Family Planning for Guatemalans Living in Poverty

Life for Teenage Mothers in Guatemala

Adolescence should be a period of discovery and change, of transitioning from childhood to adulthood. In Guatemala the reality is unfortunately a different one, where young girls have to learn to be adults too early. Guatemala has one of the highest teenage pregnancy rates in Latin America, and is the only country in Central America where teenage pregnancy is on the rise. A shocking 58.1% of young women become pregnant for the first time before age 18. This can often be attributed to sociocultural norms, lack of sexual education, and little access to reproductive health services. Unmet need for family planning is the highest among this age group, with 25.6% of young women between 15 and 24 expressing an unmet need.

In a recent mobile clinic in San Francisco Zapotitlán, on the country’s Pacific coast, we met 21-year-old Fabiola. Born in San Francisco Zapotitlán, Fabiola is one of seven siblings. Her mother sold vegetables and fruit in the local market to provide for her children. While her mother was working, Fabiola was in charge of the house, taking care of her younger brothers and sisters, despite being a child herself. As in many Guatemalan families, nobody ever told Fabiola about birth control. When she was 18, Fabiola had her first child. She struggled because on top of looking out for her younger siblings, she now had her own baby to take care of. At 19, Fabiola had her second child. Today, Fabiola is 21 years old and has three children. Raising her three children has not been easy: “Being a mother is a beautiful thing, but sometimes I feel like I can barely manage. I can’t afford to provide my children with everything I’d like to give them, and when they get sick, I can’t sleep because I’m worried about their well-being”.  

Days before the mobile clinic, our Field Supervisor Mylin visited women in San Francisco Zapotitlán to talk about their family planning options and encourage them to attend our mobile clinic. Although Fabiola showed up, she was very scared about using birth control. In San Francisco as in many Guatemalan communities, birth control is highly stigmatized. While she was afraid that her community would judge her, Fabiola knew that she could not afford to have more children. After discussing which contraceptive options we could offer her, Fabiola chose the subdermal hormonal implant, which provides up to 5 years of protection. Fabiola said she is grateful to WINGS because now she does not have to worry about becoming pregnant again and she is ready to dedicate all her time to raising her three boys. “WINGS is one of the few organizations that has reached out to women in my community. Many of us do not have enough money to go to a big hospital and pay for expensive services. Once I told the nurses I did not have enough money for the implant, they gave it to me for free!”

Young mothers at WINGS’ clinic

It is not surprising that many teenagers end up being parents at a young age, just like Fabiola. There is little and often incorrect information available to them and very limited access to contraceptive methods or they cannot afford them. Young women face barriers many older women do not, such as biased health care providers who refuse to attend them, claiming adolescents are not old enough for this type of education or services. WINGS strives to be as youth-friendly as possible, training our staff and volunteer promoters on how to provide youth-friendly counseling and providing contraceptive methods free of charge to anyone age 15 to 19. Last year alone 3,429 young women and men came to WINGS for a short-acting or long-acting reversible contraceptive method.

During the same mobile clinic, we met Berta, a 19-year-old girl who carried her 10-month-old baby in her arms. Berta too had never learned about birth control – not even in school where teachers are legally required to provide sexual education.  When Berta was 5 years old, her mother passed away. She was raised by her aunts and her father. Her family is very religious, and she was not allowed to ask any questions related to sexuality. She was very surprised when she got pregnant, as was all her family. A friend of her late mother told Berta about the mobile clinic, so Berta came in to get a subdermal hormonal implant. Berta may want to have one other child in the future, but she is happy that she now gets to choose when she is ready for that.

It is through the support of our donors that we can provide reproductive health services to youth in Guatemala, free of cost, so that they can have a chance at a better future. Thank you so much for supporting WINGS in empowering young women in Guatemala to take control of their reproductive lives. 

Guatemala is often known for its beautiful landscapes, travel spots, and rich Mayan history. However, Guatemala is also known for its struggles as a developing country, especially for its extremely high poverty rates. Seventy five percent of the indigenous population in Guatemala lives in poverty. Those who live in extreme poverty in this country live on $2 a day. Along with poverty, malnutrition is widespread. One in every two children under 5 years old is chronically malnourished. This makes Guatemala the country with the highest malnutrition rate in Latin America and the Caribbean, and fourth highest in the world.  Chronic malnutrition occurs over time and affects children cognitively, socially, and physically. Chronically malnourished children are very short for their age and their learning capabilities are lower than those of a healthy child. The first 1000 days of a child’s life are crucial in establishing good nutrition because after that, the effects of chronic malnutrition are irreversible.

But what do poverty and malnutrition have to do with family planning? Well, if a family has access to reproductive health services, they will get to choose how many children they have. They will most likely have fewer children than families who do not have access to family planning services. A family with fewer children will be more likely to meet the needs of each child financially. On the other hand, parents who have 11 children, for example, will find it far more challenging to properly feed them all. Many large families in this country do not have enough resources to pay for food, hence their children quickly become malnourished, and so the cycle goes on. To make matters worse, in Guatemala there is nearly a 30% unmet need for family planning. For indigenous women, it is even more challenging; 1 in 3 indigenous women have no access to health and family planning services. The average Guatemalan woman’s ideal number of children is 2, but they have 3.8 on average and 4.6 in indigenous communities. This makes Guatemala the country with the highest fertility rate in Latin America and the Caribbean.

Ana is from San Pablo la Laguna. At 46 years of age, she has been pregnant eight times and currently has five children. Ana is chronically malnourished and weighs less than 100 pounds; her body is not fit for pregnancy, resulting in three pregnancies ending in miscarriage.  Ana came to a WINGS clinic held at a partnering hospital in Santiago, extremely pale and clearly anemic. She had never used a contraceptive method before, simply because she could not afford one. Ana came to the hospital in hopes of getting a tubal ligation, even though she had no way of paying for it. Unquestionably, our staff was prepared to waive the operation costs so that Ana could receive the method of her choice. Because her health was quite unstable, it was a very delicate procedure, but Ana’s operation was successful. Even though our medical staff recommended that she stay in the hospital that night, Ana had no one to look after her children, so she went back to her village. WINGS’ staff is still in regular contact with Ana, to make sure that her health is better than the first time we saw her. Ana is now able to focus more on her own health and the health of her family, without being concerned about future unintended pregnancies.

Family planning positively impacts Guatemalans by enabling them to take ownership of their reproductive lives, providing them a path out of the cycle of poverty and malnutrition. Just in 2015, we provided reproductive health education, contraceptive methods, and family planning services to more than 21,310 people in Guatemala. Through WINGS stationary and partner clinics, we performed six times the number of tubal ligations and vasectomies projected for 2015. In the first three months of 2016, we have already provided family planning services to 3221people in Guatemala.  

It is through the support of donors like yourself that we can provide family planning services in Guatemala, to break the cycle of poverty and malnutrition. Thank you so much for your continued support and for standing with WINGS in bringing reproductive health services to the most vulnerable in Guatemala.