Adolescent Childbearing Factors as Determinant of Safe Motherhood in Abeokuta Metropolis of Ogun State, Nigeria

Introduction


Adolescent parenthood often places the teen mother and her child at high risk for a variety of negative personal and social outcomes, one of which is an increased risk for abusive parenting (Schellenbach, Whitman and Borkowski, 1992). Adolescent mothers and their children are at a greater risk than children of adult mothers (Bolton, 2000).


Women under 20 years of age are more likely to experience maternal complication than women ages 20 and above (Eure, Lindsay and Graves, 2002; Zabin and Kiragu, 1998). Among 50 developing countries surveyed, an average of 23% of adolescent women, including both married and unmarried women, have given birth or are pregnant. Adolescent childbearing is most common in sub-Saharan Africa, at 25% of women ages 15 to 19. In the Central African Republic, Chad, Guinea, Madagascar, Mali and Niger, over one-third of adolescent women are pregnant or have had a child (Eure, Lindsay and Graves, 2002).


On average, among 16 surveys in Latin America and the Caribbean, 19% of all adolescent women have begun childbearing. The levels are highest in El-Salvador and Nicaragua, at 25%. In nine countries surveyed in Eastern Europe and Central Asia, about 8% of adolescent women are mothers.


Most adolescents who are married or in a union have begun childbearing. In Latin America and the Caribbean, on average, 80% of married adolescents have begun childbearing, and in sub-Saharan Africa, 73%. Among all developing countries surveyed, South Africa has the lowest proportion of married adolescents who have begun bearing children, at 50%. Elsewhere, the highest level of childbearing among unmarried women ages 15 to 19 is in Nicaragua, at 10%, Nigeria, at 30%, and Ghana at 29% (Eure, Lindsay and Graves, 2002).


Predictors of higher incidence of adolescent childbearing among adolescent mothers have been examined in a variety of studies. Connelly and Strauss (1992) found that the mother’s age when her first child was born was a significant predictor of the occurrence of adolescent mothers. This relationship held even when other variables – such as income, race, education, number of children, and child’s age – were controlled. Bolton (2000) has pointed out that, there are numerous contextual similarities between adolescent parents and adolescent mothers – such as poverty, social isolation, and a poor understanding of child development – which may, collectively, provide the foundations for the development of parenthood.


Both Belsky (1980, 1993) and Azar (2001) agree that adolescent childbearing is almost always multiply determined, with numerous factors interacting to contribute to the onset of abusive behaviour. Therefore, a risk assessment that measures different areas of risk simultaneously may provide a more comprehensive picture of the characteristics associated with adolescent childbearing among adolescent mothers than do assessments that do not combine multiple components. In the present study four contextual risk factors (social support, maternal psychological adjustment, maternal preparation for parenting and child temperament) were examined in combination as predictors of adolescent childbearing in adolescent mothers.


Psychopathology or personality disturbances in one or both parents has frequently been implicated in the development of adolescent child bearing (Azar, 1991; Wupe, 1987). Most importantly, adolescent parents tend to have more psychological problems than adult mothers (Wurtz-Passino et al, 1993). Therefore, reconceptualizing parental psychological risk for adolescent mothers in terms of psychological adjustment and obtaining a more general assessment of psychological functioning may be more useful than trying to predict behaviour based on the diagnosis of specific clinical disorders.


The importance of social support in the etiology of adolescent childbearing has also been identified (Azar, 2001; Belsky, 1980, 1993; Wolfe, 1985, 1987). Two common correlates of adolescent childbearing that reflect Belsky’s (1980) social support construct are the financial and emotional support available to the family. The socio-economic status (SES) of adolescent mothers and adult mothers frequently differs (Bolton, 2000). Lower SES of adolescent families are more highly represented in poor parenting. This over-representation may be due, in part, to the increased financial stress within families and the decreased availability of family-based financial resources to deal with unexpected expenses related to child care. The emotional support provided by the parents, peers, family, or spouse is also important in distinguishing adolescent mothers and adult mothers (Bolton, 2000; McKenny et al, 1991; Wolfe, 1987). Thus, both SES and emotional support are important aspects of social support reflecting the instrumental and interpersonal components important to a broad-based assessment of this construct.


The third risk construct emphasizes the dysfunctional interaction patterns in adolescent childbearing. That is, a lack of knowledge of child development, unrealistic expectations, and a limited repertoire of skills for interacting with the child are predictive of adolescent child-bearing (Belsky, 1980; Bolton, 2000; de Lissovoy, 1973; McKenny et al, 1991; Schellenbach et al, 1992; Wolfe, 1985). In this way, a mother’s understanding and general expectations about her role as a parent, as well as her beliefs about how she is going to interact with her own child, may be early indicators of insufficient preparation for parenting, thus setting the stage for dysfunctional interaction with their children. This mental preparation for parenting termed cognitive readiness to parent by Borkowski and Colleagues (1992) – was found to be lower for teen than for adult mothers. Therefore, it is important to assess mothers’ preparation for parenting as a reflection of early predispositions towards dysfunctional parenting.


Using the ideas from Wolfe’s (1987) theory, the two components of the psychological predisposition for aggression coping may mediate the relationship between the first four risk factors derived from Bolsky’s (1993) model – that is, social supports, maternal psychological adjustment, child temperament, and preparation for parenting – and the potential for adolescent childbearing. This mediational relationship may provide some understanding of the process through which maternal and early child factors increase the adolescent mother’s susceptibility to childbearing behaviours.


Most research work on adolescent childbearing focused on the nature, causes, and prevalence. It is therefore, not to the knowledge of the researcher that studies linking adolescent childbearing and safe motherhood may have been conducted in Nigeria. It is against this background that this study becomes relevant in filling such missing gaps in our knowledge in the issue of adolescent childbearing and motherhood in Nigeria.


Purpose of this Study


The purpose of this research is to examine the predictive relationships between the contextual risk factors as social supports, maternal psychological adjustment, maternal preparation for parenting and child temperament serve to justify safe motherhood.


In order to achieve the purpose of this research, the following research questions were answered at 0.05 alpha level.


1.           To what extent would adolescent childbearing attitudes (as social support, maternal psychological adjustment, maternal preparation for parenting and child temperament) when combined predict safe motherhood among adolescents of reproductive age in Abeokuta Metropolis of Ogun State, Nigeria?


2.           What is the relative contribution of each of the factors to the prediction of safe motherhood among the adolescents?


Methodology


Research Design


This study focused on adolescent childbearing factors as determinants of safe motherhood among adolescents of reproductive age in Abeokuta Metropolis of Ogun State, Nigeria. A descriptive survey research design was adopted in which questionnaire was employed in collecting data from the respondents on the variables involved in the study.


Participants


The target participants for the study is made up all the Pre-degree female students of University of Agriculture, Abeokuta. A total of one thousand and two hundred (1200) female Pre-degree students were randomly drawn from the university Pre-degree female students to take part in the study. The range of participants’ age was between 16 years and 23 years with a mean age of 18.4 years and the standard deviation of 3.67.


Instrumentation


Two instruments were used in the study.


(i)           Self-reporting Questionnaire on Adolescent Childbearing (SQAC) measures the social supports, maternal psychological adjustment, maternal preparation for parenting and child temperament. It has 25 items rated on a 4 point likert type scale. The respondents are to indicate their degree of agreement with each item by ticking Strongly Agreed (4); Agreed (3); Disagreed (2) and Strongly Disagreed (1). It has 0.64 and 0.69 as the internal consistency and revalidation reliability respectively.


(ii)          Motherhood Inventory (MI) measures the characteristics and values attached to the institution of motherhood. It has 20 items response format anchored on Partly True to very Untrue. The test-retest reliability of the inventory was found to be 0.66 and 0.71 respectively.


All the two instruments were author-constructed and were considered valid through the favourable comments of experts in psychometrics on the suitability of the items.


Procedure for Data Collection


The participants for the study were administered two questionnaires with the assistance of two research assistants and the University Guidance Counsellor. The collected questionnaires were scored and the data obtained from them were analysed to answer the research questions. On the whole, 1200 copies of the questionnaires were distributed and returned fully filled, giving a return rate of 100%.


Data Analysis


The data collected were analysed using multiple regression and chi-square (X2) statistics to establish the relationship between adolescent childbearing and safe motherhood.


Results


Results got from the data analysis are presented in Tables 1, 2 and 3.


Research Question 1:


To what extent would adolescent childbearing factors when combined predict safe motherhood?


Table 1: Regression Analysis on Sample Data using A Combination of Independent Variables to Predict Safe Motherhood.







Multiple R:                 0.351


Multiple R-Square:     0.301


Standard Error:           3.37






Analysis of Variance






Sources of Variation




Df




SS




MS




F-Ratio




P-Value






Regression




3




5278.832




1759





5.10





<0.05






Residual




1196




517249.688




432.483






Total




1199




522528.512










Table 1 shows that the combination of the independent variables (social support, maternal psychological adjustment, maternal preparation for parenting and child temperament) in predicting safe motherhood among the adolescents yielded a coefficient of multiple regression (R) of 0.351, multiple correlation square (R2) of 0.301. The result shows that 30.1% of the variance in the prediction of safe motherhood is accounted for by the independent variables. The table also indicates that, the analysis of variance of the multiple regression data gave an F-ratio of 5.10 significant at 0.05 alpha level.


Research Question 2:


What is the relative contribution of each of the factors to the prediction of safe motherhood among the adolescents?


Table 2: Testing the Significance on Relative Contribution to the Prediction of Regression Weight of Independent Variables







S/N




Variables Description




Unstandardized Coefficients




Coefficients




Standardized




t-value




Sig.






B




Std Error




Beta






1




Social support




0.110




0.033




0.205




3.3




<0.05






2




Maternal psychological adjustment




0.124




0.037




0.288




3.3




<0.05






3




Maternal preparation for parenting




2.330




0.469




0.075




4.959




<0.05






4




Child temperament




0.144




0.044




0.022




1.2




NS






5




Constant




35.121




3.915







000










Table 2 shows for each independent variable the standardized regression weight (B), the Standard Error Estimate (SEB), the Beta, the T-ratio, and the level at which the T-ratio, and the level at which the T-ratio is significant. As indicated in the table, the T-ratio associated with the four variables (social support, maternal psychological adjustment and maternal preparation for parenting) were significant at 0.05 alpha level. The contribution of child temperament can escalate threat and violence to the prediction of safe motherhood among adolescents of reproductive age. The degree of contribution of each of the variables in order of merit are: maternal preparation for parenting (B=2.330; t=4.959; p<0.05); social supports (B = 0.110; t = 3.3; P<0.05); maternal psychological adjustment (B = 0.124; t = 3.3; p<0.05); and child temperament (B = 0.144; t = 1.2; p>0.05).


Table 3: X2 Summary on Adolescent Childbearing Factors and Safe Motherhood.










Variable Description




X2 Cal




Df




X2 tab




Sig (2 tailed)






1




Social support




16.986




3




7.81




0.001






2




Maternal psychological adjustment




29.762




3




7.01




0.000






3




Maternal preparation for parenting




33.956




3




7.81




0.000






4




Child temperament




5.969




3




7.81




0.113






* Significant at 0.05 alpha level


The result on table 3 shows that each of the independent variables made significant contribution to the prediction on safe motherhood at 0.05 alpha level. This implies that there is a strong relationship between those factors and safe motherhood. The contributions of each of the variables shows that maternal preparation for parenting (X2 = 33. 956) has the most potent variable followed by maternal psychological adjustment, (X2 = 29.762); social supports (X2 = 16.986); and child temperament (X2 = 5.969) in that order.


Discussion of Findings


The major goal of this study was to find out the influence of adolescent childbearing factors as determinants of safe motherhood.


It is on the above premise that the findings of the present investigation is reported. The result on Table 1 showed that adolescent childbearing factors either collectively or relatively predict safe motherhood. The joint combination of the four variables when taken together and regressed against safe motherhood account for 30.1% of the variance (R-square = 0.201). This is statistically significant as corroborated by the analysis of variance result of 5.10. This result agree with the findings reported by Bolton (2000); Eure, Lindsay and Graves (2002); Belsky (1980, 1993) and Azar (2001). This agreement was also supported by Wolfe (1987) and Belksky (1980).


Maternal preparation for parenting was shown to significantly relate to safe motherhood. This result agrees with Borkowski and colleagues (1992). The result obtained in the study also showed that social support was a significant contributor to the prediction of safe motherhood. This finding supports the report of Bolton (2000); Azar (2001); Belsky (1980, 1993) and Wolfe (1985, 1987). Maternal psychological adjustment was considered significant in this study. This finding supports the work of Wolfe (1987) and Belsky (1980). Child temperament was not found to significantly predict safe motherhood. This result was however at variance from the work of Belsky (1980 and Wolfe (1987).


Conclusion and Recommendations


Adolescent childbearing in any society of the world has been viewed as a social and health problem that requires urgent attention of well-meaning citizens. It is on this premise that the following recommendations are provided:


(i)           The government of Nigeria should as a matter of urgency adopt a National Adolescent Reproductive Health Policy.


(ii)          Youth centres be opened to provide information on family planning, reproductive and sexual health, and STIs and their treatment.


References


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