1.1 Background to the Study
In 2017, the National Demographic and Health Survey of Nigeria reported that 24.2 percent of women and 51 percent had their first sexual intercourse before getting to the age of 18 years. This means that in Nigeria, one out of four women would have been exposed to sex before the age of 18. Over 60 percent of the nation’s population are young people and significant numbers of them are exposed to sexual intercourse very early in their life either voluntarily or involuntarily which leads to future problems such as sexually transmitted diseases , teenage pregnancy , trauma and its accompanying physical and mental complications such as vaginal fistulas, depression ,suicidal ideas e.tc. (Adelowo, 2017). Every year, an estimated 21 million girls aged 15 to 19 years and 2 million girls aged under 15 years become pregnant in developing regions. Approximately 16 million girls aged 15 to 19 years and 2.5 million girls under age 16 years give birth in developing regions. (WHO 2018).
Due to religious and cultural sensitivities, Nigerians live in denial of how common teenage sex is. A mere two percent of sexually active girls between 15 and 19 of age use contraceptives. One should not be surprise that 23 percent of the girls in this age group have children due to their lack of access to contraceptives. Some girls get pregnant because they had sex voluntarily at early age which could be due to peer pressure. Some were abused or forced to early marriage .They lack proper sex education and information on contraceptives with few who have access to contraceptives. Impacts of teenage pregnancy will result in the destruction of teens lives which does not have to do with either married or not, whether they are engaged in sex voluntarily or involuntarily. The implications are, teenage girls drop out of school and end up not acquiring any skills that will help them make a living. If they yet to be married, they end up in a terrible marriage with their child father who might be too young for parenthood himself.
In Nigeria, sexual issues are not discussed freely. This is also noticed among the married couples who do not talk about sex, advocates of sex education in schools have encountered stiff resistance from religious leaders who believe that such education would increase immorality .In Nigeria society, we only preach about abstinence ignoring that masses of teenagers are sexually active nonetheless. (Oyedele, 2017)
In this 21st century, there is still a stigma that is perceived from the public that causes a cloud of shame towards a teenage mother. This shame can enhance the way a young mother feels about her child raising abilities also her failure as a person; such negative outlook brings down her self-esteem. The babies of teenage mothers often come with different complications such as pre-term or low birth weight. There is risk of still birth or dying within the few weeks of birth, while those that survive suffer from poor nutrition, infant illnesses, poor reasoning and educational attainment, emotional and behavioral problems, the mothers become teenage parents themselves. (Akinbola, 2017)
Undiyaundeye (2012) in her book titled “Introduction to Child studies: Help us to grow into our dreams” suggested that the girl- child gets misinformation highlighted in the beauty of the teenage years in her famous Quote: “the four stages of human life are; infancy, childhood, adolescence, and teenage (the condition of no longer being used or useful) in her opinion, life becomes useless after adolescence period if not properly reared by parents and other adults”. As true as this assertion may be, it is ironic to note that this is the only part of the picture. However, life for many teenagers is a painful tug of war fixed with mixed messages and conflicting demands from parents, teachers, friends, family and oneself.
Teenage pregnancy is a major medical and socio-economic burden in both the developed and developing countries and is becoming prevalent in recent times (Okonofua, 2010).
One third (36.5 million) of Nigeria’s total population of 123 million are youths between the ages of 10 and 23 years (Population Reference Bureau, 2011). One-third of the 600,000 abortions performed yearly, as well as 80% of Nigerian patients with abortion-related complications occur in adolescents. The complications which usually result in illegally induced abortion includes hemorrhage, septicemia, perforated uterus, secondary sterility and in many cases death has been described as a school girl’s problem in Nigeria (Okonofua, Otoide, & Oronsaye, 2011).
Mental health disorders such as anxiety disorders, depression, eating disorders are fairly common in adolescence with one in four or five teenagers suffering from a disorder, according to the National Comorbidity. Low social economic status is associated with the development of mental disorders in children and adolescents (Merikangas& Burstein, 2010). The effect on a woman’s mental health does not mean that she loses the capacity to make decisions about her health and her life. We have often seen how health care service providers confuse “mental health disorder” with “mental disability.” Mental health disorders, such as depression, anxiety... etc. do not affect the patient’s ability to make decisions about her life, health or personal affairs. A distinction must be made between mental health disorder and diminished autonomy (mental disability). Most mental disorders refer to a type of emotional or psychological suffering and not to alterations in cognitive functions (Okonofua, 2010).
Teen pregnancy can cause different financial, physical and academic difficulties to an expectant mother. Some of the challenges that are usually overlooked by family and physicians. Psychologically this teens need major support which is the major support at the period of the pregnancy, delivery and after delivery of the fetus. Some of the psychological issues are Denial, Narcissism, Guilt, Low Self-Esteem.
Denial is one of the most dangerous reactions a woman gives to a positive pregnancy after carrying out the test because most of the time, the pregnancy is unintentional.