On this Women’s Day we would like to shed light on the need for more reproductive health education for teenage girls and young women in West Africa. Sierra Leone and Ghana have in the past year continued to struggle with high rates of adolescent pregnancy, and we believe this will continue to be the case until parents especially leave old taboos behind and start getting real about sex, reproductive health, and contraception. Just last year some 5000 girls who were pregnant in Sierra Leone could not attend school, and here in Ghana the rising teenage pregnancy rates in Kumasi especially is a cause for concern. So on this International Women’s Day we want to encourage African parents at home and in the diaspora to make a commitment to educating their daughters about their health, their sons need to know to but young women are most vulnerable. In this regard we have reached out to Dr. Fatu Forna, OB GYN, to get first hand advice on why African parents need to educate their daughters about sex, reproductive health, and contraception. Let’s break the cycle of silence and empower our young women the right health information so that they may make informed choices.
Happy Women’s Day,
Please read Dr Forna’s passionate piece below.
As an Obstetrician and Gynecologist and a mother of three girls, I know the challenges that young girls face as they navigate their teenage years. Every teenage patient that I care for reminds me in some way of my own daughters.
I am from Sierra Leone and currently practice in the United States. I know that teenagers and young women, whether living in Africa or in the Americas, all have a need to be knowledgeable about their bodies, so that they can protect their reproductive health. Every few months in my clinic I see a teenager with a genital herpes infection who thinks the sores on her “bottom” are from scratching herself too hard; a teenager brought in by her mother with abdominal pain who finds out she is five months pregnant; a college student who has chlamydia; or a recently married young woman who cannot get pregnant and finds out that her tubes are blocked, probably from a sexually transmitted disease (STD) she had as a teenager. I know that my colleagues in the African diaspora often see patients with similar stories, demonstrating the need for the availability of more reproductive health services for our teenagers and young women.
Many of my teenage patients have not had a frank discussion with their parents about their bodies, or about sex, STDs, or contraception. Growing up in an African family, my parents never said a single word to me about sex, and I have realized that even today many parents never discuss these issues with their children. Many young people do not have access to this information at school either, as most schools do not have reproductive health education. It breaks my heart each time I see a teenage patient with a preventable STD or an unintended pregnancy. We need to do better within the family and within the community to give our young women the tools they need to protect their reproductive health.
I believe we can do a better job of educating our teenagers about reproductive health by starting discussions with our teenagers early, before they start thinking about having sex, so that they have the information they need to better protect themselves. They need to learn about their anatomy so that they can understand their bodies. They need to see pictures, not just illustrations, of STDs so that they understand the gravity of these infections, the dangers and consequences of having sex too early, and of having unprotected sex. They need to understand that only abstinence can prevent pregnancy and STDs, but they also need to know that condoms can decrease the risk of STDs and that contraceptives can decrease the risk of unintended pregnancy. They need to know that STDs can lead to infertility and make them unable to have children when they are ready to start a family. They also need to know that there are sexual predators who will take advantage of girls and young women and subject them to sexual abuse or rape.
Parents might be hesitant and think that their teenage daughter is too young to talk about sex. I want to assure them that it is indeed time to talk about sex and reproductive health, as their daughter probably has questions. If she cannot talk about reproductive health with her parents or with a doctor or nurse, she will talk about these issues with friends who might give her incorrect information. Teenagers need to feel comfortable enough to have conversations with their parents about when the optimal time might be for them to start thinking about having sex, and about how they can protect themselves from STDs and from unintended pregnancy. Candid discussions with parents about reproductive health issues will give our young women the tools to protect themselves from sexual abuse and rape, and empower them to speak up and ask for help if needed.
Parents need to be prepared to have these discussions with their daughters early, as most young women and men start having sex as teenagers. According to a World Health Organization study, the median age at first sexual intercourse in many African countries was between ages 15 to 17. Parents need to have these discussions with their daughters early, so that they can guide her in making what they both think are the best reproductive health decisions.
Parents need to share their value systems with their daughters and partner with them so they can help guide their reproductive health decisions. They need to be able to ask important questions like: Do you plan to wait until you are married to have sex? Do you plan to wait until you are in college? Do you plan to wait until you are an adult? Are you planning to have sex soon? Are you already having sex?
Teenage girls and young women need to establish a relationship and have a first visit with a reproductive health doctor (or nurse) early, before they initiate sexual activity. During this first visit, the doctor will partner with the parent to have an age-appropriate discussion about their changing bodies, contraception, the dangers posed by STDs, and the reasons to delay having sex. The doctor will usually not do an exam if a teenager is not sexually active.
If a teenager is planning to or is already having sex, take them to see the doctor. Help them make decisions now to decrease their risk of STDs by always using a condom when they have sex, and by limiting the number of sexual partners that they have over the course of their life. Encourage them to use a safe and effective long term contraceptive method like the injection, the arm implant or the intrauterine device, in addition to condoms, to prevent an unintended pregnancy.
Parents should start thinking of these issues now, so that they have a plan to guide their daughter’s reproductive health future. Every teenage girl and young woman should have the opportunity to receive guidance from their parents and their doctor to help them make decisions that will ensure a healthy and safe reproductive life.
Dr. Forna is an Obstetrician and Gynecologist and the Chief of Women’s Services for a Multi-Specialty Group of over 500 Physicians in Atlanta, Georgia. She is the author of the book “From Your Doctor to You. What Every Teenage Girl Should Know About Her Body, Sex, STDs, and Contraception“. She is married to a pediatrician, has four children, and lives in Atlanta, Georgia.
Dr. Forna received her undergraduate degree from Florida A&M University and her public health degree from the University of North Carolina at Chapel Hill School of Public Health. She received her medical degree from Duke University School of Medicine and she completed her Obstetrics and Gynecology residency at Emory University School of Medicine.
Dr. Forna served four years as a Medical Officer in the US Public Health Service at the Centers for Disease Control and Prevention (CDC). While at the CDC, she worked with HIV prevention programs in the United States and in countries around the world. She is the Co-executive Director of the non-profit Mama-Pikin Foundation, which works to improve the health of women and children in Sierra Leone. She has authored numerous articles on STDs, maternal and child health, and HIV prevention and care.