"Contraception, HIV treatment, and abortions for 12-year-olds - all without parental consent? Health24 spoke to the experts."

Since 2007 children as young as twelve can get condoms and the Pill, get HIV treatment, and have an abortion – without their parents’ consent.

These are some of the implications of the Children’s Act no 38 of 2005, which came into effect on 1 July 2007. The issue of abortion is regulated by the Termination of Pregnancy Act.

While several studies have shown that children are becoming sexually mature and active at younger and younger ages, questions remain on the psychological and physical effects of a full-term pregnancy on a very young girl, as well as the long-term effects of multiple abortions. And what happened to the age of consent?

Health24 investigated.

The age of consent
Let’s start with the easy one. The age of consent (the age at which a person can give consent to sex) is still 16 – for everyone. Boys and girls, both gay and straight.

“It used to be 19 for boys, and 16 for girls, but the age of consent has been reduced to 16 for boys as well,” says Mariëtta Johnson, programme director of Childline in the Free State.

That means if two 15-year-olds have sex, they cannot be prosecuted, but if a man of 19 has sex with a 15-year-old, he can be.

It also depends on the age difference between minors, according to Johnson. A five-year difference is seen as problematic – if a 15-year-old boy were to have sexual relations with a 9-year-old, he would be in trouble.

Medical issues for young teen moms
Legal and ethical issues aside, what are the medical problems associated when pre-teens give birth? What are the implications for the babies?

This should be a reason for concern. A report by the World Health Organization states that the maternal mortality rate for girls between the ages of 10 and 14 is five times as high as it is for mothers aged 20.

“An underdeveloped pelvis can cause great difficulties during childbirth,” says gynaecologist, Dr Chantell Stewart. “A Caesarean section is an option in developed countries, but seldom in developing countries, where many pre-teens simply give birth at home.”

Other medical complications that occur when mothers are so young include fistulas (a tunnel between two cavities, in this case between the vagina and the anus) and eclampsia (pregnancy-induced hypertension), anaemia and sexually transmitted infections, according to Dr Stewart.

These mothers are also more likely to suffer from hypertension and obesity later in life than mothers who give birth later in life.

But the medical complications for the young mother are not the end of the story.

Several studies conducted in developed and developing countries have indicated that teen mothers are less likely to complete their schooling and that this early pregnancy is often the beginning of life-long poverty and single parenthood. The babies of these mothers also often born prematurely, raising the risks of infant death, lung complications, deafness and blindness, to name but a few.

Other problems encountered by these babies include a much higher risk of poor school performance, abuse and neglect and inadequate parenting.

Abortions and long-term complications
According to the new Children’s Act, 12-year-olds can now be given abortions without their parents’ consent. But abortion isn’t a form of contraception, and there is concern about the long-term effects of multiple abortions – what happens to someone’s body when abortion is in effect being used as a contraceptive?

“Multiple abortions do not affect hormonal status at all,” says Dr Stewart. “Each abortion may put a girl at risk of complication such as infection, injury to the uterus, or excessive bleeding. The more abortions a woman undergoes, the greater the overall risk (i.e. if the risk of complications during one abortion is 1%, if you have 5 abortions, the risk of some problem in that person increases to 5%).

Cervical incompetence (an inability of the uterus to hold a baby to full term) can also be a result, though this is less common with the modern drugs used.”

Sources: Teenpregnancy.org, Health24.com

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