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Lack of education, unsupervised visits by older males, and superstition have all contributed.
Two of Lama's friends are already married, but her family, unlike most, had supported her desire to finish school. It made her pregnancy all the more devastating.
Lama’s fingers played over her lips as she talked, the tip of her index finger finding the dent above her upper lip. Once playful and open, she has become withdrawn. Though she stayed in school as her belly swelled, she was too ashamed to visit other compounds.
“People talk about you. It’s hard,” she said.
"The girls are ashamed,” Baldé said. “Rumors go around: Look at her, look at her face, she is pale, she is this, she is that. Girls try to push down their stomachs. They try to wrap them up tight.”
Lama didn't tell her parents until she was four months along. Though mad, they took her to the nurse in Kounkané, the road town 3 miles away.
“They only told me that the birth would be hard and that I had to go to the prenatal visits,” she said. “It was difficult. I had problems. I had labor pains starting Monday but didn’t give birth until Thursday.” After struggling to get to a rural clinic, Lama was about to be taken by ambulance more than 60 miles away to Tambacounda for a C-section when the baby came on its own.
Lama was lucky. It's estimated that nine women die every day from childbirth in Senegal. According to UNICEF, 401 women die for every 100,000 births in Senegal. That number is 11 in the U.S.
Though regional statistics aren't available, medical workers say the Kolda region is the hardest hit, largely due to women having babies too young and too close together.
Teen pregnancy in the villages is a complex, stubborn problem. Birth control is one solution, Baldé said, if only women would use it.
Senegal’s health ministry has organized talks with religious leaders in the region and launched education campaigns. An array of contraception methods — condoms, natural family planning, the pill, Depo-Provera shots — is accessible and affordable in health centers.
But a woman's husband will often forbid it, fearing it will encourage promiscuity, and young women are scared it will make them sterile if they haven't yet had a baby.