When a young 17 year old girl was presented in the emergency of Columbia Asia Hospital Pune, she was collapsing severely in the medical condition she was brought in. She was in a life threatening post-partum hemorrhage and required immediate medical intervention. The team of doctors that treated the young patient was led by Dr. Mukta Paul, Consultant - Obstetrician and Gynecologist, Columbia Asia Hospital, Pune.
Swati Savarkar (Name changed), was married off at a young age of 16 years. Pregnancy followed soon. Her young body was hardly prepared physiologically for nurturing another life within her. Adding to the complexities were her diet requirements for a healthy delivery, care during her trimesters and a good doctor who could guide her and her parents through this phase of her life. Swati was in a near fatal condition and was treated with life support system and transfusion of 40 units of blood. The credit for timely action is due to the referring doctor who took pains to bring the patient to the hospital himself to ensure timely treatment was provided to her. But all are not so fortunate to reach a hospital that extends tertiary care and a skilled medical team equipped to handle such cases.
Dr. Sajal Sen, Vice President, Operations, Columbia Asia Hospital, Pune says, “The extant provisions of the rules framed under the act have provided for an elaborate implementation machinery.However, these early marriages culminate into early pregnancies which bring with it many hazards to mother as well as the baby such as Pregnancy induced hypertension, Eclempsia, Pre term babies, Low birth weight babies and post-partum hemorrhage which could be a near fatal complication as has been proven by this case.”
Early marriages of girls with older boys (even with wide age difference) are in practice due to multiple reasons one being securing future of the girl child as early as possible. In addition the cost of marriage is lower in case of younger girls as demand for younger bride is more.Though there are multiple social messages being delivered for education of the masses which include the social burden, lack of opportunities to girl child, but the medical risks associated with such marriages need to be highlighted more as a deterrence.
Dr. Mukta Paul, Consultant - Obstetrician and Gynecologist, Columbia Asia Hospital, Pune. “Young mothers such as this one have a higher risk of getting high blood pressurethan pregnant women in their 20s or 30s. There can also be a co-existing dangerous medical condition that combines high blood pressure with excess protein in the urine, swelling of a mother's hands and face, and organ damage.These medical risks have to be prevented or controlled by medications as they can also disrupt the unborn baby's growth. This condition can also lead to further pregnancy complications such as premature birth. There are health risks for the baby and children born to teenage mothers are more likely to suffer health, social, and emotional problems than children born to older mothers.”
Dr. Dr. Sunil Borde, Consultant - Anesthesiology, Columbia Asia Hospital, Punealso emphasized that by subjecting these young girls into marriage and pregnancy the parents are willingly pushing their child into a life risk for petty reasons. She insisted that social messages must also combine with more detailed information on likelihood of losing their girl child due to pregnancy related complications.
As per findings reported in NFHS-3 about 50 % marriages in India are still having brides below the age of 18 years. The provisions of Prohibition of Child Marriage Act 2006 state that girls below the age of 18 years and boys below the age of 21 years are forbidden to be married under the act and is a punishable office.In addition to governmental initiatives on mass education, the social institutions such as religious preachers, faith based institutions, and women political leaders in Panchayats should take the lead in this endeavor and save the girl child from this.