Introduction
Each year in the Nigeria, between 800,000 to 900,000 teenagers aged 19 or younger becomes pregnant. Although the overall rate of teen pregnancy in the Nigeria has declined by about 27% from 1990 to 2012, estimates reveal that 84.5 out of 1,000 females aged 15 to 19 continue to become pregnant each year (Adebayo, 2008). In 2012, over one-half of these pregnancies resulted in 425,493 teen births. These figures reflect a decrease of 33.3% for teen birth rates from 1991 to 2004, reaching a record low of 41.2 births per 1,000 women aged 15-19. However, the reality remains that the Nigeria continues to have higher teen pregnancy rates and birth rates than other modern, industrialized nations (National Campaign to Prevent Teen Pregnancy, 2012).
History reveals that most teenagers who became pregnant a two decade or three ago were married by the time the child was born. Current trends show that eight out of ten teenagers giving birth are unmarried and many are not ready for the emotional, psychological, and financial responsibilities and challenges of parenthood (Njoku, Okoye and Mmezi, 2012). The prevalence of high birth rates among teenagers becomes more alarming when one considers that 80% of these pregnancies are unintended (Adebayo, 2008) and that they are now more likely to occur at a younger age than in the early to mid-1980s (Njoku, Okoye and Mmezi, 2012).
According to Wong (2007) the most satisfactory age for childbearing and parenting are the years between 18 and 35. During this time, parents are considered to be at the height of their physical health, and have time and energy to raise a family. Concerns about teenage pregnancy and unintended childbearing revolve around the immediate and long-term impact of the situation on the young woman and child as well as on society as a whole. Teenage mothers are more likely than their non-childbearing peers to have shortened education, lower-paying jobs, higher levels of unemployment, larger families with closer spacing of children, a higher likelihood of marital disruption, future out-of-wedlock childbearing, and to live in poverty. In addition, babies born to teenage mothers are at an increased risk of low birth weight and consequently, for problems of mental retardation, blindness, deafness, mental illness, cerebral palsy, and infant mortality. The children of teen mothers are more likely to do poorly in school, to drop out of school, and to be involved in accidents. They are twice as likely to be reported being abused and neglected compared to children of older mothers (Corcoran, 2010).
Unfortunately, the consequences of being a child of an adolescent mother continues into young adulthood, with 13% of the sons of teen mothers more likely to deviants and 22% of the daughters more likely to become teen mothers themselves. The cost to society of teenage pregnancy, including social programs and medical expenses, is enormous which requires a special attention (Havemen, Wolfe and Peterson, 2009).
Definition of teenage pregnancy
According to Mayor (2010) teenage pregnancy is pregnancy in human females under the age of 20 at the time that the pregnancy ends. This means that that the classification of teenage pregnancy do not include pregnancies that began in women aged 19 if they did not end until on or after the woman’s 20th birthday. A pregnancy can take place after the start of the puberty before first menstrual period, but usually occurs after the onset of periods. In well-nourished girls, menarche usually takes place around the age of 12 or 13.
Banerjee, Pandey, Dutt, Sengupta, Mondal and Deb (2009), define teenage pregnancy as pregnancy occurring between thirteen and nineteen years of age. They further added that there are, however, girls as young as ten who are sexually active and occasionally become pregnant and give birth.
In the opinion of Armstrong (2011), teenage pregnancy is an unintended pregnancy during adolescence and attributed the cause to ignorance and perception of many teenagers who do not believe that they will get pregnant if they engage in sexual activity.
Signs and symptoms of teenage pregnancy
Pregnant teens usually experience the same signs and symptoms as adult pregnant women. The signs can vary from teen to teen, but a combination of signs along with a missed period may indicate that the teen is pregnant (East, 2010).
- Missed period: A missed period may alert a teenager that she is indeed pregnant. Though, teenager may miss her period for a variety of other reasons such as participation in sports, loss of weight or extreme stress, but a period that is over a month late coupled with other pregnancy signs can signal that the teen is expecting.
- Nausea or vomiting: Pregnant teenage girls often experience extreme morning sickness during the early stages of their pregnancy. Morning sickness is described as mild to extreme nausea or vomiting that can occur throughout the day. Some teens may experience morning sickness at the same time every day, while others may have random bouts of nausea or vomiting. In addition, a teenager may have sudden and intense aversions to certain foods such as meats or fried foods that can cause a queasy stomach. Nausea and vomiting typically begin a few weeks after conception due to increasing hormone levels.
- Frequent urination: Frequent urination is a common early sign of a teen pregnancy. A pregnant teen may notice that she needs to go to the bathroom several times a day. She may also have to get up two or three times a night to urinate. Teenagers may experience frequent urination when their uterus begins to swell putting pressure on their bladder. Many teenagers can have an increase in urination within a week or two after pregnancy has occurred.
- Swollen and tender breasts: As the pregnancy progresses, a teen may notice that her breasts have become larger and more sensitive due to increasing hormones. A girl may feel tenderness in her breasts as her breasts prepare to produce milk for her baby. Pregnant teens usually experience mild to severe pain in one or both breasts. A teen girl can experience discomfort if something touches or brushes against her breasts. She may also notice stinging and shooting pains in her nipples.
- Extreme fatigue and appetite changes: During the earlier stages of pregnancy, a teen girl may experience a decrease in energy and a change in appetite. She may feel so tired after school that she falls asleep as soon as she gets home from school. Pregnant teens may be too tired to participate in the extracurricular activities that they used to enjoy. Some teen girls may complain that they are always hungry and they may begin to crave certain foods. These girls may appear to gain weight in their breasts, abdomen and face. Other teens may hardly eat at all due to frequent bouts of nausea and vomiting. These girls may appear to be rapidly losing weight.
- Moodiness: An early sign of teenage pregnancy is unusual moodiness. Increasing hormone levels can cause pregnant teens to become uncharacteristically irritable and jumpy. Pregnant teens may have intense mood swings in which one minute they are happy and the next minute they are depressed. A pregnant teen may become moody because she does not understand what is happening to her. She may not realize that she is pregnant or she may be in denial about it because she does not want to deal with what is happening to her body.
Causes of teenage pregnancy
Societal beliefs system
In some societies, early marriage and traditional gender roles are important factors in the rate of teenage pregnancy. For example, in some sub-Saharan African countries, early pregnancy is often seen as a blessing because it is proof of the young woman’s fertility. The average marriage age differs by country, and countries where teenage marriages are common experience higher levels of teenage pregnancies (Locoh, 2009).
Sexuality
In most countries, most men experience sexual intercourse for the first time before their 20th birthdays. Men in Western developed countries have sex for the first time sooner than in undeveloped and culturally conservative countries such as Sub-Saharan Africa and much of Asia (Locoh, 2009).
Drug and alcohol use
Inhibition-reducing drugs and alcohol may possibly encourage unintended sexual activity. The drugs with the strongest evidence linking them to teenage pregnancy are alcohol, cannabis, and other substituted amphetamines (Locoh, 2009).
Lack of contraception
Adolescents may lack knowledge of, or access to, conventional methods of preventing pregnancy, as they may be too embarrassed or frightened to seek such information. They are heavily influenced by negative, second-hand stories about methods of contraception from their friends and the media. These women gave three main reasons for not using contraceptives: trouble obtaining birth control (the most frequent reason), lack of intention to have sex, and the misconception that they “could not get pregnant.” (Locoh, 2009).
In other cases, contraception is used, but proves to be inadequate. Inexperienced adolescents may use condoms incorrectly, forget to take oral contraceptives, or fail to use the contraceptives they had previously chosen (Locoh, 2009).
Age discrepancy in relationships
Age discrepancy between the teenage girls and the men who impregnate them is an important contributing factor. Teenage girls in relationships with older boys, and in particular with adult men, are more likely to become pregnant than teenage girls in relationships with boys their own age. They are also more likely to carry the baby to term rather than have an abortion (Locoh, 2009).
Sexual abuse
Studies revealed that 11–20% of pregnancies in teenagers are a direct result of rape, while about 60% of teenage mothers had unwanted sexual experiences preceding their pregnancy. Before age 15, a majority of first-intercourse experiences among females are reported to be non-voluntary; 60% of girls who had sex before age 15 were coerced by males who on average were six years their senior. One in five teenage fathers admitted to forcing girls to have sex with them. Multiple studies have indicated a strong link between early childhood sexual abuse and subsequent teenage pregnancy in industrialized countries. Up to 70% of women who gave birth in their teens were molested as young girls (Locoh, 2009).
Dating violence
Studies have indicated that adolescent girls are often in abusive relationships at the time of their conceiving. They have also reported that knowledge of their pregnancy has often intensified violent and controlling behaviours on part of their boyfriends. There have been reports that most teenage pregnancy resulted from cases of boyfriends’ attempt to sabotage their efforts to use birth control (Locoh, 2009).
Childhood environment
Women exposed to abuse, domestic violence, and family strife in childhood are more likely to become pregnant as teenagers, and the risk of becoming pregnant as a teenager increases with the number of adverse childhood experiences. Studies have also found that girls whose fathers left the family early in their lives had the highest rates of early sexual activity and adolescent pregnancy.
A girl is also more likely to become a teenage parent if her mother or older sister gave birth in her teens. Other studies attributed the occurrence of adolescent pregnancy to a breakdown of communication between parents and child and also to inadequate parental supervision (Locoh, 2009).
Media influence
A study conducted in 2006 found that adolescents who were more exposed to sexuality in the media were also more likely to engage in sexual activity themselves. Teens exposed to the most sexual content on television are twice as likely as teens watching less of this material to become pregnant before they reach age 20 (Locoh, 2009).
Effects of teenage pregnancy
Effects on the teenage mother
Teen mothers are more likely to drop out of high school. However, recent studies have found that many of these mothers had already dropped out of school before becoming pregnant. The correlation between earlier childbearing and failure to complete high school reduces career opportunities for many young women. Additional research found that nearly 50% of all adolescent mothers sought social assistance within the first five years of their child’s life. Most teenage mothers live in poverty, with nearly half in the bottom fifth of the income distribution. Other studies state that teenage women who are pregnant or mothers are seven times more likely to commit suicide than other teenagers.
Teenage mothers with other girls with similarly deprived social-economic profiles, bad school experiences and low educational aspirations, the difference in their respective life chances was negligible. Many teen parents do not have the intellectual or emotional maturity that is needed to provide for another life. Often, these pregnancies are hidden for months resulting in a lack of adequate prenatal care and dangerous outcomes for the babies (Hofferth, Reid and Mott, 2011).
Effect on the child
Early motherhood can affect the psychosocial development of the infant. The children of teen mothers are more likely to be born prematurely with a low birth weight, predisposing them to many other lifelong conditions. Children of teen mothers are at higher risk of intellectual, language, and socio-emotional delays. Developmental disabilities and behavioural issues are increased in children born to teen mothers.
Poor academic performance in the children of teenage mothers has also been noted, with many of them being more likely than average to fail to graduate from secondary school. Daughters born to adolescent parents are more likely to become teen mothers themselves (Gibbs, Wendt, Peters and Hogue, 2012).
Effects on other family members
Teen pregnancy and motherhood can influence younger siblings. One study found that the younger sisters of teen mothers were less likely to emphasize the importance of education and employment and more likely to accept human sexual behaviour, parenting, and marriage at younger ages; younger brothers, too, were found to be more tolerant of non-marital and early births, in addition to being more susceptible to high-risk behaviours. If the younger sisters of teenage parents babysit the children, they have an increased risk of getting pregnant themselves. Once an older daughter has a child, parents often become more accepting as time goes by. The probability of the younger sister having a teenage pregnancy went from one in five to two in five if the elder sister had a baby as a teenager (East, 2010).
Health implications of teenage pregnancy
Maternal and prenatal health is of particular concern among teens who are pregnant or parenting. The worldwide incidence of premature birth and low birth weight is higher among adolescent mothers. Research indicates that pregnant teens are less likely to receive prenatal care, often seeking it in the third trimester, if at all. Pregnant teens receive insufficient prenatal care and that their children are more likely to have health issues in childhood or be hospitalized than those born to older women.
Many pregnant teens are at risk of nutritional deficiencies from poor eating habits common in adolescence, including attempts to lose weight through dieting, skipping meals, food faddism, snacking, and consumption of fast food. Inadequate nutrition during pregnancy is an even more marked problem among teenagers in developing countries.
Risks for medical complications are greater for girls aged under 15, as an underdeveloped pelvis can lead to difficulties in childbirth. Obstructed labour is normally dealt with by Caesarean section in industrialized nations; however, in developing regions where medical services might be unavailable, it can lead to eclampsia, obstetric fistula, infant mortality, or maternal death (Banerjee, et al., 2009).
Prevention of teenage pregnancy
The following according to Oringanje, Meremikwu, Eko, Esu, Meremikwu and Ehiri (2009), are measure to prevent teenage pregnancy:
- Abstinence: Abstinence from sex is the only behaviour that is 100 percent effective at preventing teenage pregnancy. Abstinence from sex is the best choice for teens as it avoids early pregnancy, parenthood and sexually transmitted infections (STIs).
- Use of contraceptives: Besides abstinence, using contraception during sexual intercourse can also prevent teenage pregnancy. Whether using barrier or hormonal methods, contraception can help to avoid pregnancy. Educating already sexually active teens about contraceptive methods may help to change attitudes and behaviours toward safer sex practices.
- Communication: Preventing teenage pregnancy may also come down to overcoming parent-child communication barriers. The parents influence their decisions about sex, love and relationships the most; even more than the media or their peers. Starting a conversation about sex early and often may prove beneficial. This conversation should ideally begin well before a child’s teen years. Parents are encouraged to talk early and become “askable” parents (let kids know that they can ask you anything). Remember, this is ideally an 18-year conversation, not just one talk.
References
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Banerjee, B., Pandey, G., Dutt, D., Sengupta, B., Mondal, M., & Deb, S. (2009). “Teenage pregnancy: A socially inflicted health hazard”. Indian Journal of Community Medicine 34 (3): 227–231
Corcoran, J. (2012). Consequences of adolescent pregnancy/parenting: A review of the literature. Social Work in Health Care, 27(2), 49-67
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Gibbs, C.M., Wendt, A., Peters, S. & Hogue, C.J. (2012). “The impact of early age at first childbirth on maternal and infant health.”. Paediatr Perinat Epidemiol. 26 Suppl 1: 259–84
Haveman, R. H., Wolfe, B., & Peterson, E. (2009). Kids having kids: Economic costs and social consequences of teen pregnancy (pp. 257-284). Washington: The Urban Institute Press.
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