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TEENAGE PREGNANCY PATTERNS AND ASSOCIATED FACTORS
Background to the Study
The issue of pregnancies among teenage girls seems to be one of the social problems facing not only Nigeria, but also several other nations of the world. Surveys by investigators such as Briggs (2001), Gyepi-Garbrah (1985), Onuzulike (2003) and others revealed that teenagers become sexually active at an early age with corresponding high fertility. Teenage sexual activities in Nigeria also tend to be on the increase (Nwosu, 2005, Okafor, 1997). A major consequence of these increase sexual activities among teenagers is out of wedlock pregnancies that may result in abortion, childbirth or even death.
Teenage is often used interchangeably with adolescence. World Health Organization – WHO (1997) opined that, it is the period between 10 and 19 years when the secondary sex characteristics appear. Turner and Helms (1993) reported that the teen years fall between the ages of 13 and 19 years. Views and opinions vary among authors and researchers on the specific age at which it begins or ends. Adesomowo (1988) reported that the teen years starts at either 11 or 12 years and lasts to 19 years when the character of a person takes the permanent form. According to Nwosu (2005), adolescents include all persons aged 13 to 19 years who constitute about 20 per cent of the world population. Ezeorah (1982), Melgosa (2001), and a host of others agree that the teen years span from the 13th to the 19th years of life.
Bongaart and Cohen (1998) described the teen years as a period of transition from childhood to adulthood, characterized by heightened social awareness and accelerated physical growth. This period, they opined, marks the onset of puberty and biological maturity. It is a crucial period in the life of an individual because many key social, economic and demographic events occur that set the stage for adult life. Ukekwe (2001) described it as the most important period in human life, which if not properly handled, could lead to the most disastrous consequences in later life, especially among females. Notwithstanding the varied opinions on the beginning and the end of the teen years, studies by numerous authors and researchers, as mentioned earlier indicated that the teen years span from the 13th to the 19th year of life. Based on the opinion of researchers on the specific age at which teenage begins, the present study will be based on the age limit of 13 to 19 years. Ukekwe held that teenagers are expected to grow up morally, and gradually observing the norms of the society into adulthood. On the contrary, some of these teenagers engage in pre-marital sexual activities, which expose them to the risks of abortions, sexually transmitted infections (STIs) and pregnancies.
Pregnancy as defined by Gordon(1983) is a condition in which a female carries in her womb, the young before it is born. Similarly, Skyes (2000) defined pregnancy as the condition of carrying a developing offering in the uterus. A look at the two definitions of pregnancy above could reveal that pregnancy is meant for procreation and continuity. Nwosu (2005) is of the opinion that when pregnancy occurs at the appropriate time and in wedlock, it is a welcome development, but if a teenager engages in pre-marital sex that may result in pregnancy, she is putting herself in a responsibility that she is inadequately prepared for. Teenage pregnancy therefore means conception by girls between the ages of 13 and 19 years. According to Allan Guttmacher Institute – (AGI) (1988), teenage pregnancy is an undesirable phenomenon. Onuzulike (2003) supported this when she observed that teenage pregnancy interferes with expectation regarding education, self-realization and economic prosperity among the affected teenagers. Ukekwe (2001) stated that stress arises even when pregnancies are planned, and to think of unplanned pregnancy means that the girl has to restructure her roles because she is inadequately prepared for parenthood. Fadeyi (1978) observed that numerous cases of school dropout; maternal mortality and morbidity, infertility, abortion and children being abandoned in gutters, dustbins, latrines and other deadly places are clear manifestations of the malady of teenage pregnancies.
Teenage pregnancy has vital implication for population growth. Nwosu (2005) opined that there is a global increase in teenage pregnancies. She observed that more than 14 million adolescents give birth each year thus contributing roughly 10 per cent of the world’s total number of births. Ukekwe (2001) noted that many of these babies are unwanted by their teen mothers. These babies, she maintained suffer from starvation, sicknesses, homelessness and abandonment among other complications. Briggs (2001) identified several complications associated with teenage pregnancy. These include; high blood pressure, pre-eclampsia, eclampsia, malnutrition, vesico vaginal fistula, recto vaginal fistula and death. He observed that when high blood pressure is accompanied by proteinuria, the teenager’s condition can worsen to eclampsia, which if not controlled could progress to extreme hypertension, seizures, convulsion and cerebral hemorrhage. Chabra (1991) outlined complications of pregnancy among teenagers to include first and third trimester’s bleeding, severe anaemia, prolonged and obstructed labour, cephalo-pelvic disproportion, and toxaemias of pregnancy, stillbirth and high prenatal mortality and morbidity.
Besides the health consequence of teenage pregnancy, the educational attainment of most, if not all teenage parents is hampered. Gorgen, Maier and Diesfield (1993) observed that students who become pregnant rarely go back to school. Stevens-Simon and McAnarmey (1993) noted that teenage pregnancy is a marker for socio-demographic factors such as poverty and poor education. Brown (2001) collaborated this when he posited that many of the teenagers end up as school dropouts. Action Health Incorporated (2004) also described teenage pregnancy as a major cause of school dropout among girls. They maintained that the pattern of pregnancies among young unmarried adolescents has assumed an alarming proportion, which if unchecked could result in undesirable consequences. According to Osuala (2003) the patterns of teenage pregnancy and its complications need to be addressed in order to avert the perpetuation of poverty and unskilled women in the economy.
Many authors and researchers have variously described pattern. Gadsby (2000) described pattern as the regular way in which something happens, develops or is done. He maintained that when events happen or develop in the same fixed way, one could say that they follow a set pattern. Gadsby further described pattern as a regularly repeated arrangement of events, words or sounds. Gessner (1997) studied the demographic variables of patterns i.e. residence, gender, race and age. He noted that patterns of events could occur in clusters or epidemics in relation to time (temporal), and space (spatial). Pridemore and spivak (2003) outlined the general patterns of suicide mortality across time, (temporal) space (spatial) and demographic variables. These temporal, spatial and demographic variables could also apply in the study of teenage pregnancy patterns and associated factors which the present study intends to do.
Teenage pregnancy patterns could therefore be taken to mean the occurrence of pregnancy among teenagers aged 13 to 19 years with regard to time, space and demographic groups. Teenage pregnancy has occurred overtime, but the present study intends to study the occurrence of teen pregnancy between 2001-2007 with emphasis on its distribution across school types, as well as the demographic variations. Pregnancy could occur among all teenage girls who are exposed to pre-marital sexual activities. Onuzulike (2003) outlined several predictors of pregnancy during the teen years. These include; a history of sexual abuse, poverty, lack of interest in school activities, lack of career goals, poor school performance, unhappy homes and peer pressure among others. Audu (1997) also outlined several factors associated with teen pregnancy. These factors include; moral laxity, desire for wealth and materialism, unrealistic false marriage promises as well as the influx of pornography. Okafor (1997) reported ignorance of sexual knowledge as one of the factors responsible for pregnancies among teenagers. He added that adolescents in secondary schools have low knowledge regarding sex and sexuality. Nwosu (2005) observed that adolescents face many risks ranging from unwanted pregnancies, HIV and AIDs, other STIs, sexual exploitation, yet they receive inadequate information to help them negotiate this difficult passage to adulthood. Nwosu added that teens need access to specific information about how their bodies work and how to keep their bodies safe as well as information about sexual behaviour and its consequences. She maintained that information about sexuality should be imparted to teenagers in order to help them avoid unwanted pregnancies.
Audu (1997) is of the opinion that the less knowledge teenagers have, the more likely they may have unprotected sex and engage in sexual experimentation prematurely. Briggs (2001) noted that the school system does not supply teenagers with adequate information and education about sex and sexuality. As a result, many of them end up in uncertainty and misconceptions on sexual matters. This lack of knowledge exposes young persons including teenagers to pre-marital sexual activities. Melgosa (2001) observed that the physiological changes, which occur during the teen years seem to contribute to increased sexual urge and that this increase in sexual desire is a response to biological, psychological as well as social changes, which adolescents experience. All these characteristics could be contributory to the high incidence of teenage pregnancies in the society. Gallagher and Gallagher (2000) believed that the inclination towards early initiation of sexual activity is due to a vehement desire for affection and acceptance. They also atttributed it to a demonstration of the maturity, which teenagers believe they have attained. This belief, they noted make the teenagers vulnerable to teenage unwanted pregnancies and the associated complications. All these characteristics tend to expose teenagers to pre-marital sexual activities, including those in Igbo-Etiti LGA, which is the area of study.
Igbo-Etiti LGA is one of the seventeen LGAs in Enugu State. It is made up of fourteen communities characterized by the presence of few amenities like pipe borne water supply, hospitals and clinics, good roads and social centres. The presence of these amenities seems to pave way for free interaction between boys and girls within and outside the LGA. Equally, when students are on holidays, disco and parties are always organized, giving them the opportunity to interact freely. This free and uninhibited interaction seems to predispose them to indiscriminate pre-marital sexual activities, which if unchecked may result in teenage unwanted pregnancies and its attendant complications. Such complications as outlined earlier could be embarrassing to the teenagers themselves as well as their parents and guardians. The situation may therefore constitute a serious set back to the teenager involved.
Statement of the Problem
Research shows that the teen years are the most stressful and confusing times of life (Deegan, 1989; Duval, 1995 ; Kohlberg, 1981). During this period, teenagers are expected to acquire education and skills needed for the future. On the contrary, many teenage girls engage in premarital sex, which expose them to the risks of STIs and teenage pregnancies (Umeano, 2003). Pregnancy is usually welcome when it occurs at the appropriate time such as a mature age and in wedlock. On the contrary, it is most unwelcome when it occurs outside of wedlock or during the teen years, when the individual should be acquiring skills in formal or non-formal environments. Studies (Audu, 1997, Gyepi-Garbrah, 1985, Noble, 1996, Onuzulike, 2002 and WHO, 1977) have indicated poverty, pornography, mass media and peer influence as some of the factors responsible for teenage pregnancy. All teenagers who engage in pre-marital sex are vulnerable to pregnancy. No wonder AGI (1988); McAnarney and Schredier (1984); Onuzulike, (2002); Population Report (1994); Umeano (2003) held that pre-marital sexual activities among teenagers in both developed and developing countries indicate that it is a serious public problem. Many factors, as mentioned earlier could be attributed to this. Various studies (Briggs, 2001; Nwosu, 2005; Onuzulike, 2002; WHO, 1975) have shown increase in teenage pregnancies the world over with regard to the time, space and demographic variable. Nwosu opined that over the last decade, teen pregnancy has been on the increase, with many of the girls abandoning their babies after birth. Many of these studies though were conducted outside Enugu State and Igbo-etiti LGA in particular, no evidence of what the situation looks like has been shown in the area under study. The pattern could be worse than what has been reported in other parts of the world. The need for a study of this nature in Igbo-eitit LGA cannot be over-emphasized.
Purpose of the Study
The purpose of the study was to determine the patterns and associated factors of teenage pregnancies in Igbo-etiti LGA of Enugu State. Specifically, the study set out to determine the
- temporal pattern of teenage pregnancies in Igbo-etiti LGA in the past seven years (2001-2007);
- spatial pattern of teenage pregnancies in Igbo-etiti LGA;
- demographic variations of teenage pregnancies in Igbo-etiti LGA; and
- non-demographic factors associated with teenage pregnancies in Igbo-etiti LGA.
The following research questions guided the study.
- What is the temporal pattern of teenage pregnancies in Igbo-etiti LGA?
- What is the spatial pattern of teenage pregnancies in Igbo-etiti LGA?
- What are the demographic variations of teenage pregnancies in Igbo-etiti LGA?
- What are the non-demographic factors associates with teenage pregnancies in Igbo-etiti LGA?
The following null hypotheses were formulated to guide the study
- There is no significant association between age and pregnancy among teenage girls in Igbo-etiti LGA.
- There is no significant association between educational level and teenage pregnancy in Igbo-etiti LGA.
- There is no significant association between religious denomination and teenage pregnancy in Igbo-etiti LGA.
Significance of the Study
The present study is significant in several ways. In general, the result of the study will help to clarify the relevance of the Health Belief Model (HBM) and the Precaution Adoption Process theory to understanding the patterns of teenage pregnancies. A successful explanation of whatever patterns of the problem that may be found will significantly clarify the relevance of the IBM. The study showed the pattern of the problems over seven years (2001-2007). This information will be of immense benefit to all personnel interested in intervening in the problem. Such personnel may decipher from the pattern whether the problem has been on the increase or decline. This may help them to determine the intensity of possible intervention programme.
The study also generated data on the spatial pattern of teenage pregnancies in the area of study. Finding out how the problem is distributed across such space as school types (girls and mixed school) will help school authorities appreciate where the problem is more pronounced. Such appreciation is expected to precede any decision to tackle the problem. Furthermore, the state ministries of Education and Youths may require such data to determine where to focus any control measure that may evolve against the problem. The study showed the age, educational level and religious denomination differentials in the case of teenage pregnancies in the area of study. Information about these demographic factors will be of use to intervention researchers and relevant staff of the ministries of Youths and Education charged with the responsibility of preventing and controlling teenage pregnancies. The distribution of the cases along these variables will help them decide where to channel most of their efforts.
The non-demographic factors (crave for materialism, ignorance, poverty, pornography) associated with the problem of teenage pregnancies that were determined by the study will be of benefit to teenage girls in the area of study. This will help them to appreciate the role of these factors in teen pregnancy and how to avoid them. The results may also be useful to researchers and workers interested in tackling the problems of teen pregnancy. The intervention workers and researchers would be guided by the results in the development of intervention programmes. Finally, the study is expected to add to the pool of literature on teenage pregnancies in Nigeria. Such literature may be useful to future researchers in the area of teenage pregnancies as well as sex and sexuality education.
Scope of the Study
The study was limited to Igbo-etiti LGA. Teenagers between the ages of 13 and 19 years found within and outside secondary schools in the LGA were selected for the study. They were chosen for the study because they are the ones most vulnerable to unwanted pregnancies and its attendant complications. Some of them have had the experience and were in vantage position to provide reliable information that was helpful to the study. The study was also limited to the patterns and associated factors of teenage pregnancy. The patterns of interest are temporal pattern; spatial pattern and demographic pattern. The temporal pattern generated data which showed that the problem has been undulating whereas the spatial pattern showed the distribution across school types. The study also generated data on the demographic patterns such as educational level, age and religious denomination differentials in the area of study. The study was limited to the non-demographic factors associated with teenage pregnancies. Such factors include crave for materialism, poverty, moral laxity, ignorance, unrealistic false marriage promises, pornography, among others.