Teenage Pregnancy, Reproductive Health

The purpose of the research is to demonstrate how the practice of abortion in India involves state intervention in women’s personal lives. I demonstrate how significant contradictions arise in state practice towards women’s access to abortion. I discuss the implications of these contradictions for women. Moreover the sensitive issue of female feticide, which is the product of gender inequality, has been highlighted to show how this practice is culturally embedded and are generated indirectly by some of the state policies.
This research shows how abortions in India are often a breach of reproductive rights of women, and merely serve as a tool to address the concern about population explosion. Moreover the state has imposed the 1994 Pre Conception and Pre-natal Diagnostic Techniques Act to prohibit sex selective abortions from above, without bringing changes from below, which is making the law stringent implications ineffective.

The main objective of this study was to assess awareness of danger
signs of pregnancy and its associated factors in Mekelle public
hospitals, 2014.
Institutional based cross sectional study was conducted among 422
pregnant mothers. Data was collected using interviewer administered
questionnaire; it was entered and analyzed using SPSS version 16.
The data were presented using texts, graphs and tables.
Out of the total participants of this study 79.6% mothers had
information about danger signs of pregnancy from which 61.9%
mothers had information about vaginal bleeding followed by sudden
gush of fluid before labor which was mentioned by 41.9% of
respondents. Severe unusual abdominal pain was the least known
danger signs as mentioned by 19 % of mothers. The main source of
information for the danger signs was health personnel and
Negligence was the main reason for not having good awareness about
danger signs of pregnancy.
Therefore, health extension workers should strengthen their
awareness creation activities; community mobilization and health
education should be considered with policy makers and other
interested organizations.

El presente documento busca reflejar algunas reflexiones y aprendizajes de un viaje realizado por el autor al Reino Unido entre noviembre de 2008 y febrero de 2009, con el propósito de avanzar en el estudio y el desarrollo del enfoque de derechos con relación a la situación de padres y madres adolescentes en Uruguay y América  Latina. En este sentido, la visita incluyó el estudio de organizaciones de la sociedad civil, con acciones específicas hacia esta población, y en particular, aquéllas que promueven una mirada de la situación adolescente desde la perspectiva del reconocimiento de derechos y su ampliación. La actividad se desarrolló en el marco de un proyecto financiado por el Programa NGPA (Non Governmental Public Action) con base en Inglaterra, cuyo objetivo principal es la generación de conocimiento sobre el impacto de las acciones no gubernamentales en el reconocimiento y ampliación de los derechos en niños, niñas y adolescentes.

Aim:  To develop a peer mentoring intervention to reduce teenage pregnancy in looked after children (LAC).
Design: An intervention development and pilot of peer mentoring for -LAC, followed by an exploratory -randomised controlled trial. Additional data was obtained through: scoping review and literature search; national surveys of social care professionals and LAC; focus groups with social care professionals; interviews with mentors and mentees and social care professionals.
Intervention: Recruitment and training of mentors; randomisation and matching of mentors to mentees; one year individual peer mentoring.
Comparison group: LAC, aged 14-18, receiving usual care. 
Setting: Three LAs in England. 
Participants: LAC recruited from the participating LAs. Mentors were aged 19-25 and mentees/care as usual group were aged 14-18 years.
Main outcome measures:  The primary outcome was pregnancy in the mentee/care as usual group, during the one year of the intervention.  We also looked at feasibility and acceptability of the intervention and trial, in order to establish whether progression criteria to a full trial could be met. The following proxy measures of pregnancy were collected:  age of first sexual intercourse, contraception use versus incidents of unprotected sex in past 3 month period, number/nature of sexual relationships, and sexually transmitted infections. Data were also collected on:  self-esteem; anxiety and depression; help seeking; locus of control; attachment style. Measures of change in self-esteem, anxiety and depression and locus of control were also applied to the mentors’ pre and post intervention.

Data sources: Phase I: 4 mentor-mentee pairs; Phase II:13 mentor-mentee pairs. Semi-structured interviews at baseline and at one year post commencement of intervention, or on exit with all mentors and mentees and usual care controls; focus groups with mentors post training; interviews and focus groups with social workers and other professionals. National surveys of Directors of Children’s services, social workers and LAC/care leavers aged 14 – 25 years; observations of mentor training; mentor diary data. Timesheets compiled by project co-ordinators (PCs).
Results: Difficulties were encountered in meeting the recruitment target for both the pilot and the exploratory trial, with only 54% of target recruitment reached for the exploratory trial. Thirteen out of 20 mentors (recruited during Phase I and II) retained to research (65%). Nineteen out of 30 participants aged 14-18 (recruited during Phase I and II) retained to research (63%). The mentor training programme was acceptable to mentors and could be manualised and replicated.  Problems occurred because of the delay between training and the intervention starting. A Phase III trial is not indicated as feasible.  There was a sufficient pool of potential participants for a future Phase III trial. However, our evidence was that the intervention, as designed, was inappropriate for this context.  LAs lacked the infra-structure or resources to manage the intervention project effectively, there was variable understanding and acceptance of the inclusion criteria and the research methodology by social workers and it was difficult for them to prioritise research demands over their generic work.  Social workers tended to act as informal gatekeepers, which limited access to potential participants. Mentees appeared to value the intervention. However, weekly meetings were not feasible and only 1 in 4 of the relationships continued for the full year. Mentees tended to be irregular in their attendance at meetings; mentors also found it difficult to set up meetings or to comply with their responsibilities. Sex and relationships tended not to be the main focus of the mentoring.  Mentors and social workers considered that more individual and group support would be needed in any future trial.

The depiction of teenage pregnancy as a social problem relies on the assumption of adolescence as a separable stage of development. Utilising a Derridian framework, I analyse how the dominant construction of adolescence as a transitional stage: (1) acts as an attempt to decide the undecidable (viz. the adolescent who is neither child nor adult, but simultaneously both) – an attempt which collapses in the face of teenage pregnancy; (2) relies on the ideal adult as the endpoint of development, and (3) has effects in terms of gendered and expert/parent/adolescent power relations.

The “conjugalisation of reproduction”, in which childbearing is legitimated only within a marital alliance, underlies some of the pathologisation of the single, female-headed household in the pre-democracy South African teenage pregnancy literature. I utilise a poststructural feminist framework that draws on elements of Derrida’s and Foucault’s work to analyse the conjugalisation of reproduction in South African research. The conjugalisation of reproduction relies on (1) the insidious “unwed” signifier which interpenetrates the term “teenage pregnancy”, allowing the scientific censure of non-marital adolescent re-production without the invocation of moralisation, and (2) the fixation of the husband-wife and parents-children axes of alliance as the main elements for the deployment of sexuality and reproduction in the form of the family. Pregnant teenagers are, in Derridean terms, undecidables: they are neither children (owing to their reproductive status) nor adults (owing to their age), but simultaneously both. Marriage is the authority that decides them, allowing them to join the ranks of adult reproductive subjects.

Teenage pregnancy emerged as a social issue within the United States in the 1970s, and somewhat later in South Africa. In this article I review South African research and literature concerning the consequences of teenage pregnancy, because it is on this level that teenage pregnancy is formulated as a problem. The literature is reviewed against the backdrop of some international research in order to provide a basis for comparison. Research on the disruption of schooling, socio-economic disadvantage, obstetric outcomes, inadequate mothering, neglect and abuse, relationship difficulties and demographic concerns is reviewed. Various gaps in the South African literature are identified. These include an inadequate theoretical grounding, a lack of gender and historical analyses, and no exploration of the power relations within which teenage pregnancy occurs.

Feminists have argued that the association made between teenage childbearing and long-term lower socioeconomic status hides a multitude of socially constructed inequalities. I extend this position by analysing how the association is linked in the South African literature on teenage pregnancy to economic security. I utilise Foucault’s conceptualization of the method of security. Security refers to institutions and practices that defend and maintain a national population as well as secure the economic, demographic, and social processes of that population. I analyse how the traits of the method of security are deployed with regard to teenage pregnancy; how reproductive adolescents are viewed as disrupting the production of the economic self and fracturing population control, thereby threatening economic security; and how the invocation of economic security allows for the legitimation of various regulatory practices.

From the CHA Journal Prize website:

"By dismantling the stereotype of the sexually conservative 1950s, Wall explores Canadian teenagers’ experiences with unmarried sex and unplanned pregnancies, arguing that the sexual revolution of the 1960s is better understood as a gradual evolution starting right after World War II. Drawing on demographic data, censuses, social welfare reports, and oral histories, Wall teaches us how to read sources against the grain. The article re-frames the issue of teen pregnancy to probe sexual desires and practices, balanced against the hard realities of coercion, sexual violence, and incest. Wall illuminates class and ethnic differences, while still being attentive to other fissures in identities. This rich and nuanced article is sophisticated and innovative, while being accessible to entry-level undergraduate audiences. It will find a broad audience among specialists, generalists, and students interested in gender relations, sexual identities, social change, and youth culture."

Article Abstract:
This article explores the culture of postwar heterosexuality as it impacted
(mainly) white girls who were teens between 1945 and the early 1960s.
It explores the prevalence of, and changing opportunities for teenage sex,
the issue of sexual desire, and the nature of girls’ partners and relationships.
Based on this exploration, it argues that opportunities for teen sex
were expanding, that girls’ partners were more often other teens, and
because of this and the age-consciousness of the times, that marriage was
being questioned as the appropriate solution when pregnancy occurred.
More broadly, this study challenges the (now aging) stereotype of the
conservative “Fifties,” especially the notion of this period as a sexually
conservative one. As such, it also helps to connect (rather than to contrast)
the 1950s with the decade that followed. Finally, it makes the case for an
expanded notion of sexual “revolution,” one which unfolded over several
decades of the twentieth century. In early postwar years, this was a revolution
of behaviour only for unlike “the Sixties,” there was little public
acceptance or open avowal of pre-marital sex.

Objective was to assess ante natal care utilization and its associated
factors among 15 to 49 years of age women in Ayder Kebelle,
Mekelle city 2012/2013. Community based cross sectional study
design was conducted, interviewer administer questionnaire was used
to collect the data. Pre-test was done for assuring data quality, the
study population was all child bearing women in Ayder kebelle.
Systematic random sampling technique was employed to select the
intended study subjects. Sample size was 252 and bivariate logistic
regression analysis was computed to interpret and identify factors
associated with antenatal care utilization. OR using 95% confidence
interval and p- value were calculated. Data entry, cleaning and
analyzing were done by using SPSS version16 statistical software.
The study revealed that about 88.9% of the women had at least one
antenatal visit during their recent pregnancy. Almost half of the
antenatal care (44.2%) attendants made their first visit during their
second and third trimester of pregnancy. Among antenatal care users
around 84.8% had four and above antenatal care contacts. The main
reasons for non-attendance at antenatal care clinic were related to
being in good health and poor quality of service. It was also
observed that non-attendance was higher for those with unplanned
pregnancy, low knowledge of unhealthy pregnancy and those whose
husband or partner’s attitude to antenatal care attendance were
negative. In conclusion the study revealed that Socio demographic
factors were found to be barriers to utilization of antenatal care
services and the overall antenatal care utilization is higher 88.9%.