“I never thought I would be pregnant at this age”

HAVANA, Cuba – María Karla Crukshank Fuentevilla is 15 years old and 29 weeks pregnant. It has not been an easy pregnancy.

“This pregnancy was a surprise. At first it scared me, because it was something too hard for me,” she told UNFPA Executive Director Dr. Natalia Kanem, during her recent visit to Cuba. “I never thought I would be pregnant at this age, because I wanted to graduate and then have my children.”

María Karla is trying to complete her last year of secondary school, but her health has been a hindrance. She struggled with a kidney infection, and she was recently diagnosed as anaemic. 

For seven weeks, she has been staying in the Doña Leonor Pérez Cabrera maternity home, a place where pregnant women and girls with high-risk pregnancies can go to be under the care of medical professionals. 

Acute hardships for pregnant adolescents

In Cuba, 15 per cent of all births are to adolescents. These early births are accompanied by heightened risk of premature birth, anaemia and hypertension, explained María Karla’s doctor, Aylin Fernández Ruiz.

Globally, the risk of dying of pregnancy-related causes is highest among girls in this age group.

Cuba’s high adolescent fertility rate is due in part to gaps in education about sexual and reproductive health, says Linerzo Abreu Suárez, a nurse at the maternity home. Another factor is that young people aged 15 to 19 have a 21 per cent unmet need for family planning – the highest of any age group.

This has only been aggravated in recent years, with supply chains strained by the COVID-19 pandemic. Contraceptive availability has plummeted compared to prior years, and the country also faces serious economic strains from inflation, production shortages and trade restrictions. 

Support from the ground up

UNFPA is working with the Government and partners to address these issues, including by supporting the implementation of comprehensive sexuality education programmes both in the school system and in out-of-school settings, such as through public awareness campaigns conducted with the National Centre for Sexuality Education.

UNFPA is also helping to strengthen standards for the quality of comprehensive health-care services tailored to adolescents, particularly for sexual and reproductive health. Together with the Ministry of Health, a plan was also recently agreed to acquire intrauterine contraceptive devices and insertion instruments for use in the public health system.

This partnership with Cuba’s health-care system is far-reaching, and includes support to the country’s 132 maternity homes, like the facility María Karla is staying at. The maternity homes ensure at-risk women and girls are able to quickly receive emergency obstetric care, should they need it.

“Here, they are assured of medication, food and, above all, psychological care. We carry out educational talks, in which they learn about the process of childbirth, breastfeeding and caring for their babies,” Dr. Fernández explained. 

But the medical staff have been just one source of support for María Karla, who says she also received invaluable help from her fellow students. They have been steadfast in keeping her up-to-date with her school lessons, and thanks to their friendship and solidarity, she is certain she will be able to finish her schooling, even after having her baby.

Her mother, too, has been a source of strength, María Karla said. “She advised me to think carefully if I wanted to continue this pregnancy because I am very young… but I decided to have the baby… My mother has been with me the whole time.”

Above all, María Karla has displayed her own well of resilience and wisdom. Based on her experience, she told Dr. Kanem, she hopes “to advise all teenage girls to never have sex without protection, to never become mothers at a such young age."