Las Tunas, Cuba - At the end of last September, 805 pregnant women between the ages of 12 and 19 years were identified. It shows a decrease of 120 women in the same condition in relation to the same date of the previous year and, even so, the current figures represent a constant alert for the Maternal and Infant Program (PAMI).

Osmara López Borrero, head of the PAMI section in the Provincial Health Directorate, told the Cuban News Agency that although Las Tunas has a low birth rate, accompanied by an accelerated aging of the population, adolescent pregnancy is a problem that complicates the panorama with its multiple complications.

Not only because of the consequences for the future mother, who before the age of 20 is not prepared to assume gestation from the biological, psychological and social points of view, but also because the main causes that affect infant mortality in the province are congenital malformations and low birth weight, elements to which adolescents are much more prone.

However, efforts to increase sexual and reproductive education are not sufficient, as pregnancy in this age group becomes a multi-causal problem that needs to be addressed systematically from an interdisciplinary perspective.

The psychologist Elia Marina Brito Hidalgo warns that it is not only about the family, since it does not assume the responsibility that corresponds to it in the fulfillment of its educational, communicative and affective functions and does not look for the tools and abilities to educate its sons and daughters in this sense.

The problem involves girls and boys, and it is a reality that some are beginning their sexual practices around the age of 12, and are doing so in an unprotected manner, said the specialist of the Provincial Hygiene Center, the responsible institution for the educational component of the Maternal and Infant Program.

Brito Hidalgo explained that another of the causes is the fact that, independently of the information that the youngest may have, sometimes it is not sufficient.

Consequently, their attitudes and behaviors do not allow them to act in favor of a responsible sexuality, nor to have perception of the risk, besides the fact that the topic involves both members of the couple and, therefore, also deserves a look with a gender perspective.

Nevertheless, where does the adolescent population find this information? In this regard, Yolanda Palma Torres, Health Advisor to the Provincial Directorate of Education, pointed out that pregnancy at these ages, as a subject within one of the prioritized axes, and in recent times as a component of the third Improvement of Education, is a priority and is addressed as such.

Several activities are developed to mitigate this situation such as videoconferences with municipal health advisors, family education schools and extracurricular activities with the student federation in which the family is invited. Besides, the close link with the Health System and specifically with PAMI, always with a preventive approach in the first instance, and aimed at delaying as much as possible that first sexual relationship, characterize the work of the school as a fundamental pillar in this task.

Education and health strategies exist, but they are not effective in reversing the situation, acknowledges Elia Marina, who has also identified herself as one of the most understood in the territory, thanks also to her work as a social activist in the Campaign for Nonviolence toward Women (Campaña Por la No Violencia Hacia las Mujeres).

Professionals from both sectors still require more preparation, and this must continue to be an issue of agenda and action that is addressed from a diagnosis of the needs that the adolescents themselves present, she advised.

In the voices of the protagonists, ACN found criteria such as that of Xavier Raúl Verdecie Ramos, 16 years old. He states that although in Junior High School and Senior High School, teaching in which he attends the eleventh grade, he has been spoken to on some occasions about the subject, it has not been very deep, and currently one of his classmates is not attending classes because she is pregnant.

On the other hand, it is not exactly an easy thing for families to talk to their descendants about initiation into sexual life, use of contraceptive methods or the possible consequences of an early pregnancy. It is much more a relationship based on providing the necessary material inputs than one of communication and trust, good enough to talk about sexuality.

For me as a mother it is sometimes complex to assume that she is growing up and that sooner or later the moment will come, although she is a very responsible girl for her 14 years, the truth is that times have changed a lot and we can't lock our children in a bubble, says Yoenia Núñez Rodríguez.

In Las Tunas, as in the rest of the eastern provinces, being these five together with Camagüey the ones of greater incidence, the cases of pregnant women at an early age respond to particularities associated to each context. Therefore, it is necessary that the approach of the question in different places is not generalized, because in the head municipality as in the remaining eight, and within these in the communities, particularities exist.

For example, there are adolescents who come from rural areas where their mothers and grandmothers became pregnant very young, and this cannot be seen normally, just as abortion should not be seen as a contraceptive method when the ideal is to prevent and educate in responsibility. The objective does not seek to demonize a process as natural as the discovery of sexuality, points out the master Elia Marina Brito.

In a demographic scenario in which 2019 will be the year of fewer births in the last calendars in Las Tunas, around 5,500, this topic represents an important concern in a country like Cuba, in which efforts are directed to ensure access to education, healthy recreation and improvement.