnancy. If a teenager does get pregnant, the parents need to acknowledge that this is a problem, and they need to deal with the matter in the best possible manner. A better approach to get the teens’ cooperation is not to be punitive, but to be supportive. 
  • There is a need for a review in sex education in secondary schools, which only emphasises on the basic biology of the human body’s reproductive system.

The approach to sex education is too academic and still indirect as most people shy away from discussing the topic of ‘sexuality’. Schools are teaching the usage of intrauterine contraceptive device (IUCD) at Form 1 level. IUCD is taught to medical students in local medical schools.

“When statistics showed that teenage pregnancy was higher within 15-year olds, we simply decided to educate students earlier, in Form 1 at 13 years of age. How is this thoroughly thought? Schools don’t teach about the sex act per se and highlighting the pros and cons. The eventuality of not knowing the consequences of having unsafe sex deceives the girl into pregnancy, and enduring the problems thereafter,” UM Specialist Centre (UMSC) psychiatrist, Dr Aida Syarinaz Ahmad Adlan affirms.

Actions Taken by Government

While the information on teenage pregnancy has been available on the Ministry of Health’s myHEALTH portal since 2012, it only saw 34 visitors as at end-of 2018, reflecting the poor outreach among youths.

Primary 6 students study basic information in health science subject about safe and unsafe touch while Form 1, Form 2 students study basic science about reproduction and sexual organs. The subject is skimped past quickly by teachers who are unused to talking about sexual subjects.

As of 2018, the Government was no longer in denial as to what truly worked to prevent teenage pregnancies. The Ministry of Women, Family and Community upped its efforts to reduce child sexual abuse in Malaysia through more awareness activities. On June 24, 2019, Deputy Prime Minister, Dr Wan Azizah Wan Ismail, who is also the Minister, launched five videos on sex education for children via the YouTube platform.

The series of one-minute videos in Bahasa Malaysia, produced by the Ministry in collaboration with the NGO, Malaysians Against Pornography, was initially targeted to draw 150,000 views among children this year. By October 2019, the five videos were viewed 2.79 million times (Ministry of Women, Family and Community Development 2019).

The Health Ministry has implemented the ‘Generasiku Sayang’ programme that is aimed at increasing public awareness of the importance of efforts to prevent teen pregnancy.

Under the programme, the Ministry has set up care centres to provide protection to teen girls or women who get pregnant out of wedlock, as well as their babies. Such centres have already been set up in all the states except Kuala Lumpur, Labuan and Pahang. The Terengganu Health Department, for example, opened the state’s first ‘Rumah Generasiku Sayang’ in October 2018 to house teenagers who become pregnant out of wedlock. 

Moving Forward

UM Specialist Centre (UMSC) experts have recommended that a think-tank working group, drawing the expertise of doctors, parent-teacher associations, teenagers, social workers and various religious groups, be established to put a workable firm system in place to deal with the issue. This outreach team should be able to break through religious and cultural barriers to tackle the underlying problems. The activities must be pragmatic, open-minded, forthcoming and non-judgemental in order that all parties — teens, parents, religions authorities, schools, health care professionals – can work together to reduce teen pregnancy and out of wedlock births.

Any outreach activities should work with the relevant public authorities to establish realistic hands-on programmes and activities to educate teens on the consequences of births outside marriage. The think-tank group should collaborate with ministries such as the Education Ministry and the Women, Family and Community Development Ministry to seek practical solutions to reduce teenage pregnancy, if not eradicate it.

Significant awareness campaigns will also be required to involve youth leaders who could work together with the community in realising the think-tank’s objective.

In conclusion, it is not enough for schools and government agencies to intervene with activities to prevent teenage pregnancies, it is also crucial that the whole Malaysian society provides a supportive and understanding environment whereby proper parental supervision and a safe environment at home to nurture the girls’ transition into adulthood.

Although the government is taking more concrete actions to tackle teen pregnancy problem, there are still many more steps and strategies to be implemented, such as training of healthcare professionals, more effective school-based teaching, community engagements, legal amendments to adolescent access to services, birth control, and parental education. Each one should impact its own effectiveness with clear evidence for scaling-up.

eHomemakers wants to support our government’s efforts to ensure that no one, especially those in the digital divide areas, is left behind.  

Research has shown that imparting sex education through SMS brings awareness to youths in African American youths in 2006 (before WhatsApp and internet was more common among African Americans). A similar system in Kenya shows the same results. From this, we can deduce that using ECHO to send SMS lessons will work just as effectively in rainforest areas where internet is practically non-existent or unstable.

Bibliography

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