By Ang Lai Lai
Going by the combined number of live births and abortions registered to teenaged women, the total number of teen pregnancies has declined from 1,622 in 2005 to 747 in 2016. The corresponding numbers of live births to women below 19 years for those years are 343 and 404.
Social workers believe the declining number of pregnancies results from a better knowledge of contraception. The larger number of pregnant teenage women who go on to deliver may reflect greater acceptance of single mums and better support during pregnancy and beyond.
On Diagnosing a Teenage Pregnancy
What is the doctor’s responsibility upon making a diagnosis of pregnancy in a teenager?
Pregnancies in women fifteen years old and younger are considered high risk, and should be referred to an obstetrician.
In Singapore, the legal age to have sex is sixteen years. This means that sex with persons below the age of sixteen years is punishable, according to Section 376A of the Penal Code.
Additionally, under Section 375 of the Penal Code, a man will be guilty of rape if he has vaginal sex with any girl younger than fourteen years.
The doctor has a duty to make a police report.
My Sister, My Daughter
Through the clever use of the two Genograms, the medical students document a baby born out of wedlock to a sixteen year-old girl, adopted by the mother’s parents, and brought up as their daughter instead of granddaughter. The grandparents become the adoptive parents, and the mother becomes the child’s sister.
The students envision a scenario where the young girl keeps the pregnancy because it is too advanced for termination. She receives forgiveness and acceptance from her family, and, after a hiatus, continues with her life without the stigma of being an unmarried mother. At the same time, her child is brought up by her loving parents and remains in close contact.
Diagnosing pregnancy is straightforward. Managing a pregnant teenager requires the involvement of gynaecologist, obstetrician, social worker and the family. The family doctor can play an integrating role.
——— Dr Ang Lai Lai
Ang Lai Lai practices in a polyclinic and is part of the clinical faculty for undergraduate and postgraduate Family Medicine training with NUS. She is also accredited as a medical mediator.
The commentary and vignette were reproduced with permission from the book “Being Human, Stories from Family Medicine” edited by Cheong Pak Yean and Ong Chooi Peng and published in 2021 by the College of Family Physicians Singapore.
Pictures of illness experiences were drawn by NUS medical students in workshops conducted from 2012-2017 by A/Prof Cheong Pak Yean. Senior family physicians subsequently shared vignettes and commentaries based on the pictures.
