Motherhood in Childhood

ADOLESCENT ABORTION RATES DROP BY
TWO-THIRDS IN UKRAINE
One million abortions were reported each year in Ukraine in the
early 1990s. Since then, the number has decreased by more than 80
per cent, mainly because of increased access to contraceptives and
family planning information and services.
The abortion rate among adolescents between the ages of 15
and 17 has also declined, from 7.74 abortions per 1,000 girls, to 2.51
today. This decrease is attributed to Government efforts to increase
access to youth-friendly health services and to legislation, policies
and programmes that prioritize young people’s sexual and reproductive
health.
One such programme, the Government’s “Reproductive Health
of the Nation,” aims to preserve the reproductive health of the
population and positively influence reproductive health among
adolescents. Another, the national Youth of Ukraine programme
promotes healthy lifestyles as a national priority.
UNFPA, the World Health Organization and UNICEF are supporting
the Ministry of Health’s development of a comprehensive
regulatory and institutional framework for youth-friendly health
services.
Access to quality family planning services, including counselling
on modern methods of contraception, has improved, and awareness
about the health benefits of family planning has grown. The
Government has entered into partnerships with pharmaceutical
companies and pharmacies to broaden the range of available contraceptives
and reduce their price, and the Ministry of Health has
strengthened its capacity to support and promote family planning
initiatives, including those available to adolescents and youth.
Viktoriya Verenych, an obstetrician-gynaecologist at a youthfriendly
clinic in Kyiv, says that over the past five years, she has
noticed a trend of earlier sexual debut among her clients.
“It is very important that at this point in their lives, they have
access to qualified counselling on prevention of unwanted pregnancies,
HIV and sexually transmitted infections,” Verenych says. “This
counselling must be provided in a youth-friendly manner.”
60 per cent more likely to report the current use
of a modern contraceptive compared to similar
youth not exposed to the programme. Likewise,
attitudes towards child marriage changed. At the
start of the programme, 66 per cent of boys and
60 per cent of girls believed that the ideal age of
marriage for girls was 18 or older. After the programme,
the comparable figures were 94 per cent
of boys and 87 per cent of girls (Kanesathasan et
al., 2008).
Access to emergency contraception is especially
important for adolescents, especially girls, who
often lack the skills or the power to negotiate
use of condoms and are vulnerable to sexual
coercion, exploitation and violence. Emergency
contraception is a method to prevent pregnancy
within five days of unprotected intercourse,
failure or misuse of a contraceptive (such as a
forgotten pill), rape or coerced sex. It disrupts
ovulation and reduces the likelihood of pregnancy
by up to 90 per cent. It cannot prevent
implantation of a fertilized egg, harm a developing
embryo or end a pregnancy.
Barriers to adolescents’ accessing emergency
contraception include lack of knowledge about
it, reluctance of health care workers to provide
it, cost, community opposition to its use and
legal restrictions.
In 22 countries, a dedicated and registered
emergency contraceptive pill is unavailable
(International Consortium for Emergency
Contraception, 2013). Even in countries where
emergency contraception is available, adolescents
may be reluctant to obtain it from traditional
health outlets, such as clinics, which may be
staffed by judgmental providers. To make it
easier for adolescents to obtain emergency contraception,
the non-governmental organization
PATH developed a project in Cambodia, Kenya,
72 CHAPTER 4: TAKING ACTION