Reproductive health of adolescents in Bangladesh.

ABSTRACT

PIP: The health and social effects of pregnancy in married women 13-23 years of age were studied among a population of 175,000 in rural Bangladesh. Data collected by a structured questionnaire identified pregnant women who were followed twice during pregnancy postpartum. Maternal mortality for the 13-17 age group was 5.8/1000 compared to 1.8/1000 for the 18-23 year olds. Major causes of death in the younger group were obstructed labor and toxemia. The neonatal death rate was 80/1000 for the younger group and 43/1000 for the older group. The major cause of death of infants born to the younger mothers was birth injury. In infants born to older mothers, it was tetanus. Perinatal death rate was 66.4/1000. All deliveries occurred at home, and 89% of births were attended by relatives, neighbors or an untrained birth attendant. Only 13% of the women had ever used contraceptives. Use varied from 2.9% at 16 years to 24.7% at 23 years. Improvements in the quality of services at welfare centers and health complexes and inclusion of traditional birth attendants after adequate training could help in reducing infant and maternal mortality. Improvement could also occur via trained female fieldworkers. An educational program on the importance of antenatal care, child care and identification and referral of high risk groups is urgently needed. An educational program on the use of contraceptives will also increase contraceptive practice by married teenagers, leading to better reproductive health and lower pregnancy wastage. Furthermore, a broad community approach to inform and educate husbands and mothers-in-law about the importance of antenatal and natal care in reducing risks to mothers and their infants is also needed.