19 tuổi làm mẹ 3 con: Nạn tảo hôn vẫn nhức nhối ở vùng cao | VTV24

Key Concepts

• Tảo hôn (Child Marriage): Marriage involving one or more parties below the age of 18.
• Dân tộc thiểu số (Ethnic Minorities): Indigenous groups within a country, often facing unique social challenges.
• Hủ tục (Harmful Custom): A traditional practice that is detrimental to individuals or society.
• Suy dinh dưỡng thể thấp còi (Stunting): A form of malnutrition characterized by low height for age.
• Chửa trứng (Molar Pregnancy): A rare complication of pregnancy characterized by abnormal growth of the placenta.
• Tiền giật mình (Preeclampsia): A serious pregnancy complication characterized by high blood pressure.
• Sụn tiếp hợp (Epiphyseal Plates): Areas of growing tissue near the ends of long bones in children and adolescents.

Tảo Hôn: A Persistent Challenge in Ethnic Minority Communities

Despite a decrease, child marriage remains a significant and persistent issue in Vietnam, particularly within ethnic minority communities. The Hmong ethnic group exhibits the highest prevalence, with nearly 36% of marriages involving underage individuals. Beyond legal violations, child marriage leads to severe consequences, impacting the health of both mothers and children, and ultimately diminishing population quality. However, a lack of full awareness among ethnic minority communities perpetuates this harmful custom, forcing adolescent girls into the heavy burdens of early motherhood.

Case Studies and Real-World Applications

1. The 13-Year-Old Mother: A 13-year-old girl, six months pregnant, was supposed to be in 8th grade. She dropped out of school after becoming pregnant by her 18-year-old boyfriend. Despite being underage for marriage, their parents consented, and they began living together as husband and wife. The girl had only recently started menstruating the previous year and was set to become a mother within months. She stated, "I started dating in 7th grade. When I got pregnant, I went to get married, so I dropped out of school. I'm worried because I'm not old enough to have a child yet. I can't work, so my husband will work."

2. The 17-Year-Old Mother with Two Children: A 17-year-old girl, six months pregnant, visited a health station not for her own prenatal check-up, but for her 10-month-old son who was suffering from a cough and fever. Shockingly, she was unaware of her second pregnancy until the baby started moving, four months into gestation. This highlights a critical lack of awareness and prenatal care. The medical professional noted, "She's only four months pregnant and already has a second child. To reduce the risk for the next child, if she continues breastfeeding the first, there's a high risk of miscarriage. The mother must wean the first child, which is also a disadvantage."

3. The 19-Year-Old Mother of Three: A 19-year-old mother of three was forced to send her two-year-old to her parents for care while she attended to her one-year-old and six-month-old babies at the Tam Duong Medical Center in Lai Chau province. Both infants were suffering from coughs and fevers due to influenza A, leading to pneumonia. The mother displayed significant distress and lack of knowledge, accidentally spilling formula and tangling her necklace while holding a baby. Medical staff had to provide detailed instructions on infant care. She admitted, "From the age of 15, I decided to get married and have children. My husband was 18 and had dropped out of school after 4th grade. I was still playing and having fun, and I didn't know what to do when I got married. I was still studying and didn't know what my husband did or how to farm. I'm very confused about childcare. First, I don't know how to monitor a child's fever. Second, how to feed them properly. Third, many parents are busy playing, looking at their phones, watching videos, and often leave the children to their grandparents."

Consequences of Child Marriage

Child marriage leads to a cascade of negative outcomes, affecting physical health, mental well-being, educational attainment, and economic stability.

Health Impacts

• Maternal and Child Mortality: Adolescent mothers face a significantly higher risk of death during pregnancy and childbirth compared to adult women. The mortality rate for mothers under 18 is four to five times higher.
• Reproductive Health Issues: Due to underdeveloped reproductive organs, adolescent girls are prone to complications such as molar pregnancies (chửa trứng), which can be life-threatening if not managed properly. They also have a higher risk of preeclampsia (tiền giật mình).
• Physical Development: Carrying a pregnancy and childbirth before the body is fully developed can lead to stunting (suy dinh dưỡng thể thấp còi) and long-term physical impairments. The epiphyseal plates (sụn tiếp hợp) are still developing, and the body's resources are diverted to supporting a fetus, hindering the mother's own growth.
• Mental Health: The immense responsibility of early motherhood, coupled with lack of education and support, can lead to significant psychological distress and developmental delays.

Social and Economic Impacts

• Educational Disruption: Child marriage forces girls to drop out of school, limiting their future educational and employment opportunities.
• Cycle of Poverty: Lack of education and skills perpetuates poverty, as young parents struggle to provide for their families. This can lead to a continuation of backward thinking and lifestyles.
• Intergenerational Impact: The negative consequences of child marriage are passed down through generations, creating a cycle of disadvantage.

Addressing the Issue: Challenges and Strategies

Efforts to combat child marriage in ethnic minority areas face significant hurdles.

Current Situation and Statistics

• The Hmong ethnic group has the highest rate of child marriage, at nearly 36%.
• Five years ago, the rate of child marriage in some areas was around 50%.
• Stunting rates in children in these communities are as high as 39%, a direct consequence of intergenerational child marriage.

Prevention and Intervention Strategies

• Local Government Initiatives: Local authorities are incorporating the eradication of child marriage into village regulations and agreements. They are also forming committees and signing commitments.
• Religious Leader Collaboration: Religious leaders are being enlisted to assist in awareness campaigns.
• Shifting Dynamics: A new challenge has emerged: child marriage is increasingly driven by young people's own choices rather than parental arrangements or traditional beliefs. This makes intervention more complex, as evidenced by cases where couples threatened suicide by consuming "lá ngón" (a poisonous plant) when authorities intervened.
• Healthcare Provider Role: Doctors and nurses in these areas often find themselves not only treating illnesses but also educating families on basic healthcare practices, such as proper fever management, infant feeding, and the dangers of unverified traditional remedies. They encounter cases where parents administer unproven treatments like burning fingernails or toenails, or even puncturing the child's abdomen with needles, leading to severe infections and internal bleeding.
• Financial Barriers to Healthcare: Some families delay seeking medical help for their children, opting for expensive traditional rituals costing 3 to 5 million VND, while children under six are fully covered by insurance if they have proper documentation.

Medical Interventions and Misconceptions

Healthcare professionals frequently encounter severe health issues stemming from child marriage and lack of proper care.

• Misuse of Traditional Remedies: Doctors report instances of families burning fingernails or toenails and giving the ashes to children, or puncturing children's abdomens with needles, causing significant harm and internal bleeding.
• Delayed Medical Care: Some families delay seeking professional medical help, opting for costly traditional rituals (3-5 million VND) instead of utilizing free healthcare services for children under six.
• Pregnancy Complications: Adolescent pregnancies are associated with a higher incidence of molar pregnancies and preeclampsia.
• Surgical Interventions: Due to a lack of understanding of labor and delivery, many adolescent mothers require C-sections, which can lead to complications like postpartum hemorrhage in subsequent pregnancies.

Conclusion and Key Takeaways

Child marriage in Vietnam's ethnic minority communities is a deeply entrenched issue with devastating consequences for individuals and society. The problem is exacerbated by a lack of awareness, the perpetuation of harmful customs, and a shift towards young people making their own decisions to marry early. The health, educational, and economic well-being of girls and their children are severely compromised, creating a cycle of poverty and disadvantage that impacts future generations. Addressing this complex issue requires a multi-faceted approach involving continued awareness campaigns, legal enforcement, community engagement, and support for young people to pursue education and healthy development. The long-term damage to the gene pool ("tổn hại giống nòi") is a significant concern, underscoring the urgency of eradicating this harmful practice.