We appreciate the tazkirah (reminder) of our Muslim colleagues not to ape the “morally bankrupt narrative” of the Occidental civilisation.
But the trajectory of their moralising which suggests that we are subtly promoting premarital sex is irresponsible, outrageous, and offensive.
There is a world of difference between the philosophy of harm reduction in public health interventions and the blatant accusation of encouraging promiscuity among our younger generation.
Let us first begin by laying out the facts underscoring this teenage pregnancy conundrum.
A review of the published research on teenage pregnancies in Malaysia from 2000 to 2014 recorded 19,000 births each year between 2009 and 2011. Many of these births were from unwed pregnancies, which accounted for 1.99 per cent of total deliveries.
The fertility rate of women aged between 15 and 19 years old in Malaysia increased from 13.07 in 2011 to 13.57 births per one thousand women in 2020.
Between 2017 and 2022, 41,083 teen pregnancies were recorded by the Ministry of Health (MOH). Of these teen pregnancies, 4,561 cases (35 per cent) were out of wedlock.
About 10,000 pregnant teens sought antenatal care at MOH facilities. This represents 28 pregnant girls each day.
Teenage mothers have higher incidences of maternal anaemia, premature rupture of membranes, pregnancy induced hypertension, infections, emergency cesarean sections, obstructed labor, post-partum depression, low birth weight babies, prematurity, and inadequate breastfeeding initiation.
There are also other complications such as the risk of an unwanted pregnancy, unsafe and illegal abortions, sexually transmitted infections (STI), HIV/AIDS, and baby dumping.
Therefore, the various ministries and agencies have started to implement carefully crafted interventions and preventive programmes dealing with life experiences and reproductive health, for example, the Ministry of Women, Family, and Community Development’s PEKERTI. These programmes seek to inform and create better awareness among adolescents, families, and the community.
This is certainly a very sensitive and taboo subject which must be handled with due care. The following infographics emphasise the urgent need for such programmes.
We cannot sweep these happenings that are affecting our children under the carpet, and being rhetorical about it won’t solve anything either.
If you look at the media statements from the Malaysian Paediatric Association (MPA) and the Obstetrical and Gynaecological Society of Malaysia (OGSM), you will realise that their motive is to beseech not just the Terengganu state government, but other state religious councils as well, to act with love, compassion, and mercy for the “failings and mistakes” of young parents, and to prevent dire consequences for the foetus and newborn babies.
After all, the greatest attribute of Allah (SWT) is Rahmah, the Most Compassionate and Most Merciful. Should we not as His servant and khalifah (vicegerent) on earth, try our level best to embrace His Asma ul Husna (Most Beautiful Names of Allah) in our daily practices?
The Messenger of Allah (Peace Be Upon Him) said: “Allah has one hundred mercies, out of which He has sent down only one for jinn, mankind, animals, and insects, through which they love one another and have compassion for one another; and through it, wild animals care for their young. Allah has retained ninety-nine mercies to deal kindly with His slaves on the Day of Resurrection.” (Al-Bukhari and Muslim)
Those in offices of law-making and judges who mete out sentences should similarly model the following attribute of our Creator in this authentic hadith of the Prophet (PBUH):
“When Allah completed the creation, He wrote in His book with Him upon the Throne: Verily, My mercy prevails over My wrath.” (Al-Bukhari and Muslim)
And Allah (SWT) described the Prophet (PBUH) as rahmatan lil alamin (mercy upon mankind):
“And We have not sent you (O Muhammad), except as a mercy to the worlds.” (Quran: Surah al-Anbiya, Verse 107)
And within the context of Maqasid Shari’ah (Higher Objectives of the Islamic Jurisprudence), there is an Usul al-Fiqh (Major Maxim of Jurisprudence) which states: “And harm reduction takes precedence over a perceived benefit”.
The overarching objective of the harm reduction approach is to prevent the negative consequences of teenage pregnancies and improve both the short and long-term health outcomes of the mother and baby.
Harm reduction within the context of health care embraces the principles of human dignity, flexibility and practicality, respect for individual autonomy, gradual advocacy for change, and accountability.
Prevention through reproductive health (RH) education is the most cost-effective approach. Serious problems are costly and very difficult to solve once they manifest.
The adverse consequences of poor RH education, and the benefits of good RH education extend well beyond health and will have an impact on society in general.
Studies on the impact of global RH education have shown a 53 per cent reduction in risk-taking behaviour (Kirby D. United Nations expert group meeting on adolescents, youth and development, July 2011).
Evaluation research has further confirmed that education about sexual and reproductive health does not lead to increased sexual activity.
Girls are less likely to marry young, have lower rates of STI and HIV/AIDS, unsafe abortions, and unwanted pregnancies. They also remain longer in secondary education and are more likely to lead healthy and productive lives.
Apart from RH education, the study from Universiti Putra Malaysia and others have reaffirmed that “it is not early pregnancy that had adverse occurrence, but rather, the responses towards the pregnancies”.
The lack of support systems, family condemnation, societal stigmatisation, and punitive laws have further increased their troubles and hardships, both physically and mentally.
Religious councils, policymakers, health care professionals, and the general public should empathise with the physical and psychological burden of teenage mothers, and help them to get back on their feet, not further punish and traumatise them.
The MPA and OGSM have suggested a few interventions to achieve this, premised on unconditional love, compassion, rahmah, and non-judgemental health care services.
Equally important are support groups for unwed teenage mothers, mental health care professionals providing psychological support, help with child care services, and educational and employment opportunities.
All this will further empower teenage mothers to make more responsible choices with their future lives and facilitate their safe return to life within the larger community.
Dr Musa Mohd Nordin is treasurer of the Malaysian Paediatric Association, and Dr Johari Bux is past president and trustee of the Obstetrical and Gynaecological Society of Malaysia.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of Ova.