VISITING THE clinic of Goregaon-based gynaecologist Dr Nikhil Datar for a medical termination of pregnancy for their 17-year-old daughter, a middle-aged couple admitted to the doctor that their daughter had engaged in consensual sex, but with little or no knowledge about contraceptives.
Since 2013, at least 4,172 teenage girls have undergone medical terminations in Mumbai, highlighting the need to strengthen adolescent sex education, especially in slum areas. “Most of them are from poor socio-economic strata and get physically intimate out of curiosity,” says Dr Padmaja Keskar, executive health officer at the Brihanmumbai Municipal Corporation (BMC), which recorded 33,526 abortions in 2016-17 across civic hospitals and maternity homes. Of these, 47 pregnancies were a result of sexual assault. Girls aged less than 19 years accounted for 1,073 abortions in 2013, 1,595 in 2014 and 1,013 in 2015. In 2016-17, 491 abortions were recorded, but civic officials expect the figure to see an upward revision.
Doctors say sex education programme need to be strengthened to raise awareness about contraceptives. Currently, while sex education is not a component in the state board’s school curriculum, BMC schools hold sessions on adolescent health, of which sex education is a small component.
“The problem is mandatory FIR registration under Protection of Children from Sexual Offences (POCSO) Act whenever a teenage pregnancy is reported. Adolescents get scared to discuss sexual activity in the open because the boy will be held for rape. The law is beneficial, but it hampers open discussion and counselling of teenagers over contraceptive usage,” says Dr Nikhil Datar, medical director of Cloud 9 Hospital.
Under the Women and Child Development department, anganwadi centres are supposed to provide adolescent health counselling under Kishori Shakti Yojana. Anganwadi workers, however, counsel only on personal hygiene, health and nutrition related issues. Discussions on safe sex or types of available contraceptives are not held. “We come across cases where teenage girls have both parents working and she is alone at home. These girls are mostly school dropouts and have no knowledge of safe sex,” said Dr Ganesh Shinde, gynaecologist and dean at Cooper Hospital.
He adds that while teenage pregnancy count has reduced in a decade, more awareness can help bring it down further.According to Dr Shrikala Acharya, additional project director in Mumbai District AIDS Control Society, National Aids Control Organisation trains school teachers on adolescent health who are, in turn, supposed to hold three sessions for students in a year.
Parents do not openly discuss about this issue with their children, leaving the job to teachers and health workers. With no full time counsellors in government schools, discussions on identifying sexual needs and use of contraceptives has been lacking. In 2000, UNICEF began an educational module on adolescent health which included sex education. The module was added in the National Council for Educational Research and Training (NCERT), but discontinued later.