Risk Factors For Teenage Pregnancy In Vhembe District Of Limpopo

DR OSEDIMILEHIN OLABODE SAMSON. STUDENT NO: 11582285. RISK FACTORS FOR TEENAGE PREGNANCY IN VHEMBE DISTRICT OF LIMPOPO, SOUTH AFRICA Teenage pregnancy means when an underage girl within the ages of 13 – 19 becomes pregnant (Langile, 2007, pp1601). It differs from one country to another but generally refers to women below legal adulthood. Teenage pregnancy has become an important public health problem. It is common, preventable and associated with negative outcome both on the mother and child (Langile, 2007pp1601; Christensen et al, 1996). In the developed countries, teenage pregnancy carries social stigma because it is outside marriage but in the developing countries, it is usually within marriage and does not involve stigma (Population council, 2006).There are some risk factors for teenage pregnancy which are community dependent. They include educational failures, poverty, unemployment, risky sexual behaviors and lack of supportive adult models. It also includes substance and alcohol abuse, sexual abuse and coercion and peer pressure (Christensen et al, 1996; Bempechat et al, 1989; Women Health Fact Sheet, 2007). Moreover, the risk factors of teenage pregnancy differ from one country to another, so also is the rate. They are country dependent which has made international comparison difficult (Langile, 2007, pp1601). United Kingdom has the highest teenage pregnancy rate in Western Europe. In 2002, the conception rates in Canada, England and Wales and United States were 33.9, 60.3 and 76.4 per 1000 females aged 15-19 years respectively (Langille, 2007, pp1602). Sub Sahara Africa has the highest rate of teenage pregnancy rate of 143 per 1000 women 15-19 years old (Treffers, 2003). In South Africa, teenage pregnancy is very common at about 66 per 1000 females aged 15-19 years old (Jewkes et al, 2000, pp 733). The prevalent rate for Vhembe district is not available. Also, while the prevalent rates of some countries like USA and Canada are reducing, the rates for England and Wales and South Africa are increasing every year (Lagille, 2007, pp1602). The latest finding shows that sexual abuse was more common reason for increase in teenage pregnancy in South Africa (Saville, 2006, pp 24).

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In teenage pregnancy and poverty, the girls’ parents are usually jobless or poor income earners. They accept their children being pregnant by a working partner who in turn support the family financially (Saville, 2006, pp 24).There is also inability to procure abortion due to economic reasons. Most medical aid do not pay for abortion but only pay for child birth services which rule out abortion as alternative (Christensen et al, 1996). Moreover, lack of contraceptive use is a common cause of teenage pregnancy. Despite global increase in contraceptive knowledge, contraceptive use among teenagers is still very low (Chen et al, 2007, pp368). In England, about 50% of under 16years and 33% in 16-19 years age group use no contraceptive at first intercourse. This is as a result of ignorance about reproduction and false assumptions that pregnancy cannot result from first sexual intercourse (Bempechat et al, 1989). Furthermore, school factors could be failure, academic problems and poor performance and lack of commitment for education. The lack of motivation for a better future could result to teenage pregnancy as an escape route (Christensen et al, 1996). Though schooling may not occupy teenagers but determines how their future time will be occupied. Therefore, school drop outs are more likely to get pregnant (Jones et al, 1990, pp 50). Drug abuse and alcoholism as a risk factor is rampant. Teenagers who drink usually take risk including sex. Substance and alcohol abuse could also lead to sexual abuse and rape (Alcohol concern, 2002; Bempechat et al, 1989). Moreover, growing up with maternal role model of young single motherhood, single parent household or sisters who have become pregnant motivate teen girls to get pregnant. Also, exposure to social problem during childhood and adolescence increases individual risk of early pregnancy (Woodward et al, 2001, pp1170; Christensen et al, 1996). The implications of teenage pregnancy are very diverse. Though the impact in Vhembe district and Limpopo province at large could not be estimated but will be similar to other countries. It could put the health of the mother and child in jeopardy. Low birth weight, preterm delivery and congenital malformations are associated with teenage pregnancy

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(Gortzal-Uzan et al, 2001, pp393; Women’s Health Factsheet, 2007). Teenagers are more likely to have poor preconception health, alcohol exposure during pregnancy and inadequate diet. Moreover, they usually delay seeking ante-natal care (Chen et al, 2007, pp369; Public Health Factsheet, 1997). Young mothers and their children are at risk of contacting STI including syphilis and HIV/AIDS (Jewkes et al, 2001, pp733). In South Africa, the prevalence of HIV among teenage mother is 15.9 and 2.1 for syphilis in 2005 while the prevalence of syphilis in Limpopo is 1.1 (DOH, 2006, pp8). The education of the girls is not spared by teenage pregnancy. More than 20% of school dropout is due to pregnancy and about 50% of teenage parents eventually graduate from high school (Bempechat et al, 1989). The societal impact of teenage pregnancy could include divorce, separation and violence. Teen parents have employment difficulties which maybe due to poor or no qualification. The children born by teenage mothers are usually dependent on social grants (Public Health Factsheet, 1997; Bempechat et al, 1989). Teenage pregnancy could lead to alienation by peer. This could lead to low self esteem and worthlessness among them (Women Health Student Factsheet, 2007). In addition, teenage pregnancy must be approached with threefold multilevel intervention (Saville, 2006, pp 24). This should include efforts to delay initiation of teenage sexual intercourse. The adolescents who are sexually active could be prevented from pregnancy while those that eventually become pregnant should be protected (Christensen et al, 1996). These efforts could be in form of sex education, career guidance and life skill training. There should also be community projects and teen awareness programmes. More also, family planning services should be teen friendly (Public Health Factsheet, 2007; Saville, 2006, pp 24). Human right awareness should be improved so as to increase the report of sexual abuses and rape. In conclusion, teenage pregnancy needs the consolidated effort of all tiers of government, NGO’s, communities and individuals. This will help to reduce common risk factors responsible for teenage pregnancy and its associated implications. There is a

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research opportunity to determine the prevalence of teenage pregnancy and its common risk factors in Vhembe district of Limpopo.

REFERENCES. 1. Bempechat .J, 1989, `Teenage Pregnancy and Drug Abuse; Sources of Problems Behaviors, ERIC Digest, vol7, no.58. Available at; http://www.ericdigests.org/pre-9214/drug.htm. (Retrieved 2008 July 07) 2. Chen X, Wen S.W, Fleming N, Demissie K & Walker A. 2007 `Teenage Pregnancy and Adverse Birth Outcome: Large Population Based Reproductive Cohort Study` International Journal of Epidemiology, vol.36,no.2,pp368-373 3. Christensen S. & Rosen A., 1996, `Teenage Pregnancy; Memorial Health System. Available at; http;//community.michiana.org/famconn.teepreg.html. (Accessed 2008 July 06). 4. Department of Health, 2006, 2005 Report: National HIV and Syphilis Ante natal Sero-prevalence in South Africa. 5. Gortzan-Uzan, L., Hallak, M., Press, F., Katz, M. & ShohanVardi,I.2001,`Teenage Pregnancy: risk factors for adverse peri-natal outcome` Journal of Maternal-Fetal Medicine, vol.10,no.2,pp393-397. 6. Jewkes, R., Vundule, C., Maforah, F., & Jordaan, E., 2001, `Relationaship dynamics and teenage pregnancy in South Africa` Social Science & Medicine, vol.5, no.5,pp 733-744. 7. Jones, D.J. & Battle, S.F., 1990, `Teenage Pregnancy: Developing Strategies for change in the Twenty-First Century, Transaction Publisher, pp 50. 8. Langille, D.B., 2007, `Teenage pregnancy: trends, contributing factors and the physician’s role` Canadian Medical Association, vol.176, no.11, pp 1601-1602. 9. Population Council 2006, Unexplained Elements of Adolescence in the Developing World, Population Briefs, vol.12, no.12.

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10. Public Health Fact-Sheet: Teen Pregnancy, 1997, Washington State Department of Health. Available at; http://www.doh.wa.gov/Topics/teenpreg.html (Accessed 2008 July 07). 11. Saville, S., 2006, ` Study finds teen pregnancy fashionable `The Mercury, vol.3, no.5, pp24. 12. Treffers, P.E., 2003, Teenage pregnancy, a worldwide problem. Available at; http://www.ncbi.nih.gov/entrez.fcgi? (Accessed 2008 July 05). 13. Women’s Health Queensland Wide, 2007, Teenage Pregnancy, Student Factsheet, Available at; http://www.womenhealth.org.au/studentfacsheets/teenagepregnancy.htm (Downloaded 2008 July 04) 14. Woodward, L., Fergusson, D.M. & Harwood, L.J., 2006, `Risk factors and life processes associated with teenage pregnancy` Journal of Marriage & Family, vol. 63, no.4,pp 1170-1184.

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