The Bitter Taste of Forbidden Fruit--Dealing with Teenage Pregnancy

According to Department of Health statistics, on average some 15,000 underage women give birth in Taiwan every year. But research shows that 90% of girls who get pregnant don't want to have a baby. Thus it is estimated that every year 135,000 underage women intentionally abort the fetus they carry in their womb.

In the past, there used to be a "September abortion wave" following the summer vacation, but this has not been seen in Taiwan for quite some time. These days, teenage girls may abort at any time of year.

What can an underage woman who has an unwanted pregnancy do? Usually, she has four choices: First, get married for the sake of the child; second, have the child and be a single mother; third, have the child and put it up for adoption; and fourth, get an abortion.

In a society full of traps and temptations, inexperienced young women need good sex education and counseling.

Marrying for the child's sake

To parents for whom saving face is essential, marriage is the most satisfactory way of solving an unwanted teenage pregnancy. But to an immature young couple the prospect of becoming kids raising kids is clearly an unmitigated disaster.

Moreover, because many teenage boys bolt at the first sign of a bulging belly in their girlfriend, it is estimated that only 10% of unmarried girls in this predicament actually have the "courage" to carry the pregnancy to term.

For this reason, at the end of 2000, the Garden of Hope Foundation (GHF) established a premarital pregnancy service offering phone counseling, one-to-one interviews, visits to parents of pregnant teenagers, discussions with families, job placement, guidance, and the like. In the experience of the GHF, an ever-growing number of young fathers are abandoning the teenage girls they have gotten pregnant. A GHF survey shows that almost 87% of unwed mothers had a boyfriend before the pregnancy, but 70% of underage fathers provide no support whatsoever to their pregnant partners, break up with them, or break off all contact with them.

When a woman becomes a mother, she takes on responsibility for a new life and experiences major physiological and psychological changes. Are underage women capable of coping with motherhood?

It's me or the baby

To help underage expectant single mothers, the GHF has set up a halfway house that provides them a peaceful and reassuring environment during pregnancy. But what happens after the baby is born?

Chi Hui-jung, chief executive officer of the GHF, says that after giving birth, 60% of the unwed mothers at the halfway house choose to keep and raise their babies, while almost 40% give them up for adoption.

According to Chi, single mothers receive very little support in Taiwan. At the GHF, for example, only a minority of girls who decide to keep their baby get any financial or emotional support from their parents, and then only after considerable resistance from them. Most unmarried girls who choose the hard road of raising their child, do so without the proper skills or support from their family or boyfriend.

Hsiao Hui turned 20 this year, and is caring all alone for her seven-month-old son. Because Hsiao Hui's mother cannot stand the thought of people looking down on her daughter for having a child out of wedlock, she has refused to help take care of the baby. When Hsiao Hui goes to work, she has to leave her son at her elder sister's house. Because her boss often fails to pay her salary on time, she sometimes does not have the money to buy diapers or baby formula. This worries her elder sister no end.

When she became a mother, Hsiao Hui seemed to mature overnight. "I always think of my baby first," says Hsiao Hui. Raising her child is her one goal in life. Her biggest worry is, "What will I say to him when he grows up and asks me about his father?"

Hsiao Ying, 18, lives with her boyfriend and is raising their nine-month-old baby with him. Thinking back to the time when she found out she was pregnant, Hsiao Ying says that she "felt totally hopeless." Because she was already more than four months pregnant and could not raise the NT$20,000-30,000 needed for an abortion, she put on a bold face and decided to have the child.

"Sometimes I'm full of regrets," says Hsiao Ying. Whenever she has an argument with her boyfriend, or is unable to go out because of the baby, feelings of regret well up inside her. But then she sees her baby's innocent smile and feels great tenderness. "It's all very contradictory," says Hsiao Ying.

Government agencies provide very little assistance to these young single mothers. Taipei City provides temporary financial assistance to women in straitened circumstances. Unmarried young women from low-income families are eligible for this assistance, but many who live alone and receive no support from their parents fail to receive this benefit because they are still registered in their parents' household register. Chi Hui-jung says that "unless the family has sufficient financial resources, the young mother, her parents, and the newborn child, will suffer." Chi can understand why parents don't want to assume the burden, and often tells pregnant teenagers to think twice before going through with the pregnancy.

"No condom, no sex." Condoms are an effective method of contraception and help prevent sexually transmitted disease. They are the best way for a woman to protect herself and avoid an unwanted pregnancy. (courtesy of Taipei City STD Control Center)

Who is my real mother?

Religious social service groups believe that in an age of limited resources, the best solution lies in carrying pregnancies to term and putting children up for adoption. This solution provides children with a healthy environment to grow up in and gives young mothers a second chance in life.

But does adoption really benefit the mother and the child? Some people argue that it doesn't. Sue Huang, chairperson of Taiwan Women's Link (TWL), thinks that giving up a child for adoption often results in psychological scars that never heal. Many Taiwanese children who are put up for adoption grow up abroad and end up feeling like they don't belong because the color of their skin is different from their parents'. Consequently, many suffer from depression and stop at nothing to return to Taiwan in search of their mother.

The most famous recent case was that of Kartya, a young Taiwanese girl who had been stolen from her Taiwanese mother and was reunited with her in 1998. Brought up by adoptive parents in Australia, Kartya said that her greatest sorrow as she was growing up was the question, "Who is my mother?"

Fortunately, the spectacle of children looking for their birth mothers across the sea will not be repeated in the future. Chi Hui-jung points out that when children were given up for adoption in the past, they were like kites whose line had snapped: there was no way of knowing where they would end up. To remedy this sense of regret, children put up for adoption by unwed mothers at the GHF halfway house are all registered with the Children's Bureau of the Ministry of Interior. Thanks to this registration system, when such children reach the age of 18, they can trace and meet their mothers.

By carrying the pregnancy to term and putting their baby up for adoption, young women not only avoid killing a young life, but also contribute to solving a serious demographic problem that is besetting society. In recent years, Taiwan's birth rate has been falling while the average age of population has continued to rise. And Taiwanese society is increasingly distressed by the huge number of abortions performed every year.

Professor Chen Kuan-cheng of Cheng Kung University's healthcare management department thinks that instead of encouraging women to have more children it would be better to set up a good adoption system. By allowing babies to be born rather than aborted, you would on the one hand solve the problem of underage or unwed mothers and on the other help offset the low birth rate.

Demographic considerations and well-meaning proposals of this sort are unlikely to be accepted by women's organizations. TWL chairperson Sue Huang says that to encourage more women to have children, we should explore why women who are in a position to have children choose not to have them, instead of making women who are in no position to have children have them at all costs.

In a society full of traps and temptations, inexperienced young women need good sex education and counseling.

Relief, or guilty conscience?

"Should I have the baby? Should I not have the baby?" Given their different circumstances and points of view, the answer to this question differs from woman to woman. Although all women may face the problem of an unwanted pregnancy, age and marital status determine the personal circumstances of Taiwanese women, and thus result in very different choices when it comes to deciding whether to have an abortion.

The Genetic Health Law states that unmarried women aged 20 and above have the right to make their own decision regarding abortion without the consent of anyone else. Adult married women need their husband's consent, but more often than not they resort to dissimulation. Unmarried girls below the age of 20 require the consent of their guardian to have an abortion. This is one of the reasons teenage pregnancy is a thorny issue.

Kao Tien-fu, convener of the law and medical disputes committee of the Taiwan Association of Obstetrics and Gynecology, points out that one of the original aims of Taiwan's Genetic Health Law was to provide a legal solution to the problem of teenage pregnancy. But more than ten years on, the problem remains unresolved, and the group the legislators most wanted to protect is the least protected of all. The crux of the matter is the provision requiring underage women to obtain the consent of parents.

The Genetic Health Law stipulates that to have an abortion, an underage woman must obtain the consent of her legal guardian. The aim of this provision is to protect underage women, but given that most teenagers who get pregnant don't dare tell their parents, the provision in effect does the opposite of what it is meant to.

Kao Tien-fu, who has more than 20 years of experience as an obstetric gynecologist, says that several years ago when he would ask pregnant teenagers to come back with their parents, a good third of them would show up for a second consultation, but today if he asks them to bring their parents, he is sure never to see them again.

Kao knows of three or four cases of gynecologists who were sentenced to prison terms of six months for helping underage women have an abortion without their guardians' consent. Kao explains that whereas in most countries the age of legal majority is 18, in Taiwan it is 20. Because many doctors and young women are unaware of this, a small mistake can get them into trouble with the law.

Aside from legal obstacles, some gynecologists also have moral misgivings.

The moral debate over abortion continues unabated. Which takes precedence: the fetus's right to life or the mother's right to choose? Should an underage expectant mother follow her conscience or make the best choice for her own future? Are underage mothers capable of assuming responsibility for another human life?

Because individual opinions and beliefs differ, different women have different emotional responses to abortion. Some see abortion as a solution to a problem, and feel a sense of relief after the procedure. Others feel that by having an abortion they have killed a young life, and consequently suffer from pangs of conscience. Young women with little experience of life can experience these contradictory feelings with great intensity. For example, a high school student who accompanied a schoolmate to have an abortion felt like an accomplice to a crime, and began to have nightmares about it. Unable to hold back her tears, she went to ask her teacher for help. The teacher advised the two girls to offer sacrifice and prayer to the aborted fetus so as to seek spiritual peace.

Love enraptures man and woman alike. But after a moment's carelessness it is all too often the woman alone who has to assume the responsibility of parenthood. (photo by Chuang Kung-ju)

No right to education?

When teenagers get pregnant, their schoolteachers are the people from whom they most need help-next to their parents and social welfare agencies. Unfortunately, because of prejudice and lack of institutional support, during the crucial high-school years, schools are utterly incapable of providing guidance and protection to students who get pregnant.

Professor Lin Wan-I of the Department of Social Work, National Taiwan University, recalls that four years ago, when he was vice-mayor of Taipei City, he was astonished to discover that junior high schools had rules that stipulated that female students who got pregnant would be considered to have committed the equivalent of three major violations of the school code and would therefore be expelled. Following his strong recommendation, Taipei County schools did strike this provision from school rules. But although this provision is no longer in the books, visibly pregnant students are never seen in schoolyards. Before their bellies begin to show, pregnant students either get an abortion on the sly, or they quit school.

GHF CEO Chi Hui-jung points out that discrimination against pregnant students is rare in the West, where many schools even have childcare facilities. In Taiwan, on the other hand, there is no adequate system to provide schooling to pregnant students. In most cases, when schools find out that a student is pregnant, they persuade her to quit school, arguing that she would otherwise "set a bad example." After being forced to leave, many students never get another opportunity to go back to school.

After quitting school, teenagers are not necessarily accepted by their parents and given the peace of mind to see the pregnancy to term in the home they grew up in.

A Chinese saying goes, "a good birth is followed by the fragrance of sesame seed oil, and a bad one by a coffin." Yet because teenagers don't have a fully developed reproductive system they tend to have high-risk pregnancies. They are likely to give birth prematurely, their babies tend to be underweight, and they often experience complications during delivery. During the month following childbirth, unwed teenage mothers are not cared for at home and honored with traditional dishes prescribed by Chinese custom. Instead, they are made to feel ashamed.

Given the problems faced by unmarried and underage women who have a baby, it's no wonder that they often see abortion as their only choice. According to sociologist Lin Wan-I, "It's a simple tradeoff: if society can't accept the idea of underage unmarried women having children, these women will choose to abort."

A teenage body matures much faster than a teenage mind. Her parents' helping hands and attentive ears are what a daughter needs most during this stage in her life.

No sex without condoms

Why is Taiwan's teenage abortion rate 10,000 times higher than Sweden's? Why does Taiwan have the highest rate of teenage pregnancy in Asia? Many people blame inadequate sex education.

Everything starts with education. Effective sex education can substantially reduce the rate of abortion and teenage pregnancy. But without proper preventive work from the outset, girls will be caught unawares and will be unable to turn back the clock.

Swedish primary and middle schools began to provide sex education as early as 1955. In recent decades the results have been spectacular. Pregnancy and abortion among women under 20 is very rare, and the rate of venereal disease in the Swedish population is also very low.

In Taiwan, on the other hand, a Department of Health study of sex among high school students shows that the number of students with sexual experience has grown three- to fivefold over the past decade. Eighty percent of those students admit that they rarely or never use a condom.

According to a study conducted in 1998 and 1999 by Durex, a British condom manufacturer, 49% of Taiwanese teenagers do not take contraceptive measures the first time they have sex-a world record. A report published by the Bureau of Health Promotion, DOH, also indicates that 77% of underage women who had premarital sex got pregnant before they got married.

Sex education

Although a great many high-school students have seen documentary films about abortion, Chi Hui-jung thinks that the goriness of such films makes kids look away. Chi believes that sex education based on fear and intimidation is worthless.

Jeng Cherng-jye, chairman of the Taiwan Association for Sex Education and an obstetric gynecologist at Cathay General Hospital, says that present-day sex education focuses on teaching the basics of abstinence, faithfulness, and condoms. It also promotes the idea that "love is worth waiting for" and the importance of having a single sexual partner and using contraceptives. But because two linchpins of current sex education-abstinence and faithfulness-are becoming increasingly difficult to achieve, condoms have become the only line of defense. The fact is, though, that high school students are not allowed to carry condoms. If a condom is found in a student's schoolbag, he or she will have a warning entered into the school record and be called into the principal's office.

Given the school system's rigidity and ineffectiveness in this area, in 1999 the Taipei Association for the Promotion of Women's Rights (TAPWR) set up a "teenage hotline" to help underage women with their sexual problems and questions. Last year, the TAPWR published a sex education handbook for underage women. The handbook, which is distributed in high schools, provides general information in language teenagers can relate to about menstruation, sexual love, contraception, and pregnancy.

Parents are there to help

Society can no longer stand by as the problem of teenage pregnancy grows more serious by the day. Sue Huang of the TWL says that the solution to the problem is obvious: on the one hand, Taiwan needs to strengthen sex education to lower the pregnancy rate among unwed and underage women. On the other hand, women coping with an unwanted pregnancy ought to be given support and assistance, including housing, legislation, financial aid, psychological counseling, adoption programs, and healthcare.

Sue Huang notes that Scandinavian countries provide very comprehensive social welfare benefits to single-parent families, enabling them to cope with all sorts of problems. Nor do unmarried women who get pregnant suffer social discrimination in Scandinavia. In Taiwan, on the other hand, sex education is ineffective, underage women are prevented from getting an abortion without their parents' consent, and single mothers receive no assistance whatsoever. Young women are really put in an impossible situation.

Sue Huang says, "I have a teenage girl who has a boyfriend. I hope she won't have sex too early, and I want her to make sure she doesn't get pregnant. Even more, though, I want her to be happy and safe. I have therefore told her that if she does get pregnant, she must tell me about it. I've promised not to be angry and to do my best to help her cope. I hope that more parents will be able to express their love and concern for their daughters in these terms before it's too late. Failing to offer help and scaring your daughter away once she's pregnant is the worst thing you can do." Huang's words surely echo the heartfelt wishes of many responsible parents.

According to a GHF survey, 90% of teenagers fail to tell their parents when they get pregnant, while 90% of parents are more than willing to help their child cope with the situation. To all teenagers out there: are you listening?