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When we think of 10-year-old girls, we usually envision them as children playing with dolls or doing some other child-like activity. The very last thing we fathom is a 10-year-old having a baby. Yet, the international media reported such a case in Spain. A 10-year-old Romanian girl delivered a 6-pound-4-ounce baby in a hospital in the southern part of Spain last week and it lit up the radar screen of the international community. Mother and baby were reported to be fine. Fortunately in the U.S. these episodes are rare only to be seen under horrific conditions such as incest or rape. But in the case of the 10-year-old, this was not true. It appears that in her native Romania, arranged marriages are made once girls reach puberty.  However, the father of the 10-year-old’s baby was allegedly “under-age” but the Spanish authorities did not intend to make any arrests.

I do not envy the physician or midwife who had the untenable position of admitting this child to the hospital for her delivery. The pediatric unit would have made more sense had she not been pregnant. The potential complications are daunting. Does she have an adequate pelvis that would allow the delivery of a full-term baby? As a pubescent female, her pelvic bones may or may not be fully developed. Do you allow her a trial of labor with the possibility that she could encounter a shoulder dystocia (the baby’s head is delivered but the shoulders remain stuck)? Would there be increased fetal distress if she becomes agitated during labor? What type of pain meds would you offer a 10-year-old? Should she or can she receive epidural anesthesia? Would she be able to tolerate multiple pelvic exams to check for progress of labor? Does she even know what’s going on?

How do you teach a 10-year-old child how to push out a baby? With extreme difficulty and extra loving care.