Maternity In Adolescence

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Maternity in adolescence

Adolescence is defined as the period between 10 and 19 years of age, is a stage characterized by accelerated body growth, the appearance and development of secondary sexual characteristics, in addition to the consolidation of psychosocial identity.

The appearance of sexual desire can bring the initiation of sexual relations at an early age, this together with socio -economic factors and misinformation in the subject, it can lead to unwanted pregnancies at a young age.

Adolescent pregnancies are associated with high perinatal risks, such as low weight products, premature, malnourished and with cognitive development delay. Due to factors such as family rejection, in addition to emotional and biological immaturity, pregnant adolescents have high rates of school drop -up and drug addiction.

The teenage pregnancy responds to socio -economic factors such as poverty and low schooling;It has been found that 60% of teenage mothers only had basic education and 50% of them had deserted in their studies prior to getting pregnant.

The high risk involved in teenage pregnancy, calls effective strategies for prevention and attention, then the efforts made for this purpose by the federal government will be analyzed, during the administrations between 2006 and 2018.

JUSTIFICATION

The high risk involving a teenage pregnancy requires the implementation of strategies in the health system, designed to prevent it, in addition to serving pregnant adolescents and reducing the danger of developing perinatal pathologies. The nutritionist should be trained in the evaluation and nutrition.

Teenage prevention programs

The adolescent population of Mexico represents a heterogeneous social group characterized by special needs due to their rapid development and increase in the possibilities of getting involved in risk behaviors. The beginning of desire and sexual activity are factors in which they must be educated and guided by the family, educational institutions and the health system, in order to exercise a free and informed sexual life, preventing them from affecting problemsas sexually transmitted infections and unwanted pregnancies.

According to government data, 340 thousand births are recorded annually in women under 19, representing 77 births per thousand adolescents. According to data from the National Health and Nutrition Survey, the adolescent population that began their sex life went from 15% in 2006 to 23% in 2012. In response to this problem, in 2015 the Federal Government created the National Strategy for the Prevention of Pregnancy in Adolescents, which prospects eliminating births in girls from 10 to 14 years, in addition to reducing it to 50% in adolescents from 15 to 19years for 2030. This program observes five specific objectives:

1. Influence social determinants of health, improve academic achievements, promote positive youth development, reduce poverty and social disparities.
2. Improve the context to encourage healthy decisions, such as the legal framework.
3. Provide an integral education of sexuality.
4. Provide effective access to long -term contraceptive methods.
5. Provide effective clinical interventions.

In the state of Coahuila, it was detected that two out of 10 births are from mothers between 15 and 19 years, it was also observed that, by 2015, 31% of the population was a teenager. The state government set five purposes to reduce teenage pregnancy in the entity:

1. Contribute to the labor and educational development of adolescents.
2. Generate conditions for making free, responsible and informed decision making on the exercise of sexuality and prevention prevention.
3. Guarantee the right of adolescents to free and informed choice in the exercise of sexuality, in addition to access to contraceptives, including prolonged action.
4. Increase the quality of sexual and reproductive health services for adolescents.
5. Guarantee the right of girls, boys and adolescents to receive comprehensive sex education at all educational, public or private levels.

Relying on the ENAPAA, 17 actions for the execution of the program were defined.

1. Ensure that adolescents finish their compulsory education.
2. Generate job opportunities for adolescents, in a legal framework and according to their age.
3. Implement health and sexual rights communication campaigns, in addition to health services, gender perspective and interculturality adapted to their age, with scientific bases and under good praxis.
4. Approve federal and state criminal codes related to minor sexual violence, such as stupro, rapture, equated violation, forced marriages and violation of minors.
5. Strengthen preventive actions and attention to violence and sexual abuse to the child, with special attention in rural areas, marginalized and migrant population
6. Guarantee the provision of sexual and reproductive health services, eliminating bureaucratic barriers.
7. Strengthen adolescent’s ability and space to transform social and cultural regulations on their sexual and reproductive rights.
8. Finance projects that carry out science -based interventions to reduce adolescent pregnancy risk factors.
9. Finance research to generate effective models to generate favorable environments to prevent adolescent pregnancy.
10. Explore novel strategies of contraceptive distribution.
11. Strengthen the co -responsibility of the male in the exercise of sexuality and the use of contraceptive methods.
12. Improve and expand adolescent services, guaranteeing effective attention under WHO criteria.
13. Promote social marketing actions on sexual and reproductive health services, emphasizing social disadvantage groups.
14. Prevent subsequent pregnancies in teenage mothers.
15. Strengthen the inclusion of integral sexual education, HIV/AIDS prevention and reproductive health in educational programs.
16. Guarantee training and permanent training of teachers in the teaching of integral sexual education.
17. Link the community and school environment in the promotion of integral sexual education, with evidence -based interventions.

In other states, such as the State of Mexico, models such as comprehensive care for teenage mothers have been implemented, in which courses are offered in three phases:

1. Prenatal: Maternal care information, pregnancy, childbirth, puerperium, family planning, contraceptives, self – esteem and personal improvement.
2. Postnatal: Information on neonatal care, food, breastfeeding early stimulation, immunization, personal improvement and family planning.
3. Labor training: personal overcoming information and self – esteem, in addition to job training according to the economic activity of each region.

This program includes multidisciplinary attention in the area of Psychology, Medicine, Pediatrics, Nutrition, Gynecology, in addition to Legal and Labor Orientation.

Perinatal care programs

It is necessary to strengthen the quality of perinatal control, starting even before pregnancy. It is estimated that maternal death represents 60% of the causes of infant mortality, due to poor attention, and practices such as unnecessary caesarean sections, which until 2012 were at levels well above the standard. Other causes include prematurity, birth defects and infections, which happen more frequently in teenage pregnancies.

It is necessary to give greater importance to nutrition in perinatal care. It has been observed that most health careers do not include matters of nutrition or breastfeeding, there is a high correlation between exclusive breastfeeding and the reduction of child morbidity and mortality, the improvement of nutritional status and the decrease in the incidence ofmetabolic, digestive diseases and breast cancer. Unfortunately, in the six -year period from 2006 to 2012, exclusive breastfeeding decreased from 22.3% to 14.4% in the urban environment and 36.9% to 18.5% in the rural environment.

The two previous administrations made a series of efforts and took actions with the purpose of improving perinatal attention. In 2008, the strategy of identifying people willing to accompany the pregnant woman during prenatal control, childbirth and puerperium, in addition to being trained to perform effective accompaniment and manage some emergency situation.

In 2009, the General Collaboration Agreement was implemented, an alliance between the IMSS, ISSSTE and Ministry of Health, to increase collaboration between health agencies in order to attend obstetric emergencies, providing safe and quality services regardlessThe pregnant women have or not right-habit, by 2014 they had assigned to the program 414 hospital units. In 2011, a record to keep control of obstetric emergencies was implemented, in addition to the improvement of maternal deaths in the National Epidemiological Surveillance System, because many deaths were not identified or recorded as such by adeficient monitoring and registration.

Between 2005 and 2012, 2488 training courses in neonatal resuscitation were developed, in addition to increasing access to confirmatory and neonatal sieves between 2011 and 2012, a rise was observed in the detection of congenital hypothyroidism of 57.7 to 98% between 2000 and 2012.

During this period, Posadas of Attention to pregnant women (AME), lodging, food and child care spaces for women from dispersed or located more than two hours away from the health service were installed, in addition to the AME transport towards units of units ofHealth in case of obstetric emergencies. Additionally, the Hospital Amigo del Niño and the girl was resumed, which consisted of medical units with trained personnel in the promotion of breastfeeding, in addition to implementing human milk banks to guarantee food security and optimal nutrition of neonates.

In 2013, the Specific Action Program in Maternal and Perinatal Health (2013-2018) was established in the improvement of the following aspects:

Universal access to:

• Sexual and reproductive health information.
• Integral prenatal and prenatal care with emphasis on vulnerable groups.
• Counseling in contraceptive methods.
• Reorganization of the perinatal care model with intercultural approach.
• Creation of obstetric networks of attention to the puerperium.
• Access to obstetric emergency care from immediate response equipment.

Improvement of the quality of care

• Comprehensive prenatal control.
• Identification of risks and diseases in endemic areas.
• Gender perspective, interculturality and respect for human rights.
• Obstetric care at first -level risk, qualified in the second level and obstetric emergency.
• Necessary caesarean sections.

Qualified human resources

• Guarantee sufficient personnel capacity for gestational care 24/7.
• Personnel training and development in obstetrics, childbirth and obstetric and neonatal emergencies.
• Training of immediate response equipment in obstetric emergencies.

Infrastructure and supplies

• Remodeling of services.
• Provide team for integral gestational care.

Strategic information

• Harmonize information systems, registration and surveillance of maternal and perinatal.
• Integration of study committees, prevention and monitoring of maternal and perinatal morbidity and mortality.
• Monitor compliance with regulations and procedures.
• Impact research on the quality of care.

The objectives established in the program were:

1. Guarantee zero rejection in health sector institutions, regardless.
2. Awareness of health personnel before people, in treatment, provide necessary information and respecting human rights and intercultural deferences
3. Increase breastfeeding.
4. Increase the reduction of neonatal death.
5. Expand the distribution and application of neonatal sieve.

CONCLUSION

The federal government has strongly invested in the creation of programs for the improvement of the health system, focused on the prevention of unwanted pregnancies, pregnancies at an early age and the implementation of protocols for the optimal attention of pregnancies in high -risk populations,Like those pregnant women in marginalized areas, without right-right or those pregnant women still in development. It is vitally important.

BIBLIOGRAPHY

• Baron, j. G. P., Castellanos, p. M. J., Molina, j. J. P., Moore, e. G. P., Martínez, d. P., & Figueroa, N. A. Q. (2012). Pregnancy in adolescents and their perinatal maternal repercussions. Gynecology and Obstetrics of Mexico, 80 (11), 694-704.
• National Institute of Women (2019) National Strategy for Prevention of Pregnancy in Adolescents. (2015) Mexico City. Recovered from: https: // www.Gob.mx/cm/uploads/attachment/file/232826/ENAPEA_0215.PDF
• Secretariat of the Youth of Coahuila of the State of Zaragoza (2015) State Strategy for Prevention in Adolescents of the State of Coahuila de Zaragoza. Recovered from: http: // www.Icmujeres.Gob.mx/documents/prevention_embarazo.PDF
• Family Integral Development of the State of Mexico (DIFEM) Comprehensive attention to the adolescent mother. Recovered from: http: // difem.Edomex.Gob.MX/SECURITY_PREVENTION_ATENCION_INTEGRAL_MADRES_ADOSNECENTES
• Federal Government (2013) Specific action program: Maternal and Perinatal Health (2013-2018). Recovered from: http: // cnegsr.Health.Gob.MX/CONTENTS/DOWNLOADS/SMP/HEALTHMATERNAYPERINATAL_2013_2018.PDF