Indigenous teenagers are the most affected by pregnancy before reaching the age of majority and those who have less access to prenatal care, shows a survey released this week by the Oswaldo Cruz Foundation (Fiocruz). Among babies born to Indigenous women from 2008 to 2019, nearly 30% had Indigenous youth ages 10 to 19 as mothers. The study was carried out in partnership between the Institute of Collective Health of the Federal University of Bahia (UFBA), the Center for the Integration of Data and Knowledge for Health (Cidacs/Fiocruz Bahia) and the United Nations Population Fund (UNFPA). Data from the Information System on Live Births (Sinasc) and the Information System on Notifiable Diseases (Sinan-Datasus) of the Ministry of Health are used. The number of babies born to teenage mothers between 2008 and 2019 reaches 6,118,205, and in 95.14% of cases, mothers were between 15 and 19 years old. The youngest age group, from 10 to 14 years old, corresponds to less than 5% of pregnancies, but is highlighted in the survey for “strong evidence of pregnancy related to situations of sexual violence”, according to Fiocruz. According to the survey, these teenagers had 296,000 babies in the period. Indigenous mothers The research resulted in a booklet, released in February, which contains details of the years studied by the scientists. According to the study, the percentage of live births to teenage mothers aged 15 to 19 dropped from 2008 to 2019 among all races, but remained stable above 25% among indigenous teenagers. This means that, for every four indigenous babies, one had a mother in this age group. Among brown women, there was a decrease from 22.76% to 16.77%; among black women, from 18.81% to 13.19%; and, among white women, from 16.26% to 9.18%. In the youngest age group, from 10 to 14 years old, the rate among indigenous women started the research period at 3.46% and, 11 years later, it dropped a little, to 3.27%, while all other race groups are below 1%. In the case of white girls, the percentage is 0.34%. “Without going into the merits of discussions on cultural relativism, it is necessary to observe that the perspective of teenage pregnancy among indigenous peoples faces the challenge of ethnic-cultural discussion, on the very concept of girls, adolescents and women, as well as the process of transition between these phases”, indicates the study. “That said, it is necessary to seek greater detail of information in the process of building evidence and elaborating public policies focused on indigenous peoples. Respect for autonomy, non-violence and the right of decision of girls is a fundamental principle in access and fruition of reproductive rights”. The frequency of maternity in adolescence is also higher in the North and Northeast. About 24% of live births in the North during the period surveyed are young people aged 15 to 19, while in the Northeast the percentage reaches 20%. In the Midwest, they are 17%; in the South, 15%; and in the Southeast, 14.5%. Mothers aged 10 to 14 from the North had 1.54% of babies born in the region in that period, while for those from the Southeast, the percentage was 0.59%. No prenatal care Access to consultations during pregnancy also has racial inequalities pointed out by the survey. Among indigenous adolescents who had babies between the ages of 10 and 14, 10% had no prenatal consultations. Among black and brown girls of the same age, 3.6% and 3.3%, respectively, were not followed up. Among white women, lack of access was reported by 1.9%. In the group of indigenous mothers aged 15 to 19 years, only 26.6% of the adolescents had access to at least seven prenatal consultations, a percentage that reaches 64.3% in the case of white adolescents who were mothers in the same age group. The survey explains that quality prenatal care, with an adequate number of consultations, is a factor in promoting safe and healthy births and reducing cases of maternal deaths. The text adds that “adolescents often take longer to have the first prenatal consultation and may have fewer consultations throughout the pregnancy”. The reasons for this may be related to the greater difficulty in identifying, emotionally and socially processing the pregnancy and the difficulty in accessing the service. The researchers point out that there may also be influence of stigmas in relation to motherhood in adolescence and lack of acceptance. Child marriages In the period analyzed by the researchers, of all teenage mothers, 29.2% experienced some type of marital relationship, be it marriage or consensual union. This rate was higher among young indigenous people, reaching 42% among mothers aged 15 to 19 years, and 31% in the case of those aged 10 to 14 when they had children. The United Nations Convention on the Rights of the Child (CRC) considers child marriage to be a union involving at least one spouse under the age of 18. The study explains that these early unions threaten the lives and health of girls, limiting their future prospects and causing pregnancies while they are still teenagers. This increases the risk of complications in pregnancy or childbirth and mortality in this age group. “Evidence shows that early marriages in Latin America are mostly informal and consensual, often involving adult men and girls in childhood and adolescence. In the region, Brazil stands out for its high ranking in absolute numbers”, says the primer. “Although Law 13.811/2019 (which amended the Brazilian Civil Code) expressly prohibits the marriage of adolescents under the age of 16, the practice still remains relatively frequent, for several structural reasons, including persistent poverty and gender, race and gender inequalities. /color and ethnicity. Although both boys and girls experience early unions, girls are significantly more affected by this practice”. A total of 69,418 consultations at health services resulting from sexual violence against girls and adolescents were registered in the country, according to data from 2015 to 2019, collected by the survey on Sinan. Girls aged 10 to 14 years were the main victims (66.92%) of these cases. Black adolescents (black and brown) were the ones who suffered the most sexual violence, with 64.18% of the total number of cases, according to the study. Of every 10 cases, six occurred at the victims’ homes (63%).
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