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Planning, pregnancy and the right to decide

In Cuba, the phenomenon of delayed motherhood is having an unfavourable effect on fertility and population replacement rates.

 

Lisbet Rodríguez Candelaria

 

The Caribbean nation has the oldest population in Latin America, and in 2050 Cuba will be one of the 10 most elderly countries in the world, according to demographic studies.

With a current population of more than 11 million, the island is experiencing accelerated population ageing; more than 20% of the population is over 60.

This forecast stems from the prevalence of medium and long-term projections regarding the plans of adolescents and young adults to start a family. In terms of reproduction, they are the focus in pr esent-day Cuba, which is characterised by new configurations in family and partnership dynamics, says Rayda Semanat, specialist at the Centre for Youth Studies.

Research carried out by this institution among just a section of the Cuban population (1,406 participants), shows that of the young women surveyed who were aged 20 to 24, 16.2% were not planning a pregnancy in the near future.

The same was true of 10.8% of 25 to 29-year-olds, and 23.3% of 30 to 34-year-olds.

The res ults show that, to a large extent, the right time, the desired number of children and the age-gaps between them depend on factors such as material conditions and plans for professional development.

“The fact that adolescents and young adults are inconsistent in their use of contraception puts them at risk of unwanted pregnancy”, says Semanat.

The myths and prejudices surrounding contraceptive methods are often legitimised by family and friends, especially during adolescence, which also exposes them to the consequences of irresponsibility, she adds.

Contraceptive decisions

Each year, approximately 14 million children are born to adolescent mothers (15 to 19-years-old) worldwide, of which two million are in Latin America and the Caribbean.

If all adolescent girls used contraception, unplanned pregnancies would be reduced by 1. 2 million annually and maternal deaths – caused by complications from giving birth at an early age – would decrease, says Gabino Armán, Cuban specialist in gynaecology and obstetrics.

Nowadays, Cuba has modern contraceptive methods such as the progesterone implant (medroxyprogesterone acetate), ideal for adolescents as it is highly effective and long-acting; intrauterine devices; progestogen-only injectable hormones; and oral contraceptive pills.

 However, Armán claims that Cuba’s low rate of contraceptive prevalence is linked to family, social and religious pressure, and the refusal to begin sex education at an early age.

 As a result, terminating a pregnancy often forms part of reproductive decision-making. The study on youth issues carried out by Cuban specialists shows that of the adolescent girls aged 15 to 19 interviewed, 13.4% have had an abortion. The same is true of 44.1% of young women between the ages of 20 and 24.

In the 25 to 29 age group, 68.7% had had at least one abortion, while 67.9% of women aged 30 to 34 had made the decision to terminate at least one pregnancy.

In the case of adolescent girls, this points to a lack of information, resulting in their use of abortion as a method of contraception, without being aware of the full physical and psychological consequences, says Semanat.

Cuban institutions respect the rights of adolescents and young adults to access sexual heath and reproductive services, which have been universally implemented in society.

“However, challenges remain, such as working on legal and cultural barriers to achieve better protection in issues related to marriage”, states Matilde Molina, specialist at the Centre for Demographic Studies at the University of Havana.  “To this we add knowledge management, with emphasis on generating data and disaggregating statistics, making their use in decision-making possible”, she states.

(Translated by Rebecca Ndhlovu) – Photos: Pixabay

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