Teenage pregnancy affects millions of girls every year worldwide and is extremely common in Africa. Teenage pregnancy reflects a pattern f sexual activity which not only puts teenagers at risk of pregnancy but also of infection by the human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs). The subject of sexual behaviour is complex. It is an interplay of several factors - social, biological, economic and psychological.
Teenage pregnancy has been widely studied, but attention in relation to Africa has been largely limited to its prevalence. In particular, little work has been done on the consequences of teenage motherhood. The present study focuses on factors that pre-dispose a girl to teenage pregnancy, the effects of pregnancy on physical and mental health, and the socio-economic consequences of teenage motherhood.
The initial part of this study used qualitative research methodology. Focus group discussions were conducted with ten unmarried teenage mothers and a comparison group of ten teenage in-school girls aged between 10-19 years. Content analysis of the ensuring data was carried out to identify factors that predisposed teenage girls to unwanted pregnancy, and to determine the level of awareness about sexuality and sexually transmitted infections among teenage mothers and in-school teenage girls. The key themes that emerged as factors that predispose teenagers to unwanted pregnancy were: early sexual initiation, peer pressure, perception that other teenagers had sexual intercourse, knowledge deficit about their sexuality, sex-for-money, multiple partners, parental poverty, coerced sexual intercourse, and rape. Teenage mothers listed the following as consequences of their premature pregnancy: dropping out of school, abandonment or mistreatment by parents, desertion by their boyfriend, loss of friends, being scorned by relatives, contemplation of abortion, attempted abortion, depression, complications during or following delivery, sleep deprivation after delivery, and disillusionment about their future.
The second part of the study was a quantitative survey which aimed to compare the experiences of teenage mothers and in-school girls. Of major concern was depression among teenage mothers, an area that has received little attention in the literature. The Beck Depression Inventory (BDI) instrument was used to assess depression. There were 198 teenage mothers and 188 in-school girls who took part with their consent and/ of their parents. Analysis was by quantitative methods, including both bivariate statistical procedures and some multivariate methods.
Results show that of the teenage mothers, 65.2% had sexual intercourse before age 15, compared to 29.8% of the in-school girls. In the study, 12.1% of the teenage mothers and 3.5% of in-school girls suspected that they had ever had a sexually transmitted infection, while 6.1% of teenage mothers and 2% of in-school girls indicated that they had a confirmed and treated STI.
During pregnancy, abortion was contemplated by 25.3% of the teenage mothers. However, most of them were vague in their knowledge about available methods. About half of the teenage mothers (49.5%) in the study indicated having contemplated committing suicide, while only 17% of the in-school girls in the control group had contemplated committing suicide.
Teenage mothers were more depressed than in-school girls; the average depression score for teenage mothers being moderate to severe depression compared to mild to moderate for the in-school girls. The respondents who reported having consensual sex were examined along the three traits of early/non-early sexual initiation, multiple/single sexual partners, and sex-for-money. In each category, the teenage mothers were more significantly depressed than in-school girls, with the average depression scores being moderate to severe for teenage mothers and mild to moderate for the in-school girls in all the groups. For those who reported having coerced sex (those raped or teacher-seduced), there was no significant difference in the state of depression of the teenage mothers and the in-school girls - the average depression score being mild to moderate fort he raped, and teacher-seduced respectively.
The study explored the predictors of depression in teenage mothers, through multiple regression analysis. The models derived found the following four variables to be significant predictors: age at 1st sexual initiation, the teenage mother's own level of education, father's level of education, and whether the teenage mother had experienced rape.
In conclusion, this study suggests that being a teenage mother at such a young age is a difficult journey. The study adds to growing knowledge about depression among teenage mothers and suggests this is a significant problem which needs to be addressed. It is anticipated that health professionals, ministries such as the Ministry of Culture and Social Services and the Government of Kenya will use this knowledge to improve the services of its youth in general.