DETERMINANTS OF ADOLESCENT DECISION FOR ABORTION OR MOTHERHOOD IN OBOT AKARA
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DETERMINANTS OF ADOLESCENT DECISION FOR ABORTION OR MOTHERHOOD IN OBOT AKARA
- Background of the study
According to David (2010) in Healthcare Magazine, 45 million abortions – legal and illegal – are performed every year. A report by the International Planned Parenthood Federation said that this figure has risen to 55 million abortions worldwide each year and adolescent that abortions, have increased from 23.2%to 45.0%(David, 2010). As stated by World Health Organization, (2011) specific 1.06 million abortions were performed in 2011, down from 1.21 million abortions in 2008, resulting in a decline of 13% (WHO, 2011)
In Nigeria, Oye – Adeniran (2013) found that 760,000 abortions occur in Nigeria each year. With regard to the age group and marital status of applicants for abortion, he said that 55% were adolescence less than 25 years of age. David again maintained that abortion is a social defect that operates at a high level among teenagers in the world and the evidence has resulted in the death of a teenage girl (David, 2010). To support this, Onwudiegwu and Odunsi, (2013) opined that in the various hospitals in Nigeria, there are cases of criminal abortions among adolescents that have resulted in death or permanent damage to their uterus (Onwudiegwu and Odunsi, 2013).
On the other hand, abortion is defined as the termination of pregnancy before the embryo/fetus (baby in the womb) attain the age of viability (maturity) (WHO, 2012). In line with WHO (2012), Okeye, (2013) defined abortion as the termination of pregnancy before the fetus attains birth weight of 500mg or gestational age of 20 weeks. To Okeye,abortion is the ending of pregnancy by removing or forcing out a fetus or embryo from the womb before it can survive on its own. In addition, Okeyeargued that abortions can occur spontaneously, and are then often called miscarriages. It can also be purposely caused in this case it is known as an induced abortion (Okeye, 2013). Ani (2011) explained abortion as a spontaneous or deliberate ending of pregnancy before the fetus can be expected to live. Okeye, (2013) opinion is that abortion can otherwise be termed miscarriage. Okeyealso added that, many clinical reports collected in dozens of cases of abortion, induced abortion accounted for about 60 percent to 80 percent of infertility cases among teenage mothers (Okeye, 2013).
In 2011, there were 16 million births to teenage mothers aged 15–19 years; representing 11% of all births worldwide (WHO, 2011). Almost 95% of these births occur in developing countries. In reality half of all the births occur in just seven countries, Nigeria, Ethiopia, Democratic Republic of Congo, Bangladesh, Brazil and the United States of America (WHO, 2012).Teenage motherhood under certain situations is acceptable while in others it is regarded as being a clog in the wheel of progress especially for the female teenager. The same may not be said about male teenagers who impregnate a female teenager, thus indicating a gender bias in the consequences of teenage pregnancy. In many parts of the world parents encourage teenage marriage in hopes that there will be financial and social benefits to the family (UNICEF, 2015).As a result of teenage childbearing, the affected teenagers are likely to curtail their educational attainment because women who become mothers in their teens are more likely to curtail their education (FMOH, 2011).
Teenage pregnancy encourages illegal abortion with the attendant problems of pelvic infection and infertility. Some medical opinion recommends that legal abortion should be available to all pregnant teenagers age 16 years and younger (Swierzewski, 2015).Swierzewski further stated that teenage pregnancy is a serious issue that may seriously impact the future of an adolescent. Any teen pregnancy will be a challenge as teens typically lack skills needed to handle a pregnancy and motherhood. Patience, maturity and ability to handle stress are required by pregnant mothers of all ages (Swierzewski, 2015). However, complications that may occur during a teen pregnancy include anemia, toxemia, high blood pressure, placenta previaand premature birth of the baby.Also, women who become pregnant during their teens are at increased risk for medical complications, such as premature labor, and social consequences (CDC, 2011).
On the social and economic standpoint relating consequences, there are regular patterns across individuals. For example, a majority follow a common pattern regarding timing of school leaving, entry into employment, marriage and childbearing. Social ostracism for the mother may result in rejection by her family and peer group (Hofferth, 2016). More often, those who are students drop out of school due mostly to pressures they experience, which include stigmatization that is limited with early parenting; isolation from their peers; and lack of the necessary support from their family, friends, schools, social service agencies and other organizations. These factors emerge because of the cultural and normative values that teenage pregnancy tends to breach (Ekeng, Samueland Esien, 2014).
It has however been noted that teenage births are associated with lower annual income for the mother. Pregnant teenagers are almost always trapped in a cycle of poverty. Even if they are employed at the time of becoming pregnant, they are often dismissed and then receive low maternal benefits to cover their needs with little or no education and no skills; she may be forced to prostitution as a means of support for herself and the child. Having multiple partners, places her at a greater risks for STD, including HIV/AIDS (Hofferth, 2016).Eighty percent of teen mothers must rely on welfare at some point. Teenage mothers are more likely to drop out of school. Only about one-third of teen mothers obtain a higherdegree. In addition, teenage pregnancies are associated with increased rates of alcohol abuse and substance abuse, lower educational level, and reduced earning potential in teen fathers (Swierzewski, 2015).
A teen pregnancy may also impact the baby. The U.S. Centers for Disease Control and Prevention notes that babies born to teens may have weaker intellectual development and lower skill set scores at kindergarten. They may also have ongoing medical issues and behavioral issues. For example, there are health risks for the baby and children born to teenage mothers are more likely to suffer health, social, and emotional problems than children born to older mothers. Here children also suffer psychological consequences, e.g. not knowing who their father is, a lack of father-figure as a role model, and the trauma of the mother’s bad-luck and subsequent poverty(CDC, 2011). According Ekeng, Samueland Esien, (2014) the boys suffer most from the absence of a father-figure and tend to develop a negative image of females which can lead to violence against women including rape in young adulthood.Children born to teenage mothers are often left to the care of ageing family members. They may be exposed to the violence of family life in the townships and may then accept violence as the only means to resolving problems. The growing number of street children in urban areas of developing countries may be connected to teenage pregnancies(Ekeng, Samueland Esien, 2014).
The studies examined here are particularly important because they reveal the process by which early birth affects later economic well-being. First, most impacts on later economic welfare are indirect. That is, early birth reduces school attendance and increases the size of the family later. It is these variables that reduce active participation in work, earnings and family income, not anticipated birth itself. This implies that if the links between an early birth and schooling or the size of the family could be broken, the link between an early birth and an economic disadvantage could also be broken. This is the optimistic part. It has proved difficult, in fact, to break these ties. More research on the factors associated with decreasing these connections is necessary.
1.2 Statement of the problem
Reports indicate that there are approximately 1 million adolescents globally who become pregnant each year. Of those, 78% are unintended. Of all the teenage girls that become pregnant, 35% choose to have an abortion rather than bear a child. This indicates a problem in the amount of sexual activity with teens, and ultimately the decision made once they find out they are pregnant (Jones, 2015). Abortion still carries a very high stigma in the Nigerian society; teenage girls who have an abortion or who are teenage mothers usually lose their self-esteem and prestige due to the negative reaction towards them by other members of the society (Saka, 2011).
The option to end a pregnancy has psychological and emotional consequences some more intense depending on the individuals’ belief system. However, the option of terminating a pregnancy in teenagers has its risks because this is often times done by quacks. The dangers involved in unsafe abortion can sometimes result in irreversible life time consequences such as cervical tearing and injury, perforated uterus, hemorrhage, chronic pelvic infection, infertility, incomplete abortion and even death (Ifijeh, 2016). Post abortion infection and complications are common and can lead to death. In Nigeria, complications of abortion account for 72% of all deaths in young women under age 19; moreover, half (50 percent) of all maternal deaths result from illegal abortion among Nigerian adolescents (Sotunde, 2014).
In as much as abortion among teenagers carries a lot of health risk and is socially unacceptable, teenage motherhood equally has its devastating consequences because during the teenage years, the teenage girl is not prepared to face or to deal with an unexpected pregnancy and motherhood.
It is very common to see young girls, age 18 or less, who are pregnant or already having a child. It affects every aspect of her physical and mental well-being while she is pregnant and even after the baby is born. A teenager will experience intense emotions as soon as she has realized she has missed a period. Her emotions may start out as confusion, fear, excitement, frustration, and resentment. As she tries to figure out how she feels about being pregnant, how she will tell her parents, and what she will tell the father of the baby, she will naturally be very overwhelmed. There are many choices to make early on in pregnancy that she will need to face such as ending the pregnancy, giving it up for adoption, or keeping the baby.
These are big questions that many young girls are not ready to face. All of this intense emotional upheaval interferes with her education and less than 50 percent of all teenagers that become pregnant will finish their secondary education. Some pregnant teens are so overwhelmed they may contemplate suicide, dropping out of school, or running away rather than face their parents or deal with these life-changing decisions. Many teenage mothers find that when they tell the father of the baby, they break up and 8 out of 10 teen fathers do not marry the mother of the baby. The father becomes absent in the baby’s life and may not bear any financial commitment through the pregnancy period and after the baby is born.
A pregnant teen may also suffer discrimination or ridicule from schoolmates and teachers. If she is part of a religious group, she may feel unwanted or like an outcast. There are many disadvantages to being a teenage mother and being the child of one. Being the parent at such a young age takes away many opportunities. The teenager can’t go and explore the possibilities of their future. They are forced to explore the opportunities of the future of their child. The child now become number one in their life’s and must be the first thing they think about when they wake up, and the last thing they think about before they go to sleep. Considering the health implications, individual belief, parental and societal expectations on teenage pregnancy, and this study seeks to investigate the determinants of an adolescents decision for abortion or motherhood in ObotAkara, AkwaIbom state.
1.3 General objective of the Study
The general objective of this study is to identifydeterminants of adolescent decision for abortion or motherhood in ObotAkara, AkwaIbom State.
1.4 Specific Objectives
The specific objectives of this study will seek:
- To determine parental influence on decision for abortion or motherhood
- To determine male partners influence on decision for abortion or motherhood
- To determine the role of socio-economic status of male partner on decision for abortion or motherhood
- To determine the influence of knowledge of health risk of abortion on decision for motherhood
- Research Questions
- What is the parental influence on decision for abortion or motherhood?
- What is the male partners influence on decision for abortion or motherhood?
- Does the socio-economic status of male partner play a role on decision for abortion?
- To what extent will knowledge of health risk of abortion influence decision for motherhood
1.7 Significance of the Study
The result from this study will be significant to social health workers, community health workers, counselors, parents as well as future researchers. This study will give better understanding of the influence of parents, partners and other social influences on abortion or motherhood among teenage girls.
Looking at the benefit aspect to health workers, findings of this study will be of immense benefit to doctors/nurses and all health workers, it will help them understand the reasons why young womenopt for abortion or tow the part of motherhood. The results of this study will add to the existing literature and will as well provide reference materials for the academic society and further research.
1.8 Limitation of the study
The challenges that might pose a threat to this work include the following;the attitude of some respondents to provide the researcher with necessary information. Since the study has some social implications.
1.9 Operational definition of terms
Abortion: Is the deliberate termination of a human pregnancy, most often performed during the first 28 weeks.
Determinant: Refers to a cause or factor which contributes to thedecision leading to the abortion of pregnancies amongst adolescents.
Decision: Is a conclusion or resolution reached after consideration resulting to a choice that one make about something after thinking about several possibilities
Adolescent: Is the period when teenagers begin to identify a noticeable change in their physical body such changes would make them aware of their body. Changes such as breast growth, the onset of the menstrual period in females, breast width and hair growth in public areas.
Motherhood: Is the state of being a mother, the kinship relation between an offspring and the mother referring to maternity.