Early marriage creates health complications for mothers: Physicians

Kashem Mia lives in a remote village Laxmandia in Shilkupa upazila of Shatkhira district along with his wife and three children at a small house.

He is struggling to meet his day-to-day expenses as he is the lone bread-earner of his family.

Despite having his extreme economic hardship, Kashem is forced to take decision to marry off his 10-year-old daughter because of social stigma.

Most of the villagers in his neighborhood have been creating mental pressure on Kashem’s family for long that his daughter, Sathi has become eligible to get married.

In the cycle of social stigma Sathi got married and conceives her first child within a year.

Following her early marriage and pregnancy, her nightmare started when her first child died during birth under the care of an illiterate midwife.

Like Sathi, in Bangladesh many girls are forced to get married at an early age and subsequently become victim to the negative outcomes related to early marriages.

Dr Ferdousi Islam of Gynecology Department of Dhaka Medical College said marriage and pregnancy before the age of 18 years pushes the life of a girl into danger.

Early marriages increase the chances for maternal and neonatal death.

“Some of the negative health consequences of early marriage, for both mothers and their children, are related to the fact these women are so young – they are more likely to be having their first births and these are always riskier. Others are related to their physiology, for example, pregnancy complications associated with young, biologically-immature mothers,” she said.

Those marrying early may be more susceptible to domestic violence, poor mental health, and malnutrition, she added.

Dr Ferdousi said around 83 per cent mothers give birth to their babies at home in the country, of which 10 per cent is delayed-delivery, but admission of the mother to the nearest hospital or health centre is very urgent to stop delayed-delivery.

Besides, most of the mothers suffer from malnutrition due to financial insolvency and exact knowledge; she said, adding, maternal malnutrition increases the risk of poor pregnancy outcomes including obstructed labour, premature or low-birth-weight babies and postpartum haemorrhage.

According to UNICEF and WHO, Bangladesh has been lauded to cut down the death of children below five years but death of newborn baby is still a challenge for the country, as six newborns die every hour which takes the tally to around 50,000 deaths of newborns annually.

The international organisations have published a new report on children mortality rate and its trend simultaneously from New York, Geneva and Washington which said around 6.3 million children aged under 5 years died in 2017 that means in every 5 second a child dies globally. But, we can stop this from occurring.

UNICEF said over 0.5 million children die before the completion of 28 days, and as per this counting over 50,000 new born babies die annually in Bangladesh. Respiratory difficulties during birth, contagion and under-weight related complexities are the main reasons for death of the new born baby, reports BSS.

However, the latest report of UNICEF revealed that 62,000 new born babies die annually in Bangladesh, of which 50 per cent die within the time of birth to 28 days while the remaining 50 per cent die within one day of birth.

But, in general children mortality rate in Bangladesh has decreased.

UNICEF’S “Level and Trends in Child Mortality Report-2017” showed that in last 25 years child mortality rate has reduced by 73 per cent in Bangladesh. 19 per cent newborn baby dies within 7-28 days after birth. While of the children who die under the age of 5 years, 60 per cent of them are newborn babies. Around 88 per cent of the new born die due to respiratory difficulties during birth, contagion and under-weight related complexities.

Early marriage and pregnancy at an early age is a direct cause of death for adolescent mothers, said Chairman of Reproduction and Child Health of Bangladesh University of Health Science Professor Dr Rawshan Ara. She said birth of those babies take place before time and in some cases they die instantly due to respiratory problems.

Besides, supply of insufficient nutritious food to mothers during pregnancy and birth taking place in unhygienic condition at home increases the infant mortality rate in Bangladesh, said Rawshan Ara.

Department of Family Planning Director Mohammad Sharif said the government is running newborn health activities nationally and supply of antibiotic has been ensured in union parishad level to prevent the contagion of newborn babies.