In the Family Way

In the States, it's relatively rare to see an obviously pregnant person. I know I always do a bit of a double-take whenever I see a woman with that huge protruding belly walking down the street. In Peru, it seems like every other woman under the age of 30 is either pregnant or nursing a baby. My first thought was that because the country is Catholic, there was no form of birth control available, but this is not the case. Condoms, pills, and hormone injections are all available free of charge at the hospitals and clinics.

Even so, the average age of the gestantes in the hospital is around 17 or 18. It's certainly part of the cultural norm to have children young. Despite realizing this, I find it extremely difficult to listen to a 16 year old girl, a few weeks pregnant, talk nonchalantly about having regular unprotected sex with her boyfriend while jiggling her two year old son on her lap. Peru is a poor country and I feel a certain feminist indignity well up inside me when I think about how these girls become so limited as soon as a child comes into the picture. Some of them have husbands and most have at least boyfriends, but how many of us can claim to have met our soul mate before our 20th birthday?

Girls in the mountain regions fare worse. The doctors all blame a lack of education, despite reported access to free family planning options. The most dramatic example was a girl who came to Huarmey hospital at 38 weeks (40 is full term) in order to be near a hospital with more resources when she went into labor. She is 12 years old. It completely boggles my mind that this is even possible. I wanted to ask her who the father was (older boyfriend or sadistic uncle?), but her labor was deemed to dangerous for the capabilities of Huarmey and she was taken to a larger hospital two hours away, and I never got my chance.

When I shadow in the gynecology clinic, where gestantes come in for routine checkups and minor problems with their pregnancies, the patients are typically 15-19 in age. Patients in the family planning clinic, which distributes the condoms/pills/hormone injections, are quite different. These women are generally older, in their 20s and 30s, and they invariably carry their babies/young children with them. And so the pattern appears to start a family early, and only after establishing one, to limit its size. Again I realize that I am in a different culture and that not everyone wants to or thinks about waiting to establish financial stability (at the very least) before having children, it's difficult to see teenager after teenager burdened with such heavy responsibility.