2Reproductive Health (Sexual and Reproductive Health) Care for
Adolescent Girls in Children's Homes in Iwate Prefecture
Yuko Fukushima, Professor, Saori Ito, Assistant professor, Yuri Yamauchi, Assistant, Faculty of Nursing, Iwate PrefecturalUniversity

Applicableprinciple

Principle 8: A commitment to addressing issues of poverty through education
Principle 9: A commitment to promoting sustainability through education

1. Activity Overview
Girls in children's homes live in an environment where itis difficult for them to recieve wisdom about reproductivehealth (sexual and reproductive health) from their mothers.
In addition, those girls tend to have psychosocial problems
rooted in attachment disorders, such as low self-esteem andan inability to trust others, and they tend to become sexuallyactive earlier than girls of the same age, which exposes
them to a higher risk of unexpected pregnancies, contracting
sexually transmitted diseases and sexual violence. On theother hand, currently, the handling of sexual problems andreproductive health issues in children's homes is left to thehomes and due to lack of specialized knowledge and skills aswell as the embarrassment of the staff members of the homes,
cooperation with medical professionals is necessary.
In order to respond to this problem, at the Faculty of Nursing,
Iwate Prefectural University, we have developed and put into
practice a reproductive health care model for adolescent
girls living in children's homes in Iwate Prefecture from thestandpoint of experts in nursing and midwifery. This caremodel is based on interactions that consider the characteristics
of girls who have experienced abuse, etc., and aims to not
only provide knowledge, but to also encourage them to accept
themselves as well as their sexuality, so that they will be able
to acquire sexual autonomy in the future.

method of menstrual care which is communicated bymothers in an ordinary household, how to bathe and how
to wash underwear during menstruation, how to deal withmenstrual pain, as well as the mechanisms of pregnancy andcontraception. We are careful not to make the session a oneway inculcation of knowledge, and we flexibly decide topics
according to individual needs and situations based on mutual
relationships with girls. Using hand-made teaching materials
such as “My body notebook” and "XX's menstrual calendar",as well as actual sanitary napkins and birth-control devices
and models, we make efforts so that students can visualise
and experience topics with their own bodies.
Also, our care has been based on the consideration for girls
who have experienced abuse, etc. so that such girls can feelsafety and security. Touching and skin-to-skin contact such as
stroking and rubbing with hands and fingers, was incorporated
so that the girls could feel their own body and existence. Atthe care session, we place hands on girl’s abdomens, tellingthem, “You are a precious person, so please take care of here(uterus)”, or offered affirming statements such as “You know,
your body is important, important” while slowly rubbing their
shuolders and arms . A girl who used to say, “I am nothing” or“I don’t care about myself” now listens intently while thinking
about something, and touches her own body and says, “It’simportant”. After the care session, we found girls’ comments
stating, “I could feel my own body”, “I want to participate thesession again”, and “I want to take care of myself”.
It is suggested that reproductive health care that considers thecharacteristics of adolescent girls in children’s homes enables
them to realize their own bodies and sexuality, and it leads tothem regaining the “basic sense of self (Herman 1992)” thathas been weakened by experiences such as abuse.
We plan to continue this initiative in cooperation withchildren’s homes.

Girls can pick up sanitary napkins and shorts, and feel the body using a model.

2. Activities
For the reproductive health care activity, we have small grouptalk sessions of 5 to 6 people and individual continuous carefor those who are interested. The topics cover the structureof body and the mechanisms of menstruation, the specificSome of hand-madeteaching materials

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