IN what could be the first in the country, a nine-year-old girl is admitted to the United Bulawayo Hospitals (UBH) as she is 33 weeks pregnant and is expected to give birth at the institution.
This comes a few weeks after a 13-year-old girl from Mkhosana Township in Victoria Falls wrote part of her Zimsec Grade Seven examinations on a hospital bed soon after giving birth at Victoria Falls Hospital. In the Victoria Falls case, the girl was not aware that she was pregnant until a month before giving birth.
The UBH case has seen the nine-year-old, who is about one month away from giving birth, being monitored by a team of specialist doctors and nurses owing to the delicate nature of the pregnancy.
Reports have indicated that the nine-year-old is from Tsholotsho Discrict in Matabeleland North Province with officials from the Department of Social Welfare in the Ministry of Public Service, Labour and Social Welfare investigating circumstances surrounding the pregnancy. Sources claimed she could have been raped and impregnated by a “close person”, hence the investigations that also involve the police.
A Sunday News crew last week visited UBH and spoke to the acting chief executive officer of the institution, Dr Harrison Rambanapasi, who confirmed the matter, but could not share finer details.
He said the girl actually conceived when she was eight years old, which was made possible by a rare condition of precocious puberty (development of sexual maturation earlier than the normal age). Dr Rambanapasi said ordinarily puberty should start at 11 years.
“Yes, I can confirm that we have such a case at the hospital, and she is being seen by various specialists who are assisting her,” he said.
The acting CEO said this was the first time he had come across such a case, arguing that to the majority in the medical profession, this was something they came across just in medical journals.
“Books of medicine talk about a nine-year-old who has delivered before, but that is a very long time ago and not in this country, but for me this is a first in my career, the youngest I had seen earlier was a 12-year-old, a victim of sexual abuse.
Now we have this nine-year-old and it’s a bit unfortunate that we see such a case,” said Dr Rambanapasi.
Online research revealed that the youngest mother in world history was a five-year-old Peruvian who gave birth via an operation on 14 May 1939.
Reports said based on the medical assessments of her pregnancy, she was less than five years old when she became pregnant, which was possible due to precocious puberty.
Dr Rambanapasi, without shedding much information on the case in question pointed out some of the challenges that come with issues of that nature.
“There are a lot of challenges, this is a child who is supposed to be in school, a child who should be playing with other children. She is supposed to be looked after by her parents as a child but now you impose on her, this extra responsibility. This is going to affect the other things that she should be working on at this stage, like going to school.
It is going to be strange to her and also her peers, people will be looking at her, probably laughing and mocking her and that affects her mentally as well,” he said.
Dr Rambanapasi said physically a nine-year-old is not prepared for sexual intercourse.
“When we look at sexual intercourse, before the changes of puberty have fully occurred, intercourse will be very traumatic because the body has not developed enough for her to be engaging in sexual activities.
The resilience of the genitals is not yet developed. Before we even talk about her falling pregnant, this is obviously a result of an abusive relationship. Is this child capacitated to negotiate for safe sex? At this age they are also prone to sexually transmitted infections, HIV, unwanted pregnancies because they do not know how to protect themselves.
Even if they know, how do they negotiate with an adult for safe sex? They are not able to negotiate,” he said.
The acting CEO said when a person of such an age falls pregnant there is competition for nutrients in the body as both the mother and the unborn child are still developing. He said another challenge was that there were no health facilities that could provide the necessary antenatal care in a supporting environment.
Antenatal care services are provided in the form of medical check-ups, consisting of recommendations on managing a healthy lifestyle and the provision of medical information such as maternal physiological changes in pregnancy, biological changes, and prenatal nutrition including prenatal vitamins, which prevents potential health problems throughout the course of the pregnancy and promotes the mother and child’s health alike.
“Imagine her attending antenatal classes with people old enough to be her mother. It is not comfortable, she is only nine years old, and is supposed to be around Grade Four.
What does she know about antenatal care? Will she even understand what will be said in those classes? Will the nurses even understand her? She will be treated differently from a mature adult seeking the same services,” he added.
Other challenges that can be faced, he said, include Pregnancy Induced Hypertension (PIH) and molar pregnancies which are abnormal pregnancies which do not form a baby but form multiple cysts instead.
“There are a lot of challenges at play.
There is an issue of rape, there are long term psychological consequences thereof, which are long term and lifelong. When this child grows up and eventually gets married, she is likely to have problems with sexual intercourse because of this pregnancy.
She is likely to suffer from post-traumatic stress disorder and many problems. Physically the bones of the pelvis are not fully developed so when it is time for labour, she will likely get a caesarean section rather than a normal delivery.
Even with the issue of labour being painful, this child is unlikely to cooperate as it is a painful process, the vaginal examinations that are done will be more painful to her even when she delivers. Breast feeding is very painful initially and also considering that the breast may also not be fully developed, less milk will be produced too,” he said.
Dr Rambanapasi explained that the girl is unlikely to bond with her child because she is also a child who has given birth and the baby will become more of a burden to her than anything else.