Monday 21 June 2021

Nicaragua’s Teen Pregnancy Epidemic

Imagine you’re a 15-year-old girl. One day, you’re hanging out at home when an older man comes by. He tells your parents he’s a researcher who wants to learn more about teenage girls. He wants to know if he can talk with you for a while and take notes on your answers. Sure, you say, you’ll help out, for science. So you sit down with this researcher, and he starts asking you questions: Have you ever had sex? Who with? Do you regret it? What kind of contraception do you use? Have you ever seen a condom?

How candid would you be, really?

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Nicaragua has the highest teen pregnancy rate in Latin America, with more than a quarter of women giving birth before they turn 18, according to the United Nations Population Fund. For years, people have been trying to figure out why, exactly, teen pregnancy is such a problem there, but until recently, all of the research into the issue was done in settings like that one. Older researchers, often foreigners, usually older people, asking questions of young Nicaraguan girls. The body of scientific research—and the world’s understanding of the issue—reflected the awkwardness of that situation.

“People would say the girls don’t think that getting pregnant young is a problem, that they don’t have access to sex education, they don’t really know what a penis is, where it goes in, that they don’t know about birth control or that they think their religion prohibits them from using contraceptives,” says Cristina Parajon, a Harvard undergraduate who grew up in Nicaragua. “But this narrative that was building just didn’t feel accurate to me. It didn’t represent me as a Nicaraguan girl, or my friends as Nicaraguan girls.”

Nicaraguan society suffers from the ‘Virgin Mary Syndrome. Although having a child at 19 carries no stigma here, early teen pregnancies do. When girls who are 12, 13, or 14 years old are pregnant, they hide it. Sometimes they wrap bandages around their waists for months to disguise their bellies.

When Parajon was growing up in Nicaragua, she was surrounded by teen pregnancy. The hallways of her high school were always filled with whispers about who was having a baby. A girl in her church choir got pregnant and was forced to drop out of the choir, even though a boy who had fathered a child was allowed to stay. In 11th grade, she interned for an OBGYN and got to help deliver a baby; she was shocked to learn that she and the mother were the same age.

It was also during this time that Parajon started working with a sex-ed program, and talking to girls explicitly about contraception and pregnancy. And that’s when she noticed the divide between why Nicaraguan girls say they get pregnant as teens and why everyone else says Nicaraguan girls get pregnant as teens.

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When she was a sophomore at Harvard, Parajon set out to study teen pregnancy in Nicaragua for herself. She designed a study, got it approved by the Harvard University Ethics Review Board, and worked with a community health worker to find a sampling of girls between 14 and 19 in her community. When she went home for summer break, she started walking up to their doors and asking them to answer a few questions.

But unlike in the example at the top of the story, the girls weren’t expected to answer a long list of personal questions for an older adult. These interviews were more like informal conversations, one Nicaraguan teen to another. “Girls have told me things that I really doubt they would have told any other person,” Parajon says.

And the things they told her flew in the face of the conventional wisdom about teen pregnancy in Nicaragua.

Teen pregnancy in Nicaragua is mostly caused by machismo culture and a lack of sex ed.

Do girls get pregnant because they think it’s a good idea? Not at all. The girls Parajon interviewed definitely did not want to have babies while they were still teens. Even if they came from low-income homes, they were ambitious. They wanted to complete their educations and get stable jobs.

Is it because they think their religion forbids contraception? Nope. While most of the girls Parajon interviewed said they believe in god, only 40 percent of them attend church regularly, and most said they thought god would understand if they used contraception to avoid teen pregnancy.

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Is it that they just don’t know about contraception? Definitely not—85 percent of the girls Parajon talked to knew about at least three different kinds of contraception, and three quarters knew where that they could get it from a nearby pharmacy, or even go to a local clinic to get it for free.

So why do so many teens get pregnant in Nicaragua?

Parajon’s theory, after spending dozens of hours talking to teen girls: Chisme. Gossip.

“Nicaraguans love chisme,” she says. “I love chisme. Loving to gossip is probably pretty universal, but in Nicaragua and Latin America it’s especially pronounced.” The community where Parajon did her research, Nejapa, might even be especially gossipy—legend has it that it began when one family settled on a plot of land decades ago. So, even now, most people there are distantly related.

The girls that Parajon interviewed said they don’t use contraception because they don’t want everyone to know they’re having sex, which makes sense in culture like Nicaragua’s, where they have especially traditional ideas about girls and chastity. They’re afraid that someone will see them getting birth control at the pharmacy or the clinic, and spread the word—and they might be right about that. Parajon heard horror stories about rude pharmacists, or quiet waiting rooms where everyone could hear a girl telling the receptionist she had come for birth control.

  • Among Nicaraguan women 20-24 years old…almost half had had a child before their 20th birthday.
  • A quarter of all births in Nicaragua are to 15-19 year olds.
  • The proportion of 20-24 year olds who had a child during adolescence is more than twice as high among the poorest as among those in the highest socioeconomic category.
  • Nearly half of births to adolescent women i Nicaragua were unplanned.

“I really don’t think the contraceptives are the root problem, I think it’s the gossip,” Parajon says. “If people didn’t gossip, the girls wouldn’t have any problem getting contraceptives and using them.”

But the good news is that there are small fixes that can help girls feel more comfortable getting contraception—like changing procedures at the health clinic so patients can request contraception in the privacy of an exam room, instead of out in the waiting room in front of a dozen other people. In fact, Parajon has already shared her research with the community clinic, and they did just that. They also took steps to make the patient rooms more private.

This summer, Parajon is back in Nicaragua, talking to even more girls. When she finishes this round of research, she plans to present the results to the ministry of health, so that clinics around the country can take similar steps to improver their services. Parajon probably won’t be able to put an end to gossip in Nicaragua, but she might just help end to teen pregnancy there.

Article originally appeared on Today Nicaragua and is republished here with permission.

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We strive for accuracy in its reports. But if you see something that doesn’t look right, send us an email. The Q reviews and updates its content regularly to ensure it’s accuracy.

Q24N is an aggregator of news for Latin America. Reports from Mexico to the tip of Chile and Caribbean are sourced for our readers to find all their Latin America news in one place.

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Article originally appeared on Today Nicaragua and is republished here with permission.

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