I am 16. Are there contraceptives for me?
Contraceptives | A girl who becomes pregnant at a tender age is often faced with damaging consequences. These could be physical, social or economic for both her and her partner.
Meanwhile young people avoid using contraceptives or discontinue using them either because they have been misinformed about contraceptive methods or because they are worried by the side effects.
At age 14, Gabriel does not believe that using condoms can actually prevent unwanted pregnancies. He said he has heard from peers that condoms can slide off or burst during sexual intercourse and so they are not reliable. Gabriel says that “if I change my mind one day and would want to use a condom, I would prefer to obtain information from qualified health personnel.
Two adolescent girls, 13-year-old Dorcas and Akua, 16, have very limited no knowledge about contraceptives. “I have heard of condoms on the television but I have very little knowledge about other contraceptives,” said Akua. Both of them indicated that they had no use for contraceptives and have such not bothered about their usage.
Another 16-year-old adolescent, Joyce, thinks she has some substantial knowledge contraceptives. Though sexually active, she has not used a contraceptive. According to her, contraceptives are only sold to people above 18. She has heard a lot of the side effects of contraceptive usage and would not want to use it.
She said, “for now I do not have any need for contraceptives although I don’t want to get pregnant”. She indicated that she would want to get advice from a healthcare facility before using any contraceptive. But a Reproductive Health Specialist of the United Nations Population Fund (UNFPA), Dr Robert Mensah, says that contraceptives can be used by all regardless of age.
Contraceptives | Eligibility Criterion
However, for teenagers, there is an eligibility criterion that can be used to determine which contraceptive would be appropriate for the user at a particular time. He explained in an interview that under this criterion, a group of people would not need any restriction for the use of some contraceptives while others would have a condition where the advantages of using a particular method would generally outweigh the proven risks. Meanwhile, some people would also present an unacceptable health risk if the contraceptive method is used.
This Dr. Mensah noted would mean that any teenager who wishes to go on any contraceptive use for the first time must go to a nearest health care provider for proper counselling before commencement.
Contraceptives | Counseling
Dr. Mensah noted that most contraceptives can be obtained from most pharmacy shops (over the counter) but there is the need to first get proper counselling from a health care provider before commencement.
Proper counselling and clinical examination, he explained, would guarantee the user the correct contraceptive and avoid possible side effects or reactions from compounding into other more dangerous health conditions later in life adding that your eligibility can only be known through counselling.
“No matter the kind of health condition anyone has, there is an available contraceptive for them,” Dr. Mensah pointed out, stressing on the need for proper investigations before usage.
He noted that a young girl at 16 can procure a pill over the counter for use but a first time user might not get the counselling needed and explained that infections and other health conditions, for instance, must be treated before a particular contraceptive such as intrauterine device can be used.
Dr Mensah added that a contraceptive like the IUD must be used with caution in a young person’s since it can attract a lot of infection in case the person has unprotected sex with multiple sex partners.
Environment for counselling
Most health facilities in the country have youth-friendly centres where young people can access contraceptive services.
Dr. Mensah said 80 per cent the Ghana Health Service facilities have such centres. In such facilities there are people trained to handle the youth to help them settle comfortably.
These facilities are often separated from the main family planning units and the health workers who work there are orientated because of the orientated to be able to attend to young people who need help with contraceptive usage.
Dr Mensah noted that for young people to feel at ease, most facilities without a young centre can come up with different days and time for young people to avoid lumping them up with adults. He advised that other youth-friendly initiatives could be introduced to encourage the youth to seek counselling when necessary.
According to Dr Mensah counselling, a young person must be done by a midwife who is reliable, uphold confidentiality (trust) and can guarantee privacy. These things he stressed are very important for the adolescent.
Can a teenager start Contraceptive use before menarche?
Dr Mensah explained that contraceptive use can start before menarche if the person in question is sexually active. He was of the view that young girls can get pregnant without seeing their first menstruation. This he explained would be due to the fact that the adolescent was sexually active thereby making the release of her first-ever eggs coincide with the presence of a live sperm resulting in pregnancy. Due to this if the adolescent start contraceptive use early unwanted pregnancy could be prevented.
Emergency Contraceptive Pills
Dr Mensah expressed concern about the abuse of emergency contraceptive pills. Emergency contraceptive pills (ECPs) can be used to prevent pregnancy after unprotected intercourse or when regular contraceptive methods fail. Although ECPs generally are not prescribed if more than 72 hours have elapsed since unprotected intercourse, recent studies have shown that at least the progestin-only method may decrease the risk of pregnancy if taken up to five days after unprotected intercourse.
Dr Mensah emphasised that because adolescent sexual activity is often sporadic and unplanned, increased knowledge and availability of ECPs may help reduce the number of unwanted teen pregnancies. It is therefore important for teenagers who realise the need to be on contraceptives to go to a health facility nearer for proper counselling before commencement.
By Nàa Korkoi Essah
The writer is a staff of the Information Services Department, Ghana