Stable families - healthy children / by Pàl Veres

Stable lamilies-healthv children lt is rather typical nowadays that teenagers form ill-considered partnerships merely based on sexual contacts, which only result in unwanted pregnancy l]hroughout recorded human his-tory, there has always been con-flict with the " bright young things" of the day. Each upcoming new generation tends to be intolerant of earlier ones, and engages in a kind of behaviour which the older gener- ations do not know how to under- stand, or do not want to understand. The conflict is all the greater when the shifts in lifestyle are more pro- nounced. But there is little point in blaming young people for behaving as they do unless we are prepared at the same time to offer appropriate support to those in need. Statistics relating to the problems of youth show Hungary and its Central European neighbours to have a fairly average share of such problems. The country's demographical situation is also like that of its neighbours; its total population shows a declining trend, with the respective age groups changing. Fom 1970 to 1985 , the total of people aged over 50 increased by 372,000, while the number of persons aged under 25 fell by 226,000. Again as in other countries, a faster rate of physical development is a phenomenon that can best be mea- 28 by Pal Veres sured by the manifestation of the first menses of women at an earlier age than before. A century ago , the age at which women had their first menses was considered to vary from 15 to 19 years in Hungary and the neigh- bouring states. This symptom of pu- berty seems to be occurring about four months earlier every ten years in this part of Europe. In Hungary in 1984, the average age at which young girls had their first menses was around 12.5 years. VD on the rise Physical maturation at a younger age, however , does not in itself ac- count for the rise in the number of venereal diseases among teenagers. In 1984 one out of 1,150 people on average had a venereal disease , and on a global scale this is not a high ratio. But if one thinks of the consequences, it no longer appears negligible. Some 30 years ago , six per cent of males and 12 per cent of females afflicted with venereal diseases were in their teens . Fifteen years later the corresponding figures in these saddening statistics had risen to 15 per cent among men and 30 per cent among women. The situation has not improved since then. Superficially, people afflicted with sexually transmitted diseases, includ- ing the most frequent gonorrhoea! infections, can be completely cured and no longer at risk of infecting others. But the treatment may be insufficient to stop the pathological process leading to a pelvic inflamma- tory disease, in short PID. This painful disease , which in 30 to 40 per cent of the cases can lead to female sterility and all the grief that goes with it, is also a frequent cause of ectopic preg- nancy. Researchers at the Szeged Gy- naecological Clinic, who have carried out surveys supported by WHO, con- cluded, in part, that teenage abortion way lead, in one out of eight cases, to PID and, ultimately, may result m sterility. Organised research in Hungary, as elsewhere in the world , under the guidance of the International Feder- ation of Gynaecology and Obstetrics and the International Fertility Re- search Programme, and again at the initiative of WHO, is trying to define the relationship between the age of the mother , the number of births and W oRLD HEALTH. November 1986 perinatal mortality. Research workers at the Gynaecological Clinic of the University of Debrecen have proved that the second or third children born to women aged between 20 and 34 are least exposed to fetal risks, and the situation is almost as favourable as far as first-born babies are concerned. But it follows that having babies at a younger age, particularly during the teens , is a health hazard. Studies aimed at determining the optimal point of time and the most appropriate conditions for family planning are also supported by WHO. A group of research workers headed by Dr Endre Czeizel have helped 3,000 young women during pregnancy with appropriate examinations , pro- viding them with embryo-protecting vitamins and ensuring the best poss- ible cirumstances commensurate with the resources. The first such " pro- grammed" healthy and good-looking child has already been featured as a television "star" ! Another factor to be considered is that it calls for conscious education by both parents to ensure the proper physical and spiritual growth of their descendants. Families with only one W oRLD HEALTH, November 1986 parent tend to raise children who are disadvantaged in the long run. It is also rather typical nowadays that teenagers form ill-considered partner- ships merely based on sexual contacts. If such a relationship results in unwanted pregnancy-and this is not interrupted by abortion within three months, when it does not endanger the would-be mother's life-then it is often followed by a marriage contracted out of necessity owing to prevailing social prejudices. In 1984, 1,776 Hungarian women aged under 17 gave birth to a child out of wedlock. Most of the 1,333 teenaged mothers who gave birth to a baby when they were mar- ried only legalised the babies when they were already "on the way" . Ex- perience over many years show that such marriages very frequently end in divorce, and thus only result in an increasing number of children growing up at a disadvantage compared with those from a stable family. The Hungarian Government passed a decree in 1973 making it mandatory for schools to introduce courses in family life. It was felt that young people cannot be expected to discover by themselves all that medical science Teenage mothers-to-be in a Hungarian clinic. School classes in family life try to ensure that all babies are born "healthy and wanted," and that all youngsters know about the risk of STDs. Photos WHOfT. Urban and research have determined as most likely to protect the health of the unborn child and to encourage a stable family life. The fact remains that today's young people need to be understood and helped appropriately. The present author, as a doctor and staff member of the Hungarian youth press, has sized up the level of young people's knowledge of and interest in sexual life, on the basis of over 20,000 letters written to him, and has endeavoured to provide answers to their problems in his books. So too have more than 30 Hungarian professional writers, quite apart from well-known foreign authors. Since the government decree was published, the Hungarian writers alone have produced about 50 works in an effort to serve the common goal: that healthy and wanted children should be born in stable and happy families! • 29