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CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Pregnancy among unmarried adolescents or young women is a serious reproductive health problem especially in developing countries. More than 14 million adolescent women give birth each year. A large proportion of these pregnancies is unwanted, and it is estimated by the World Health Organization (WHO) that as many as 4.4 million abortions are sought by adolescent girls each year. Every year, almost one million teenage girls become pregnant in Nigeria and many of these pregnancies are unintended and unwanted. The health and social consequences of unwanted or unintended teenage pregnancy have been very much described. These include, among others, increased risk of maternal death, pregnancy and birth-related complications such as excessive bleeding, anaemia, obstructed labor, stillbirth and infant death. The socio-economic consequences include education and job termination, stigmatization, and loss of self-esteem and perpetuation of the poverty trap and cycle. With the rampaging HIV/AIDS epidemic and other sexually transmitted diseases (STDs) in the sub-Saharan region, unintended teenage pregnancy among unmarried young women has become a disturbing public health problem, not only because it is a risk factor for HIV/AIDS transmission, but also because it poses a serious adolescent reproductive health and development challenge.

Knowledge and understanding of the factors and dynamics that characterize teenage unwanted pregnancies in the region should have an impact on policy and program to meet the challenges. These challenges include the provision of easily accessible reproductive health youth-friendly services, sexuality education in schools and advocacy with all stakeholders’ parents, teachers, church leaders and health care providers to support programs to reduce the problem of unwanted pregnancy among young people. This study was therefore conducted to identify the factors and characteristics of teens with an unwanted pregnancy at a rural hospital in south-east Nigeria from January 1998 to December 2001. The implication for adolescent reproductive health in the area is further discussed. The study was conducted at Christian Hospital located in Ozubulu, headquarters of Ekwusigo Local Government Area in Anambra State of Nigeria. Its catchment area covers over five local government areas in the heart of Igboland. The customs and marriage patterns largely represent that of the Igbo tribe in southeast Nigeria. Most of the inhabitants are Christians. The customs and tradition of the area do not permit pregnancy before and outside marriage. Girls are expected to remain virgins until they get married. At marriage, if the husband confirms that the girl is a virgin, he would declare her as meaning that she was sexually intact. She had not had sexual intercourse before the marriage. The young husband would give gifts to the girl for preserving her virginity and to the girl’s mother for giving her daughter good training. The young men on the other hand are not traditionally expected to be virgins before marriage. Although monogamy and polygamy are in common practice, there are other acceptable marriage practices. For example, a woman who has no child or has only female children could marry a younger woman who will bear male children for the family in order to keep the husband’s family name. This could be done irrespective of whether the husband is dead or living.

An old man may also marry a young girl to bear male children for him if he had no male children in his earlier marriage, even with the full understanding that he would most unlikely be the biological father of the children. Also, a man who perceives himself or his wife to be infertile could marry a pregnant young woman so that he can own the baby, since he is assured of the woman’s fertility. Parents of mentally impaired male children could also marry a wife for such children. Unfortunately, however, the victims of these types of marriages are most often unmarried young women with unintended pregnancies. Child adoption is very rarely practised, and it occurs only among educated men living in urban centres.

Christian Hospital was chosen for the study because of its accessibility to the community, as it is situated in the heart of Ozubulu town, and also offers reproductive health services. The author works in the hospital, a factor considered advantageous for the collection of data on such sensitive reproductive health issue being considered. For the three-year period (January 1998 to December 2001) one 155 young unmarried women with unwanted and unintended pregnancy attended the hospital for antenatal care. This figure may however not be fully representative as some of the unmarried pregnant women or adolescents might have sought care in other hospitals in and outside the area. It is common practice in the area for mothers of pregnant teens to send them to live with relations in distant urban cities for antenatal care as soon as the pregnancy is discovered. They do this to conceal the pregnancy and save the family from embarrassment. Others may have procured abortion elsewhere and would not seek antenatal care. The nature of the interview was explained to the potential participants and their consent obtained. One hundred and thirty six of the 155 unmarried pregnant young women participated in the study. Eleven out of the remaining 19 refused to consent, while the other eight attended antenatal clinic once and were interviewed once but were not present for a second interview to crosscheck and validate information given during their first visit.

Two interviews were conducted for each woman using the same questionnaire; one at first visit or contact and the second at subsequent visit. This was to validate and crosscheck earlier information. The researcher believed that the young pregnant adolescents would have developed more confidence in the doctor and health workers to enable them to give more accurate information about the circumstances of the pregnancy at their second visit. Information was elicited from the study subjects about their sexual behavior and present pregnancy using a semi-structured questionnaire. All the interviews were conducted at the hospital.

1.2 TATEMENT OF PROBLEM

Unwanted and unintended pregnancy among Nigerian teenagers is major problem in our society and the world. Even though the level of decadence in our society is high and the combing rate of teenage pregnancy alarming, resultingfrom illiteracy, poverty, superstitious believe and traditions which kick against preventive measure for unwanted pregnancy.

1.3     OBJECTIVES OF THE STUDY

The main objective of the study is to evaluate the benefit of preventing unwanted pregnancy among Nigeria teenagers:

To ascertain the major causes of unintended pregnancy among teenager.

To ascertain the method to adopt in combating unwanted pregnancy among teenagers.

To explore avenue of preventing unintended pregnancy.

1.4     RESEARCH QUESTIONS

In other to achieve the objective of the study, the following research question are put forward

What are the benefit of preventing unwanted pregnancy among Nigeria teenagers?

What are the measure of combating unwanted pregnancy?

What are the avenue of minimizing unintended pregnancy?

What are the causes of unintended pregnancy among Nigeria teenagers?

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