Sweet Sexteen

More and more teenage girls in urban India are experimenting with sex — and getting pregnant as a result.

A chance encounter with a group of school girls in Dalhousie left Satish Kaushik in no doubt that his film would touch a hot button issue.

The Bollywood director had decided to make a movie on teenage pregnancy after reading many studies and articles on the subject, all of which suggested that teenage girls in urban India were getting pregnant like never before. So he scripted a story about the dilemmas of a 15-year-old school girl getting pregnant and set the cameras rolling. He was shooting in Dalhousie last summer when a group of Delhi school girls stopped to watch the shoot. Kaushik got talking to them. “Each one had a story to tell — either about a friend or about themselves getting pregnant by mistake and then going for a secret abortion. I was stunned at the magnitude of the problem,” he says. Kaushik’s film, Tere Sang, will be released in May this year.

Kaushik’s film is clearly very topical. Urban Indian adolescents are far more sexually active than they used to be. And gynecologists say that a growing number of teenage girls are getting pregnant as a result. “There is a huge problem of pregnancies among urban girls in their late teens. Although most girls opt for an abortion, it can sometimes leave permanent physical damage,” says Anita Soni, consultant gynecologist, L.H. Hiranandani Hospital, Mumbai.

According to a study conducted by the Centre for Voting Opinion & Trends in Election Research in September 2007, every third teenager in India today is not a virgin. Of the 1,004 teenagers from 10 cities who participated in the survey, 22 per cent claimed to have ‘done it’ by Class XII.

Soni says about five teenage girls approach her for an abortion every month. “Three years back, I didn’t see a single such case,” she adds.

Arati Basu Sengupta, a gynecologist based in south Calcutta, says 10 per cent of her total patients are pregnant teenagers. Ignorance about contraception, she says, is a major cause of teenage pregnancy. “Although teenagers have become sexually promiscuous, their awareness of contraceptives remains low,” says Sengupta.

Ignorance about contraception sometimes takes a dangerous turn. Dr Vidyamani Lingegowda, head gynecologist at Bangalore’s Lalbagh Nursing Home, says she gets three to four teenage girls every month who come to her after botched abortions. “Young girls tell me that they use the I-pill — an emergency contraceptive — five times a month. That’s dangerous,” says Lingegowda.

Recently, an 18-year-old college girl approached Lingegowda with severe pain in her abdomen. On examination, the doctor found that she had developed a pregnancy in her fallopian tubes. “To top it, the girl had had emergency contraceptives four times since then. This further messed up her case. Her tubes had to be removed through surgery,” says Lingegowda.

Twenty years ago, gynecologist Ashwini Bhalerao-Gandhi conducted a study on the physical effects of pregnancy on 200 teenage girls admitted at Mumbai’s Nowrosjee Wadia Maternity Hospital. Of these 200 girls, only six were unmarried. Today, as a practicing gynecologist at Mumbai’s P.D. Hinduja Hospital, Gandhi sees five to six cases of teenage pregnancy every month. “All the girls are unmarried and most have had multiple sexual encounters. They treat a pregnancy as a minor problem that can be terminated by a day visit to the doctor,” says Gandhi.

“It’s important for teenagers to look sexually active in the eyes of their peers. No one wants to be a virgin,” says Sangeeta Saksena, head of a Bangalore-based NGO, Enfold, which conducts sex education classes in four schools in the city.

Saksena was recently conducting a class for standard XI and XII students at a private Bangalore school. She had prepared to talk to the adolescents about abstaining from early sex and the fear of sexually transmitted diseases. “Instead, I was swamped with questions on contraception and how to avoid getting pregnant. It was obvious that sexual promiscuity was high among these school children,” recalls Saksena.

The low use of contraception also leads to pregnancies. “Most teenagers don’t have a regular sex life. They have flings. So they don’t use regular contraception,” says Kamini Rao, chairman, International Body of Obstetrics and Gynecology (IBOG).

A study conducted by a Mumbai-based maternity clinic, Gynaecworld, on 500 college students in the age group of 16-19 years in the city found that 80 per cent girls used no contraceptive while having sex. “They said their sexual encounters were always sudden,” says Duru Shah, medical director, Gynaecworld.

A growing generation gap also means that teenagers often have to bank on unreliable sources like peers and the Internet to learn about contraception, adds Shah. Anjali Kumar, consultant gynecologist at Gurgaon’s Paras Hospital, recalls a recent incident of a Class XII girl who approached her to abort her eight-week-old foetus. “As it was too late to conduct an abortion with pills, I told the girl that she would need adult consent for a surgical abortion. But she was quite clear that her mother would be the last person she would confide in,” says Kumar.

Non governmental organizations are now stepping up efforts to provide sex education to adolescents. The Mumbai-based Federation of Obstetric and Gynecological Societies of India (FOGSI) devoted 2006 to working with young people. “We held sex workshops for students in 100 cities across India,” says Duru Shah, former president, FOGSI. Shah says she found very poor knowledge of contraception among teenage girls. “They only know about condoms, for which they are dependent on boys. They don’t use the pill because of various negative myths about it,” she says.

FOGSI is also trying to liaise with the central government to set up youth-friendly health clinics at all medical colleges in the country. Three such clinics have already been set up at Mumbai’s Dharavi, Bandra Kurla complex and at Welingkar College.

But for now, the chilling findings of an Indian Council of Medical Research study still hold true — 17 per cent of the 1.4 million teenage abortions that take place in the developing countries of the world every year happen in India.