A blurry future for teenage mothers: An effect of systematic neglect in Karnataka

Reports of a Class nine student giving birth at a government residential school in Karnataka’s Yadgir district took the country by storm last month. What’s more, the case was one among three similar incidents reported across the state over the span of a single week. Shocking details of the stories began to emerge — of extreme neglect and potential abuse.

Each of these cases’ facts revealed a denial of basic rights of the young girls, now mothers. Sexual abuse, lack of healthcare services, low awareness, an absence of safe support and reporting mechanisms, are just some of the most egregious human rights violations that the girls faced.

At the state and national levels, declining numbers of teen pregnancies have been hailed as signs of progress. However, recurring cases of neglect and abuse, commonly affecting minors from vulnerable communities, point to systemic inequalities that are leaving the weakest worst off, even as conditions improve for some. 

A closer look at the numbers from recent National Family Health Surveys (NFHS) corroborates these facts too. Overall, India has seen a decrease in the rate of teen pregnancy over several years. Yet, regional disparities are alarming — Tripura has the highest rate of teen pregnancy at 21.9%, more than three times the national average. 

Further, while urban centres are seeing declining numbers of minors becoming mothers, rural regions continue to see twice the number of adolescent pregnancies as cities. Experts point to high vulnerability factors and low awareness as key causes. 

Additionally, despite gradually declining rates, the problem remains a large-scale one. Karnataka reported over 26,400 teenage pregnancies in a span of 10 months. 

Impact weighs heavy 

The reasons why the high number of cases is inherently concerning are multifold. Firstly, a large percentage of the numbers represent cases of child marriage. Others reveal instances of sexual abuse when investigated. Still others reflect low awareness about sexual and reproductive health and a lack of knowledge and access to contraceptives. 

Secondly, each number represents significantly serious negative health and socioeconomic outcomes observed among young mothers and their babies. Adolescent mothers face higher risks of eclampsia (a life-threatening complication of preeclampsia characterised by the onset of seizures in pregnant or postpartum women), puerperal endometritis (bacterial infection of the uterine lining), and systemic infections. Babies of adolescent mothers face higher risks of low birth weight, pre-term birth and severe neonatal conditions. Studies show that in low and middle-income countries, the leading cause of mortality amongst adolescent girls is pregnancy and childbirth-related complications.

Considering young mothers are less likely to continue into higher education, there are worse socioeconomic outcomes in store for both teen mothers and their babies. Several studies have pointed out the basic correlating factors behind adolescent pregnancy: Low awareness, poverty and a lack of education are at the top.

According to NFHS data, as education levels increased, the risk of teen pregnancy significantly reduced. Women with no education had the highest prevalence of adolescent pregnancy (18%), compared to 4% among women with 12 or more years of schooling. Women from Scheduled Tribes also had a higher prevalence of adolescent pregnancies. 

Care and protection

The occurrence of these cases at government residential schools makes the matter that much more alarming because the minors are from: 1) varying community backgrounds, with high levels of vulnerability, 2) away from home, and far from family and community support systems, 3) dependent on a school ecosystem where health and psychosocial support systems are barely functional. The last factor particularly evidences a violation of child protection policies, which mandate regular health check-ups and availability of support at residential facilities for children. 

Government-run residential schools are mandated by the Karnataka Residential Educational Institutions Society (KREIS) to have staff nurses conduct health check-ups for students every 15 days. These rules stipulate that health issues must be recorded in a medical register and that parents be informed. However, this is far from reality at most of the facilities. 

A common thread among several cases is the discovery of the pregnancy at the time of birth. In the Yadgir case, other students heard the young girl go into labour in one of the bathrooms and reported it to the staff. 

Consider the level of negligence it would take for teachers, support staff and medical professionals to miss health symptoms spanning nine months. 

In one of the three cases reported recently, the young girl had only attended classes for 10 days every month since she became pregnant. Yet, there was neither notice nor intervention on the part of the care staff. 

According to data provided by the social welfare department, reported by DH, as of February 2024, 41% of warden posts at residential schools remained unfilled. Nearly 65% of schools did not have permanent staff nurses. Teachers take turns as wardens instead. 

Tragically, these cases are not limited to Karnataka. Government residential schools for SC and ST students in Odisha, for instance, have been reporting distressing numbers of student deaths, sexual abuse and teen pregnancies in recent years.  

Despite improved reporting over the years, several cases continue to slip through the cracks. While the institutional set-up offers weak protections, even these mechanisms can be out of reach for some adolescents. Considering the taboo nature of sexual health and pregnancy, teenagers in many contexts struggle to find open and safe spaces, even for conversation on the topics. Being able to uncover and access means of help becomes even more difficult due to this stigma. 

High levels of community awareness, safe access to information and contraceptives, and strong cultural and psychosocial support systems are pivotal in teenage pregnancy prevention. Ensuring children are able to consistently and safely access all their basic rights, including health, education, information and safe redressal of grievances, is essential to reduce vulnerability in adolescence. This includes equipping parents, teachers, community leaders, ASHA workers, civil society staff, and local panchayat authorities to be vigilant, approachable and aware. Open, consistent conversation around menstruation, consent, abuse, contraception and other health rights, for both girls and boys, is essential. 

According to the United Nations Population Fund framework, ensuring teens are able to fully enjoy their sexual and reproductive rights includes: Age-appropriate sex education, safe and affordable contraceptive methods, sensitive counselling, and prevention and management of sexually transmitted infections. In cases of pregnancy, it is vital that we ensure young girls are able to feel safe in accessing prenatal care, safe abortions, judicial remedies and counselling. Addressing the high numbers of adolescent pregnancies involves building a community awareness and ethos that empowers teenagers and supports safe dialogue.

Policy efforts

In April 2024, in response to the alarming number of teenage pregnancies in Karnataka, Chief Minister Siddaramaiah had issued a letter to seven departments. Speaking to similar incidents, the CM wrote that “hostels should be under strict CCTV surveillance and the health of girls should be monitored by organising checkups every month”. To this end, the letter called for the setting up of a task force to investigate and prevent teenage pregnancies, particularly those seeming to arise from the residential schools.

Over 18 months later, little seems to have changed. The recent slew of cases tossed up new and strikingly similar calls for a crackdown on child protection violations at the residential schools. 

Responding to a question in the Legislative Assembly, Women and Child Development Minister Laxmi Hebbalkar, said in August, that the government is pushing sex education, cyber safety and awareness of the POCSO Act in high schools.

Hebbalkar also pointed to the ‘Akka Force’ programme, which is a special patrol by women police officers and NCC cadets to monitor public spaces and help prevent child marriages and also “provide counselling” to vulnerable adolescents.

While the push for sex education and greater awareness is the way forward, some concerns arise with the vigilance and counselling functions described. In the midst of a call for education about sexual and reproductive health, there is a belief held by some policymakers and community support workers that greater exposure to information about sexual health promotes risky sexual behaviours at an early or adolescent stage. 

This has been clinically disproven by several studies over the years. NFHS itself highlights that higher media exposure is associated with a lower risk of teenage pregnancy. 

However, this looming hesitation towards sex education remains unaddressed. Regressive, victim-blaming attitudes regarding sexual abuse and the misconception that access to contraceptives would worsen sexual and reproductive health among adolescents are other key challenges. 

Putting together programmes to address the systemic vulnerabilities behind adolescent pregnancy, therefore, requires tackling prejudice alongside addressing a lack of awareness. What does “counselling young couples” look like, and who is qualified to deliver this service? How are community support workers and police being equipped to understand and deliver information on sexual and reproductive rights? How are inherent social biases being checked? How is community misinformation being tackled? These are questions that must also take centre stage in teen pregnancy prevention, in order to ensure the rights of children are meaningfully protected. 

Strengthening local institutions and equipping support workers with unbiased, evidence-backed knowledge of sexual health is essential. Including boys and men in the conversation is crucial as well. Ensuring teenagers are able to access safe, non-judgmental healthcare will go a long way in opening up the conversation and eventually creating a safer environment.