Implications of teenage pregnancy for mental health
Teenage pregnancies result from consensual or forced sexual intercourse with a female of 19 years old or younger.
It usually occurs after menarche. Globally, about 21 million girls between 15 and 19 years get pregnant and at least 777,000 children are born to mothers younger than 15 years, according to a report by the World Health Organisation in 2020.
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The highest numbers of cases of teenage pregnancies are reported to occur in Eastern Asia and Western Africa, according to the World Health Organisation. Teenage pregnancy is prevalent in Ghana with a total of about 109,888 pregnancies recorded in 2020 among teens between the ages of 10 and 19 as reported by the Ghana Health Service.
The Dora Awuah Foundation is an NGO which promotes mental health through awareness creation on mental health issues, crisis intervention and empowerment, with a focus on the youth.
The foundation earmarked the month of June to raise awareness of the mental health outcomes of teenage pregnancy. The objective was to raise public awareness of the emerging health challenges associated with the menace.
It is also a clarion call on parents, the Ministry of Health and their agencies, civil society groups and the government to consider possible ways of preventing teenage pregnancy while providing the needed care to females who get pregnant. The goal is to promote their growth and development into healthy adults.
The case of Ghana
In recent times, Ghana has recorded a high prevalence of teen pregnancies, with the Ashanti Region recording the highest incidence of 16.2 per cent as indicated in a report by the Ghana Health Service. Multiple factors such as parental neglect, poverty and rape are attributed to this occurrence.
For instance, estimates from the Ghana Health Service indicate that about 13 teenage pregnancies occurred every hour in 2020, which translates into about 301 pregnancies in a day. This was contained in a report published by GhanaWeb on May 2, 2021.
The majority of these pregnancies are unplanned, although in some regions, girls may be pressured to marry and bear children early.
Teenage pregnancy impacts the growth and development, academic, social and health outcomes of young females. In most instances, the psychosocial challenges associated with these pregnancies predispose the victims to mental health distresses during and after the pregnancies.
Multiple research findings have identified depression, anxiety and substance abuse as some common mental health problems experienced by the teens.
Psychosocial challenges of pregnant teenagers
Pregnant teenagers are often stigmatised in society. Majority drop out of school due to social taunts and finger pointing from teachers and peers.
In addition, adolescent mothers experience financial difficulties and are, therefore, unable to access proper health care during and after pregnancy.
These mothers are mostly not ready for childbirth, a phenomenon which results in an abrupt disruption of their quest to realise life goals and subsequent exposure to emotional distresses.
In a study conducted among pregnant teenagers in Africa, which was published in the PLOS ONE journal by Kumar and Yeng in 2012, teenage mothers encounter challenges such as lack of emotional support, poor access to health care, stress adjusting to new roles and neglect by extended families.
Anecdotal evidence also suggests that poor antenatal help-seeking by some teens who get pregnant is partly as a result of the fear of being perceived as bad girls by some health workers and other users of health facilities.
These experiences heighten distress, thus leaving negative implications for mental health and well-being of such mothers and their children later in life.
Teenage pregnancy and mental health
Teenage mothers are predisposed to depression both prenatally and postpartum compared to non-pregnant peers and adult mothers.
Depression is manifested through signs such as loss of interest in the child, crying spells and sleep disturbances.
Abundant evidence from researches shows that in some instances, young mothers attempt suicide. In low resource settings such as Ghana, adolescent mothers are at a perceived higher risk of suicide both during and after pregnancy.
Adolescents whose pregnancy results from physical or emotional abuses are vulnerable to Post-Traumatic Stress Disorder (PTSD).
Generally, teen pregnancy is associated with an increased risk of substance abuse, usually used as a means of managing the negative emotions associated with the pregnancy. Commonly abused substances include alcohol, marijuana and tobacco.
Conversely, substance abuse tends to heighten the risk of engaging in risky sexual behaviours. Subsequently, the biological and psychosocial challenges associated with teenage pregnancy increase the risk of developing mental health problems in later years, which have implications for parenting and child well-being.
The way forward
Teenage pregnancy has proven over the years to impact individuals, families and the wider society diversely. As such, a collective, multi-sectoral approach to prevention and rehabilitation of teen mothers is imperative.
Adequate sex education in schools, churches and in the wider community is a necessary measure to reduce the incidence of teenage pregnancy in Ghana.
Good parenting practices such as provision of basic needs, expression of warmth and good communication are relevant in preventing teen pregnancies.
In instances where pregnancy has already occurred, unconditional acceptance and provision of basic needs, coupled with support for pregnant teens to access health care are necessary for their well-being and that of their unborn children.
Pregnant girls must be motivated to continue with their education and while in school, we recommend specialised psychosocial support for them by school authorities.
Mental health services such as screening and counselling must be integrated into antenatal care to allow for early case detection and treatment.
Periodic supportive home visits by health workers are needed to resolve family conflicts. The bigger society has a role to support teen parents by remaining warm and supportive throughout pregnancy and childbirth.
Given that the age of sexual debut for teenagers is reducing in many countries, including Ghana, as revealed in a study by Oppong, Nketiah-Amponsah, Andoh-Arthur, Boafo and Ampaw in 2018, training teenagers in assertiveness skills will in the long term, empower them to say no to forced sexual encounters.
Conclusion
Teenagers are encouraged to concentrate on school, pursue a career and find their purpose in life. Parental affection, good communication and provision of basic needs are necessities all parents must ensure to prevent teen pregnancies.
Violence against pregnant girls aggravates their plight. However, supportive home, school and community environments help promote total well-being of young mothers and fathers for a better future.
This article was co-authored by Dora Awuah
Clinical Psychologist/Mental Health Specialist,
Founder, Dora Awuah Foundation
Doraawuahfoundation.org.gh
&
Adjoa-Sam Awuku
[email protected]
Resident Nurse Specialist
Ga-South District (GHS)