TEENAGE PREGNANCY – FACTORS ASSOCIATED WITH TEENAGE PREGNANCY

FACTORS ASSOCIATED WITH TEENAGE PREGNANCY IN ISI-UZO, NIGERIA

FACTORS ASSOCIATED WITH TEENAGE PREGNANCY

Teenage Pregnancy – In developed and developing countries teenage pregnancy continued to receive increased attention because of early age at which adolescents engage in sexual activity and the result of unplanned and unintended pregnancies associated with the risk and problems of early motherhood, lack of adequate information, education and communication on reproductive health services and the perennial concern parts of the world revealed that adolescence becomes sexually active at an early age with responding high number of teenage pregnancy in the world today.

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In addition, in 17th century the case of teenage pregnancy was increasing in number every month, the researchers view teenage pregnancy and define it as the female who get pregnant at the age of fourteen to sixteen years of life which led her into different problems such as poor education.
Further more,  in many developing countries about half the population is under 15 years. These age groups have expose themselves into sexual habit which have lead many of them into teenage pregnancy in their area and at the same time cost the adolescent their educational backward. Out of wedlock pregnancy and motherhood is a taboo to the society. When pregnancy is allowed to continue, it may place the mothers health in danger. After birth the health risk to the mother and her child will be low to compare with the health risk of the adolescent mother and the baby, is likely to receive adequate parental care. Those circumstances may be responsible for increase in infanticide, baby abandonment and child abuse for his reasons pregnancies among teenagers are creating concern for many industrialized countries even though, overall teenager rates are very high WHO (1989).
Teenage pregnancy is regarded to as undesirable phenomenon. Sexually among educationally and economically under privileged females whose health is below normal as a result of poor medical care. There is also a psychological implications of unplanned pregnancy among adolescents and it may not only have adverse effect on the mother but also the babies as well as the adolescent mother. All the basic things needed for quality life some times tend to be in adequately attainable: housing, food, education, health and recreation are always problematic.
Added to the risk of being born by teenage mother, there also existed other associated risk for babies born into an already and unequally environment lacking lives basic needs, baby and mother usually stand disadvantaged and handicapped in day to day living.
Teenage mothers are typically depicted as inadequate parents (Buch Hoiz, 1993) then children are thought to be a significant risk for maltreatments. However the degree of risk to children teenage parents may be well determine by the financial, social and emotional stresses these families face. The critical factor being the availability of resources, which offer support and encouragement.
In recognition of the identified problems of teenage pregnancy and early motherhood, there are many welfare programmes and services available to pregnant adolescent in most of the developed countries, family welfare programmes are considered as a set of measures formulated at the executive level to provide concrete support and services for the advancement of groups and individuals in order to bring about social change family programmes concern social security, social assistance, health family planning, education welfare services food and nutrition etc.
The form and content of a programme as well as its organization and administration depends on the culture and history of a given country including its values, customs and social structure as well as its resources and awareness and specific programme should be organized to the parents and guidance about the prevention of teenage pregnancy in the country.
The concept of social health emanated from the multifaceted view of health which according to world health organization is a state of complete physical, social and mental well-being of an individual and not merely the absence of disease or infirmities. According to Chijioke (1990) man is well known to be a social animal and therefore lives by interacting with his fellow human beings. Similarly, Oguguo (1996) observes that man’s nature, which can not be effectively fulfilled without inter and intra relationship has equally created some social problems ranging from hatred to others, bred and natured by the so called jet age. These problems according to Oguguo (1996) are the evil effects of man’s social consciousness which health educators have designated social health. Some of these problems emanating from social health according to Asogwa (1997) are called social health problems. This is because according to him their solution require community effort, professional  know how co-operation of other disciplines and greater effort and time. Nwachukwu (1997) identified teenage pregnancy alcoholism, drug addiction, sexual promiscuity among others as social health problems which are usually associated with the adolescents. Chauhan (1983) asserted that development is a continuous process, which begins from time of conception in the womb of the mother and continues till death.
However, that period of life that lies between the end of childhood and the beginning of adulthood is termed adolescence. Njoku (1985) pointed that adolescent is that span of years during which boys and girls move from childhood to adulthood, mentally, emotionally, socially and physically. The period varies in length from culture to culture. During the adolescent years which spans between the ages of twelve and twenty years in Nigeria (Ene and Nnamani (1997) most teenage experience a period of very rapid growth the adolescent growth spurt. This growth is accompanied by the development of reproductive organs and such secondary sex characteristics as breast enlargement in girls, beards in boys and appearance of pubic hairs generally. These changes culminated in puberty marked by the development of sperm cells in boys ovum and subsequent menstruation in girls. The bodily changes that accompany sexual maturity are a source of both pride  and embarrassment in the adolescent.
Ajiboye (1982) remarked that adolescent is a period when the youngsters to develop heterosexual feelings. This sort of feeling many lead the youngsters to develop passionate affection for others.
This may be attributed to why adolescents want to go out, engage in social activities, attend church services and carryout all sorts of personal exhibitions of themselves such teenage social interactions tend to create an atmosphere for personal affection, love which may even result in sexual intercourse.

CONCEPT OF TEENAGE PREGNANCY

Teenage pregnancy is one which in the present paper occurs within the age bracket of (12-19 years).

Teenage pregnancy is the pregnancy of young immature girls of secondary school age, usually ranging from thirteen to nineteen years of age (Oguguo 1996).

It is usually that pregnancy which occurs between the onset of puberty and late adolescence. This is a period characterized by great sexual drive in both boys and girls. It is also described as an out of wedlock pregnancy.

Maxwell (1969) and Jessor (1982) agreed that engaging in socially in appropriate and undesirable behaviour is one aspect of developmental transitions of adolescents. This explains why adolescents or teenagers become overwhelmingly infatuated in love with the opposite sex.

Oguguo (1996), posited that teenage pregnancy is usually frowned at by members of the society and that it normally results into indifferent attitude from the society to the pregnancy person in question but also makes pregnancy an unhappy thing for an unmarried girls.

Globally, people regard teenage pregnancy as a social and moral problem which often results in shame, and distress to the teenager, discrimination against her illegitimate child, and added responsibility and expenses to the teenagers family and society in general.

Indeed teenage pregnancies result from accidents and therefore, is seen as a social problem (Oguguo 1996).

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Teenage pregnancy is an important public health problem as it often occurs in the context of poor social support and material wellbeing.

Some studies have suggested that first teenage pregnancies have a higher frequency of adverse prenatal outcomes.

However, there is argument about whether this is an independent association or explained by confounding factors in general, the risk of adverse outcomes is lower in second pregnancies. However, longitudinal studies comparing outcomes in first and second pregnancies in teenagers have produced inconsistent results.

Cross sectional studies comparing the outcome of second births in teenagers and older women have observed increase rates of preterm birth, low birth weight, and prenatal death but have failed to adjust for potential confounding factors such as smoking and socioeconomic deprivation.

FACTORS ASSOCIATED WITH TEENAGE PREGNANCY

According to Muaksh (1981), knowledge is essential to determine both the extend and quality of information that persons have about a particular issue or behaviour before a change can be effectively initiated. The relationship between knowledge and behaviour is that one can be knowledgeable about something positive or negative action.

In fifteen-century age, observation was carried out about the study of the cause of teenage pregnancy in the countries and study to determine an alternative approach to teenage pregnancy from the conventional, emphasis on contraception was carried out by Gold Furis (1977).

The study revealed that adolescents from larger families are not so bright in school and received sex education late and from friends are more likely to become pregnant than adolescents from smaller families, who did well in school and received sex education from their parents and the researchers contended that the age at which sex education is received and from whom as a predictive bearing on teenage pregnancy in the society.

Health education and information are promoted but little is done to give adolescents access to reproductive health services which at the end result to teenage pregnancy in the society. In other words, the educational programmes are inadequate but services are available to the teenagers.

A programme Adversary note from the United Nations Population Found (NFPA) identified issues such as reproductive health information and planning services for sustainable youth (UNFPA, 1991).

Kare (1993) report, presented results which showed that premarital sexual activity was common at a early age (14years and above), lack of knowledge and limited access to modern contraceptives were obstacles to the use of family planning which finally causes teenage pregnancy in the world today.

The second relationship between knowledge and behaviour is that one may think he or she knows, however, this assumption may result in the positive or negative actions.

Education is generally regarded as one of the best indicators of individual modernity and literacy (Nazzar, 1995).

George (1993), postulated that the girls lack of knowledge about reproduction, their ambitious motivation, the conflicting messages or ideas received, influence teenage pregnancies, George continued by adding that lack of knowledge is primarily a problem of younger students.

According to him, the school girls in the first two classes of secondary school are insufficiently or not at all informed about how their bodies function, the risk of pregnancy and about ways to avoid pregnancy.

In addition, Okeke (1990), in his studies found out that girl who become pregnant at the age of fifteen and sixteen all reported that they had been surprised to find themselves pregnant, not realizing before hand that they could be impregnated with a single act of intercourse.

Undoubtedly, absence of sex education of the teenagers is another prominent cause of teenage pregnancy.

This absence of sex education throws them into actions which result in pregnancies. Some parents and teachers are reluctant to discuss sexual matters with their children thereby making the teenagers completely ignorant of the consequences of sex. Most of the teenage girls do no know their menstrual cycle, safe and unsafe period. Some do not know and have never used any contraceptives. Besides, they engage in sexual affairs for the mere fund of it without knowing the implications. They end up in mistakes which results in pregnancies. Majority of adolescent girls, as shown by studies carried out by Oguama (1992), shows that adolescent girls who became pregnant in Nigeria often display ignorance and innocence on the circumstances that forced them into it.

Furthermore, most teenagers however believe that drugs and contraceptives can always do the magic of preventing unwanted pregnancy. This implicit  trust on the contraceptive makes the teenagers engage in indiscriminate sexual affairs that often lead into unwanted pregnancy. Disproving the belief that contraceptive pil is nearly 100% into effective in preventing pregnancy. Mac Sweeny (1985) stressed that even when taken in the priscribed way, it is three to four times less effective in the teens and early twenties than the older women.

According to him medical experts have observed that these young girls know little or nothing about conception, which is so complicated for a layman to understand.

Parenting styles, where there is extreme permissiveness-where adolescents are allowed to do what they like without control, there is move like close of deviant sexual behaviour and teenage pregnancy can result since parental control is low or absent moral factors associated with teenage pregnancy are concerned with the principles of right and wrong behaviour. The family is the primary agent of socialization where the correct moral standards should be given to children. The home plays an interesting and domineering role in sexual socialization because it is within the context of the home that one’s sexual and otherwise activities occurs (Akinboye 1987).

In many broken homes, the proper and adequate training which should have been given to the children by both parents are now haphazardly done. Furthermore, children in such homes are exposed to promiscuous knowledge.

Moreover, Onwuamanam (1982), disclosed that a home atmosphere that is full of stress, dislike, malice, boredom and unhappiness leads to delinquency in school. Teenage pregnancy is among the delinquencies.

Single parents most of whom are women, find it increasingly difficult to cope with the stress of raising their children alone. Basey, a divorcee told Igiebor (1987) in an Interview on teenage pregnancy that sometimes you get so fed up with a child’s naughtiness and just fold your arms. She added that the emotional stress is too much for one parents to beer.

Ogunade (1957) concurred that a broken home is more likely to produce a teenage mother. Most of the single parents keep boy friends and so openly to the knowledge of their children especially daughters.

Children (1986) posited that peer group is a factor in stimulating sexual permissiveness and providing information about contraceptive. The peer group provides the teenage girls conducive atmosphere for sexual promiscuity. They lure one another to sneak out of the school or homes to attend disco parties, watch and read pornographic films and books: Adolescents can watch those in cinemas and sometimes in their homes in the absence of their parents and humiliate how positive women behaviour can lead young girls to teenage pregnant.

A girl may want to get pregnant because her friends or peer group are all pregnant and perhaps are better off, she wants to belong in that group.

The influence of pornography is great. This implies the display of sexy pictures in newspapers, magazines, video and stage shows for the purpose of sexual stimulation, or to make money. This act reduces sex to the animalistic level. Thus type of exhibition encourages teenage girls and boys to try out what they have seen or heard and the results are pregnancies and births for which the society and the young teenage are unprepared for.

Fajobi (1985) asserted that teenagers of poor economic status are mostly involved in this social problem of teenage pregnancy. According to him, their parents can not afford the financial involvement for, their maintenance at home or school.

Another widely acclaimed factor of teenage pregnancy is inadequate parental care consequent upon the hard economic situation in the country has left many homes without normal cares and affection for their children.

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Delegadeye (1978) stated as he advised that parents should try to provide sufficiently for the needs and requirements of their children. He said that special attention should be paid to their clothing, feeding, lodging and education.

Fajobi (1985) further stressed that the increasing number of school drop out which has strong correlation to teenage pregnancy could be attributed to poverty. This shows that many girls are forced to fend for themselves early in life and take up jobs as waitresses in hotels, attendants in petrol stations, roadside engine oil sellers, hawkers and receptionists in business centres etc. This exposes them to men constantly.

Ifechi (1983) observed that a visit to the five star hotels all over the country in recent times will produce shocks in an individual. This is because the road leading to them are heavily infected with teenage girls soliciting for love and money. They are literally desperate for patronage. Any motor car that comes along is invaded with places and assurances of total sexual satisfaction. The teenagers find alternative means of providing for themselves by moving and receiving gifts from older men who in turn have sexual relations with which may result to pregnancy.

Poverty leads to teenage pregnancy sometimes, young girls are forced to engage sex with as a means of paying debts which parents are borrow from and promise to pay back or give their daughters which under thirteen to fourteen years to marriage, in most cases this is done without the consent of the child and some parents are so poor that they cannot afford to pay for the education of their children. In such cases, where financial is limited the boys are given preference since they will inherit their parent and keep the family name and the girls are married out early to provide money for the education of the boys.

Moreover, teenage girls are slaves to material value. They sleep around with men to earn money to meet up their material needs; particularly the fashion wears in tune with the time.

Olanika (1991) advised that ladies should not forget that they have ignite and reputation to maintain. That as future mothers, they should start to cultivate decency right from their teenage years.

 CONSEQUENCES OF TEENAGE PREGNANCY

The consequences are discussed under the following sub-headings:

1.         Early marriage (medical implications)
2.         Educational implications
3.         Socio-economic implications
4.         Psychological consequences

  EARLY MARRIAGE

Marrying before physical and mental maturity has a lot of debilitating effect on the part of the spouses and the women in particular. Flectcher (1967) pointed out the effects of early marriage stems from lack of understanding and attack of self esteem by the mates.

Fuisternberge (1976) opined that early marriage can result to couples lacking acquisition of complex knowledge and skills.  Lack of substantial investment of materials resources of the teenage girls, and lack of overall knowledge of managing a home are also effects early marriage.

Besides early marriage and the resultant pregnancy may expose the women to medical, educational and socio-economic consequences.

Nzeako (1994) summarized the health and social risk of teenage pregnancy includes.

Anemic
Premature labour
Eclipses or fit in pregnancy
High-blood pressure
Obstructed labour
Higher risk of sexually transmitted infections
Depression
Psychosis

Why on the part of the child there may be

Fetal lose
Low birth weight
Malnutrition
Infection
Poor care; due to physical and mental immaturity of the mother.

The child may grow up to become battered, this is because the mother may vent her anger and frustration of unfulfilled dreams on the child. The child may become delinquent later in life due to poor care and lack of disciplinary control.

A researcher reported that pregnancy is dangerous to early or young adolescent mothers because their pelvic growth is not yet complete to allow for safe child delivery, (Ihejiamaizv (1995). Such underage mothers may develop prolonged or obstructed labour. An obvious medical implication of this phenomenon is that it may lead to Vesico vaginal Fistula (V VF) and Rect Vagina Fistula (RVF). These condition arise as a result of prolonged and or obstructed labour emanating from the under developed nature of the mother’s pelvix,  the baby in an attempts to force it’s way out of the womb ruptures that their layer of the skin separating the anus and the uterus, resulting to continual draining of urine such teenager of VVF victims are psychologically unstable, and unable to relate well with the immediate families and the outsiders.

She may become a social out cast the repulsive odors emanating from their body is obnoxious enough to cause a separation from friends and even family members.

Another medical problem associated with early marriage and adolescent pregnancy is a condition known as puerperal psychosis, which occurs after child birth.

Two types of puerperal psychosis are toxemic sepsis and pyrexia.

Peaces, (1980) described toxemic sepsis as a state of confusion excrement or delusion in which restlessness and disturbed perception make it impossible for the mother to nurse her baby, while pyrexia refers to as a serve depression which develops some days after the birth of the child fellows pyrexia, the mother developed  feeling of general inadequacy and may reject the child.

  EDUCATIONAL IMPLICATIONS

The life of adolescent girls are put at risk by pregnancy and child birth whether within or outside marriage.

For instance, adolescence pregnancy places a serious limitation on the educational pursuit of the teenager. Due to the cultural orientation of most ethnic groups, parents usually show a luke warm attitude towards an unmarried teenager that becomes pregnant.

The father of the teenager is usually disappointed while the mother is disillusioned because of the assumption that the girls had brought shame to the family.

Arising from this, the chances will be that the educational pursuit of such teenage girls will stop abruptly. She now becomes a drop out and victim of early marriage; as the parents may be willing to give her out to any needy man under the guise of marriage. This seenario contributes to the educational backwardness of girls in our society. Consequently, this has given rise to the high incidence of illiteracy among girls. It has also brought about lack of skilled women in specialized sector of the economy. This is because a teenage pregnant women will loose opportunity for advancement in education and meet up with their peers.

  SOCIO-ECONOMIC IMPLICATIONS

Teenage pregnancy disrupts the normal life course of the mother unscheduled parenthood propels the young mother into a role for which she is only casually prepared and often feels unready to assume pregnant. This situation often leads to divorce, separation and child abandonment. High divorce rate is experienced later in life due to change of values and wanting to catch up with that they missed as teenagers do not appreciate the demands and scarifies  needed in marriage because of immaturity.

There may be wife battering and family conflict following such premature relationship. In addition precipitate entry parenthood preempts the social and vocational experiences adolescent would otherwise acquire to prepare her for the adult roles including motherhood.

Further, compared with a woman who delays child bearing until her 21 years and above, the woman who has first child below age 20 is more likely to obtain less education, have limited job opportunities and lower income; most likely, to be separated or divorced, live in poverty, have health problems and become socially dependent (Rahini and Ram 1993). Even so a woman social status is considered improve in certain cultures of the developing world as a result of early child bearing in wedlock, culture may expect females to improve their virginity so that they will not get unwanted pregnancy. (Likwa, 1993) in many developing countries where unfavourable economic circumstances have subjected most of the population to abject poverty formal education for children becomes a luxury, not to talk of education, consequently, teenage pregnancy are usually encourage motherhood even out of wedlock may be seen as a major fulfillment for the female (Berganza 1987) However may societies command and discourage earlier child birth out of wedlock (Palma 1995). This may partly be as a result of what such situation may add to the financial strain of families out a living.

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There are confined attempted instances of succeed Lama (1991). When unmarried pregnant young female find the prospect of social and family sanctions too much to bear such as been drive from home or sent away by parents.

According to Castle (1990), a disproportionate number of suicides are committed by pregnant teenagers all over the world. Added to this are instances of violence and neglect suffered by teenager forced to marry because of pregnancy in societies where divorce is unacceptable (Ogutu Ohwayo, 1995). The educational, economic, social cost, psychosocial and physiological consequences of teenage pregnancy. The issue raised here may defer from each society, culture, developed and developing countries is more disadvantageous than their counterparts in develop countries.

Moreover, school girls who became pregnant in developing countries rarely go back to school, whether married or unmarried (Gorgen, 1993) As a result compete less schooling than their counterpart who delay childbearing until their 20 years and above. This was observed by Lunderg (1995) reported that in Kenya alone, among other developing countries, nearly 10,000 school girls are expelled from school every year because of unintended pregnancy. Even when pregnant school girls are not forced to leave school mockery from peers and shame may make it unbearable for them to continue schooling, as usual action is rarely taken against their female partners responsible for the pregnancy unfortunately, early mother hood with it’s attended and child care would not allow those adolescent mothers, who may want to return to school after child birth (Moirer, 1993). Out reach programmes are fewer in developing countries than developed ones, such programmes designed to assist pregnant school girls to return to school after childbirth have recorded some success.

Furthermore in inadequate or insufficient homes, food means of transport are usually problematic in adolescent in-immigrants from rural areas to urban counters end up living in the periphery of cities in shanty and to urban counters lacking potable drinking water, sanitary and health care facilities. It seems a teenage mother either in developed or developing country living in urban centers needs skill for a good paying job.

Furthermore, educations have been out short as a result of unintended/unplanned pregnancy suffers set back in economic advancement (Foster 1993). Pregnancy among the very poor adolescents connotes a vicious circle of poverty, in that the poorest females we the most likely to have children in adolescence and likely to remain in that poverty, it has also been observed that poverty has driven teenage mothers to sell sex for survival of self and child.

  PSYCHOLOGICAL CONSEQUENCES

In examining the psychological implications of adolescent early child bearing especially out of wedlock Alvarez (1978). Stated that childbirth and teenage pregnancy may not only have advance effect on the mother but the baby as well for the aspects of living sometime tend to be inadequately attainable, housing food, education, and health care are always problematic to teenage mother and other associated risky for babies take fore instance, a child which born into crowned out unhealthy environment lack life basic need in the society and the teenage mothers are usually have disadvantaged and handicapped in day today living  in the community infact teenage mother are typically despite as inadequate parents together with significant risk formal treatment of the teenage pregnancy which attach with social, mental and emotional stress in the country.

    ADOLESCENT SEXUAL BEHAVIOUR

Many event occur in the life of adolescents that have implication for their sexual behaviour. Some of these events include: puberty, schooling, age at first intercourse and age at marriage. The trend in recent times is that adolescents are attaining puberty much earlier than older generations of adolescents. In recent years, there is decline in age of menarche.

Studies have documented decline in age menarch in western world at a rate of 3 to 4 months per decade since the 19th century, resulting in an over all decline of 3 years. In sub Saharan African the age of puberty has dropped from 15 to approximately 12 to 14 years in most areas and in some, it is still declining (Gyep-Garbrah, 1985a and 1985b).

The decline in pubertal age seems to have relationship with early onset or initiation into sexual activity among adolescents. Defo (1997) observed that there is connection between sexual onset or age at first birth and puberty.

Thus, decline in pubertal age tends to increase sexual activity among adolescents particularly in the area of early onset into sexual activity.

Zabin and Keragy (1998) stated that a declining age at puberty puts young people at risk of early premarital exposure to sexual activity even in societies with a tradition of early marriage.

Schooling is another factor that has implication for adolescent sexual behaviour. Schooling prolongs adolescence well beyond the period encompassed by puberty customs and thus leads boys and girls to a level of autonomy or independent not previously experienced.

The implication is that an increasing proportion of the period adolescence is spent in school and managed delayed. With greater period spent in school and marriage postponed, young people are exposed to the risk of premarital intercourse for a long period of time its associated risk of unintended pregnancies, induce abortions and HIV/AIDS means age at marriage is mother factor that has implication for adolescent sexual behaviour. The mean age at marriage is rising and the world wide correlation between extended education and delayed marriage evident. Marriage in most societies marks the beginning of socially sanctioned sexually relations and exposure to risk of child birth. Though tradition discourages premarital sex, Blance and Way (1998) observed that in some cultures premarital sex is tolerated and occasionally encouraged. Sex is too common in many countries as a form of trial marriage and proved fecundity leads to formalization of the Union. (Bledoe and Cohen, 1993). With increase age at marriage and decline in pubertal marriage, young people are at greater risk of premarital sexual activity as well as unwanted pregnancy.

Other factors that have implication for adolescent premarital sexual behaviour include urbanization, unemployment and high cost of living, peer pressure, mass media need for affection and marriage religions and family background. Thus, pubertal maturity beings attained much earliest in recent years and a lot more attending school and delaying marriage than ever before, the gap in pubertal maturity and marriage has increased.

This increase exposes young people to the risk of premarital intercourse for longer periods of time and is at greater risk of unwanted pregnancy and unsafe abortion.

Singh (1998) stated that the countries of sub-Sahara Africa have the highest levels of adolescent child bearing in the developing world. Rates range between 120 to about 160 in most countries of this region. At the extreme, annual age-specific fertility rates of more than 200 births per 1000 women aged 15-19 are found in mail and Niger. According to him. Current levels of adolescence childbearing or pregnancy are moderate to high in most areas of the developing world. In a lot of countries including Nigeria, the trend in adolescent pregnancy and childbearing is increasing and is viewed as a greater social problem now than ever before. It is as a result of this that Cairo population conference document signed by most national governments affirmed the importance of reducing adolescent pregnancy and childbearing (United Nations, (1994).

TEENAGE PREGNANCY

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