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07030248044CHAPTER ONE
INTRODUCTION
1.1. BACKGROUND OF THE STUDY
Teenage pregnancy is a major public health and social problem globally because of the consequences it has on adolescent mothers, their babies and their caregivers. Motherhood poses great challenges on any woman; the fact that an adolescent mother is a child that lacks the mental and financial capabilities to raise a child compounds the problem. A lot of studies have highlighted the disadvantages of adolescent motherhood on their children. These include delayed cognitive development, lower levels of language skills, academic failure, poor social outcomes, risk of becoming the next generation teen mothers and the high possibility of ending up in foster care (Jutte 2010; Staton-Chapman, Kaiser &Hancock, 2004). Teenage pregnancy is one of the primary causes of poverty, as well as the cause of certain psychosocial and educational problems in teenagers. There have been calls on governments and other stakeholders to urgently address this ugly phenomenon. Tamkins (2004) in his study found that teenage mothers often face a life of poverty, have lower levels of education and have less opportunity in the workplace than non-parenting teens. Concern about the increase in unmarried teenage pregnancy has been expressed throughout Africa (Letanro 1993). The observed consequence include contributions to higher infant mortality (Becker 1993), potential barriers to the development of the woman, increased maternal morbidity and mortality (Garenne 1997) and the spread of sexually transmitted diseases (Gyepi-Gabrah 1987). It is contributing substantially to overall fertility in Sub-Saharan Africa. Taken as a region, the countries of Sub-Saharan Africa have the highest level of early child bearing in the world (Barker et al 2009). Teenage pregnancy constitutes a health hazard both to the mothers and the fetus. The mother is at increased risk of pregnancy-induced hypertension, anaemia, obstructed labour and its sequelae (Okpani et al 2011, Ojengbede et al 1987, Uwaezuoke et al 2004). They are also three times more likely to die as a result of the complications of pregnancy and delivery than those aged 20-24 (Aboyeji et al 2013, UNFPA 2010). The fetus is prone to be delivered preterm, small for gestational age and has an increased risk of peri-natal death (Ojengbede et al 1987, Uwaezuoke et al 2004, Aboyeji et al 2013). The main issues that have strongly influenced the pattern of teenage pregnancy include the declining age at menarche and the increase in the number of years spent in school. This influences the timing of marriage. Teenagers who have finished at least 7 years of schooling (in developing countries) are more likely to delay marriage until after the age of 18 years (Salako et al 2013). This increases the length of time that they are exposed to the risk of teenage pregnancy. The reason for teenage pregnancy varies from country to country and from region to region within the same country. Factors that are associated with teenage pregnancy include rapid urbanization, low socioeconomic status, low educational and career aspiration, residence in a single parent home and poor family relationship (Adegbenga et al 2011). In 1999, Nigeria’s teenage fertility rate was 111 births per 1,000 girls ages 15 to 19, and Nigerian girls averaged more than five births during their lifetime. The emotional trauma associated with an unwanted pregnancy in teenagers can be overwhelming. The society is absolutely judgmental when it comes to issues of teenage pregnancy. This attitude has however not diminished in no way the incidence of unwanted pregnancies amongst Nigerian teenagers (Eugene 2010). In a study in the southwest of Nigeria, nearly half of the females have been pregnant before as well as two thirds of those not currently enrolled in school (James-Iraore 2013). Abortion practices remain continuously controversial in many parts of the developing countries of the world because it is intricately linked up with morality than teenagers‘liberty to live their lives the way they consider desirable. Many people, especially religious leaders have argued that providing reproductive health information and services to teenagers will encourage them to become promiscuous. As a result, the approach of successive governments to the question of teenage reproductive health tends to be based on morality, rather than the health need. It is probably for this reason that performing or seeking an abortion has been and still remains illegal in Nigeria, except it is intended to save a woman‘s life. Irrespective of public policy attachment to moral sentiments, experts estimate that more than 600,000 Nigerian girls obtain abortions each year (Henshaw et al., 1998). One study found that one-third of girls obtaining abortions were teenagers. Though students also demonstrated an increase in knowledge of contraceptive options (Centre for Communication Programs, 2011), hospital-based studies showed that up to 80 percent of Nigerian patients with abortion-related complications were teenagers (Otoide et al., 2013). This study examined the knowledge of health implications of abortion among teenage girls of Ahiazu Mbaise.
1.2 STATEMENT OF THE PROBLEM
Many teenagers are reckless with sexual practice resulting in unwanted pregnancies which are terminated in unsafe ways (Ariba 2010). Those sexually active teenagers do not receive special family planning information and have limited knowledge on dangers of unsafe abortion. Ahiazu Mbaise is no exception when it comes to teenage pregnancies and unsafe abortion as this is evident from the number of girls aged less than 20 years admitted to the maternity ward for delivery and also the high number of girls attended to for abortion complications and health issues. In 2011 there were 465 deliveries among young girls aged less than 20 , this number increased to 667 deliveries among the same age group in 2012 (Ministry of health, 2012). This is a clear indication that teenagers are sexually active and are exposed to the dual risk of unwanted pregnancies, HIV/AIDS and other health related implications. A number of teenagers were also treated for complications due to an abortion. It is beyond all reasonable doubt that teenagers in Ahiazu Mbaise resort to unsafe methods in order to terminate an unwanted pregnancy. Due to the fact that unsafe abortion is major contributor to maternal deaths, health implications its practise is a problem that needs attention. It is for this reason that the study focused on determining the level of knowledge of health implications of abortion among teenage girls of Ahiazu Mbaise.
1.3 AIMS OF THE STUDY
The major purpose of this study is to examine knowledge of health implications of abortion among teenage girls in Nigeria. Other general objectives of the study are:
1.4 RESEARCH QUESTIONS
1.5 RESEARCH HYPOTHESIS
H0: There is no impact of abortion on the knowledge of health status of the teenage girls.
H1: There is a significant impact of family planning in family health on the academic performance of the students.
1.6 SIGNIFICANCE OF THE STUDY
The result of this research work will be useful to the government. Because it will make the government to discover the consequences of abortion on the teenage girls and the role it needs to play to curb this menace in our society. The youths themselves will benefit from this research work as it will enable them to identify the problems associated with premarital sexual relationships. It will also benefit parents, because it will point out the areas through which the parents have been influencing student’s relationships among their peer groups and the quota they need to contribute to resolving the problem. The necessity to give teenage girls more attention and advocacy is obvious, therefore information from this study will be used by the policy makers and program managers in addressing the needs of young people today and come up with effective interventions to help in the reduction of unwanted pregnancies and induced abortion among this age group and hence lead to reduction of maternal mortality and morbidity in the long run. Findings of the study will also help focus attention on appropriate interventions responsive to the reproductive needs of teenage by strengthening youth friendly health services and promoting a safe and supportive social environment in which they can thrive. This is very important because the actions of young people today will shape the size, health, and prosperity of the world’s future population. It will also show their own roles in curbing premarital sex among the youths they are teaching through guidance and counselling services.
1.7 SCOPE OF THE STUDY
The study is based on knowledge of health implications of abortion among teenage girls in Ahiazu Mbaise L.G.A.
1.8 LIMITATION OF STUDY
Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.
1.9 DEFINITION OF TERMS
Abortion: This has to do with removal or termination of pregnancy between the seven month which is the viability of the foetus a time when the foetus is capable of extra uterine life and independently.
Spontaneous Abortion: This is when a pregnancy aborts on its own occurring without any external help like the use of drugs and or D and C.
Induced Abortion: This is when a pregnancy is forcedly removed with the use of drugs or D and C in a layman language; this is referred to as the criminal abortion.
Teenage Girls: school girls aged from 15 years of age to 19
Unsafe abortion: WHO defines an unsafe abortion as a procedure for terminating an unintended pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards, or both, (WHO, 2013). For this study an unsafe abortion was defined as one conducted by a member within the community or by oneself.
Knowledge: Knowledge is defined as “the facts, feelings or experiences known by a person or group of people; the state of knowing; awareness, consciousness or familiarity gained by experience or learning; specific information about a subject” (Collins English Dictionary: 2013). In this study, knowledge referred to the information teenagers have regarding unsafe abortion
Perceptions: Perceptions were defined as the attitudes towards abortion.
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