TEENAGE PREGNANCY

Determinants and Psycho-Social Consequences of Teenage Pregnancy

Abstract

The present study was undertaken to assess determinants and psycho-social consequences of

teenage pregnancy among 300 women, who had child in their teens from rural Rajasthan, India. A

quantitative as well as qualitative approach was employed with self made questionnaire cum

interview schedules. Z-tests and one way ANOVA were used as tests of significance. Early

marriage causes teenage pregnancy and has adverse impact on psycho-social health of women.

Early marriage and early age at effective marriage, lead the women’s age at birth of first child with

socio-cultural factors and access to contraception. It was found that there has been a significant

impact of age at birth of first child on fertility outcome and health status, denial of education,

denial of freedom, personal development & inadequate socialization. Most of the respondents

hesitate to share their problems and experiences, even with husbands and have repetitive

pregnancy which leads them to vicious cycle of over burdened responsibilities.

Key words:  Early Marriage, early Gauna, teenage Pregnancy, Fertility Outcome, Determinants,

and Psychosocial consequences

Author:

1. Dr. Darshan Kaur Narang, Assistant Professor (Dept. of HSc) University of Rajasthan,

Jaipur and Local Head, Dept. of Home Science, Maharani College, Jaipur

2. Dr. Ranjana Vaishnav, PhD Scholar, Jaipur

3. Dr. K. Karodia, Assistant Professor(Dept. of HSc), UOR

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INTRODUCTION

Women constitute about half of the total population of India and around 81 percent of total

female population lives in rural areas. The plight of rural women in India, irrespective of their age,

is a matter of concern. In India, birth of the child is considered legal or welcome only after

marriage and girls are socialized from the very beginning to accept the situation, role and ideology

of male supremacy, which willy-nilly makes them prey to a whole range of discriminatory

practices. She learns to be submissive and acquiescent- first as a daughter and sister and then as a

wife and mother. Early marriage and early pregnancy severely constrained the prospects of all

round development of young girls. As soon as a she enters into the institution of marriage she

becomes woman even if she is too young.

It is a well known fact that India is a country of very low age at marriage of females,

consequently girls become mothers in their teens and the practice is more common in traditional

rural communities as compared to the urban. National Family Health Survey-3 (2005-06) revealed

that child marriages, including marriages of cradle child, are widely practiced in the state of

Rajasthan of India where more than 50 percent women had married before age 18. NFHS-3 also

found that women marrying early, having their first child at 19.7 years of age and having four

children before ending their childbearing age. In India, early marriage and pregnancy is more

common in traditional rural communities compared to the rate in cities (Mayor, 2004). Save the

Children (2004) found that, annually, 13 million children are born to women under age 20

worldwide, more than 90% in developing countries. 

Santhya and Jejeebhoy (2006) documented several studies in India indicating that young

women's early sexual encounters within marriage are often described as frightening and non-

consensual. Despite the high prevalence of early marriage, little is known about the lives of

married young women including the nature of problems of the early years of marriage or the

pressures they face and little has been done to support them. UNICEF (2005) specified that early

labor, early marriage, early motherhood, seems to be a common practice for a majority of Indian

girls. This contributes to increased risks of premature delivery, various health hazards, low birth

weight babies, anemia and high maternity and infant mortality rates. UNESCAP (2001) highlights

that “young people in the Asian and Pacific region, particularly adolescents, who comprise about

half of the youth population, are increasingly exposed to reproductive health risks. Two distinct

issues in the region require serious attention. The first is the widening gap between sexual maturity

and the age at marriage, which leads to premarital sexual activity among young people.  The

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second is the prevailing rate of marriage during adolescence in some countries in the region, which

results in high rates of adolescent fertility”. Joshi and Pai (2000) studied 290 pregnant women and

found that incidence of low birth weight was higher in teenage pregnancies, with high parity and

low socio-economic status. This may be due to the fact that early marriages lead to larger number

of teenage pregnancies with inadequate spacing. According to Shah (2005) the major

complications in young mothers are thought to be high blood pressure, iron deficiency, anemia,

disproportion and birth of low weight babies. Similarly, infants born to such teenage mothers are at

higher risk of complications of pre-maturity, low weight, accidental trauma and poisoning, minor

acute infections, lack of immunization or vaccinations and developmental delays.

Teenage pregnancy is one that occurs from puberty to 19 years of age and is also known as

Adolescent Pregnancy is a matter of great concern, there is far too little concrete information on its

prevalence and its impact. Comprehensive data such as age at marriage & effective marriage and

birth of first child are essential for making significant progress in understanding the risks

associated with it. In view of this, the present study was planned to examine the age at marriage,

age at effective marriage and age at birth of first child of the women in reflection to its

determinants and psycho-social consequences.

SAMPLE AND METHODOLOGY

The sample comprised of 300 women, who had child in their teens. Rural areas of

Bhilwara district of Rajasthan state was selected as a locale of the study because of high

prevalence of child marriages. As per Registrar General of India (2001) 80.2 percent females of

Bhilwara district married before the age of 18 years. The study has main objectives to explore

determinants and psycho-social consequences of teenage pregnancy. The self constituted

questionnaire cum interview schedule was used, which included items on determinants and

psycho-social consequences of teen age pregnancy. Determinants of teenage pregnancy or age at

birth of first child (B-Age) were identified by: age at marriage (M-Age) and effective marriage (G-

Age)1, socio & cultural factors and access to contraception. The psycho-social consequences

included fertility outcome and health status, denial of education, denial of freedom, and personal

1 Age at effective marriage (Gauna/ Muklawa) (G-age): In rural context, especially for Rajasthan age at marriage itself does not

depict the virtual transfer of girl from her family to conjugal family. After few days or years of formal marriage husband returns to take

her wife back to his home to live with him permanently and this occasion is known as “Gauna” ceremony. In demographic literature it is

known as effective marriage which marks the time when sexual union between husband and wife starts. For the present study G-age is

categorized in three groups i.e. 0 to 9, 10 to 14 and 15 to 19 years.

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development & inadequate socialization. Data were sorted, coded and analyzed using the SPSS. Z-

tests and one way ANOVA were used as tests of significance. Along with qualitative measures

were done in the form of case studies.

RESULTS

DETERMINANTS OF TEENAGE PREGNANCY

1. Age at marriage (M-Age) and age at effective marriage (G-Age )

Study revealed that 82 percent respondents’ married before 14 years or even less and only 18

percent married after 14 years. Thirty seven percent respondents consummated their marriage

(Gauna) before 14 years and rest 63 percent by the age of 15-19 years. The mean age at marriage

for respondents was 10.45 years while mean age at effective marriage was 14.8 years.

Table 1

Frequency (Crosstab) distribution of women’s age at birth of first child (B-age) according to

M-Age and G-Age

B-Age(in years)

M-Age (in years) G-Age (in years)0-9 10-14 15-18 0-9 10-14 15-19 Total Percentage

13 1 7 0 0 6 2 8 2.6714 4 9 0 0 8 5 13 4.3315 10 12 1 0 11 12 23 7.6716 27 64 6 1 33 63 97 32.3317 30 35 10 2 31 42 75 25.0018 19 21 25 2 14 49 65 21.6719 3 1 10 1 1 12 14 4.67

No child 0 3 2 0 1 4 5 1.67Total 94 152 54 6 105 189 300 100

percentage 31.33 50.67 18 2 35 63

Data revealed that 7% percent respondents had their first child before the age of 14 years,

8% at the age of 15 years and 33% at the age of 16 years. Rest 25%, 21.67% and 4.67% had their

first child by the age of 17 years, 18 years and 19 years respectively. The mean age at birth of first

child of the respondents was 16.33 years. It clearly indicates that the average age at which

respondents got pregnant for the first time was adolescence and most women had become pregnant

within a year of marriage.

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Most of the respondents had their first child by the age of 15 to 19 years and this frequency

is more among respondents who got married by 10 to 14 years. Even, seven percent women had

their first child by the age of 13-14 years and 32 percent by the age of 16 years. The above table

shows that most of the women got pregnant immediately after Gauna. Results of One Way

ANOVA showed the highly significant impact of age at marriage (F=12.31) and age at Gauna

(F=38.16) on age at birth of first child and they are significantly associated with each other

(Pearson’ r= .15* and .23**).

2. Socio-cultural Factors

Study further revealed that age at birth of first child is largely governed by socio- cultural

factors. Fifty two percent respondents confessed that they had faced the family and societal

pressure to bear a child preferably a son soon after marriage; especially mother in-law and

husband. The reasons cited by them are as husband being the only child (25%), preference of male

child is a major cause for too early, too frequent and too many pregnancies (38%), Nagging and

blaming by relatives and neighbors for not conceiving (19%) and Stigma of infertility or fear of

separation (18%).

Forty eight percent respondents reported that though nobody forced them to get pregnant,

but they themselves were unaware of their first pregnancy. It signifies that in case of early

marriage and early Gauna, women have no such feeling of excitement towards pregnancy. Mrs. A,

was married at the age of seven, with her brothers and sisters. Also, her Gauna was done at the

age of 13 years and she started her new life with husband and in-laws. She says “my mother in law

did not allow me to talk and sleep with my husband as I was very young. I had to sleep with my

mother in law. My husband and I used to meet, play and sex at farms. As result, I got my first child

at a very tender age of 13 years. Today I have six children. If I was married late, I would have

been aware and my life would have been better.” She was sad that marriage of her children was

fixed by elders of family and done in Mausar at early age. She further says “late marriage is not

appreciated in our caste and forces a person to marry their children also early”. People are not

ready to marry their daughters in late age.” She is now determined to delay gauna of her children

as much as possible. She wants to educate them and make them to be self reliant.

3. Access to contraception

It was found that only 14 percent respondents were aware of any contraceptive method to

avoid pregnancy at the time of first cohabitation. In rural areas people are not much aware about

contraceptive methods and they are shy enough to get access to this. Only 36 percent respondents

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had undergone sterilization to avoid repeated and unwanted pregnancy. Sixty four percent

respondents had used any method to delay pregnancy i.e. condoms and oral pills etc. Recently,

72% and 86% respondents knew that contraceptives are easily available and men could get

condoms free of cost.

Data revealed that most of the respondents gave birth to a child soon after Gauna even in

the age of 13 years. It was found that less access to contraception causes early pregnancy and more

number of abortions and miscarriages. During FGDs a large number of respondents reported

unpleasant and embarrassing experiences at the time of first sexual intercourse. Most of them were

unaware of the situation and cannot share this with others. Probably, it is a taboo verbalizing any-

thing related to sexual activities, especially between people of two different generations and the

difference increases in case of child marriage. It was observed that young adolescent married girls

hesitate in sharing such issues with others.

Mrs. B was married at the age of seven years. Her Gauna was performed at the age of 14

years. At the time of her first cohabitation, she faced unbearable pain & decided not to sleep with

her husband but her mother-in-Law persuaded her to do so; she was totally unaware of sexual

relations and its consequences. She said “I got severe pain at first time. Nobody was there to tell

me about all this. After three months I had experienced many changes in my body. But I was too

shy to tell anybody. It continued for three more months. I did not get my monthly periods. One day

I felt severe pain in my abdomen, my mother in-law called mid wife. She declared me three months

pregnant. She further said she was shocked to hear. Mid wife told that I was not physically mature

to bear a child. I had caesarian delivery with lots of problems, and after which I could not

conceive. She is very disappointed that early marriage is the only sole reason of her problems. If

she had married later, she could have gone for another child satisfying urge of her in-laws family.

Mrs C had sexual relation by 12 years. She has one daughter and after which she was

unable to conceive and it led violence and abuse on her. Her in-laws and husband tried to kill her

when she was 18 years old. Neighbors saved her life. After this incidence she came in contact with

a social worker and got awareness to media. She recollected her strength and resumed her study.

At present she is working as tailor & living independently spreading message regarding ill effects

of early marriage.

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Psycho-Social Consequences of Teenage Pregnancy:

1. Fertility outcome and health status:

Table 2

Frequency distribution of fertility outcome

B-AGE

Spontaneous Abortion

Induced abortion

Preterm Delivery

Still BirthFull Term Normal Delivery

n % n % n % n % n %13 15 22.06 2 25.00 0 0.00 0 0.00 8 2.71

14 29 42.65 2 25.00 9 52.94 0 0.00 13 4.41

15 9 13.24 3 37.50 7 41.18 1 2.27 23 7.80

16 5 7.35 0 0.00 1 5.88 12 27.27 97 32.88

17 3 4.41 0 0.00 0 0.00 17 38.64 75 25.42

18 4 5.88 0 0.00 0 0.00 5 11.36 65 22.03

19 3 4.41 1 12.50 0 0.00 9 20.45 14 4.75

Total 68 100.00 8 100.00 17 100.00 44 100.00 295 100.00

Table 2 reveals that 68 women underwent to miscarriages/abortions, among them 54.08%,

27.55% and 18.37% faced it at one time, two times and three times respectively in their married

life. At the age of mere 13 and 14 years 15 and 29 respondents underwent spontaneous abortion.

44 women had undergone still birth. As regards current pregnancies 48 respondents were found

pregnant at the time of study, reported that their pregnancy was unintended.

Almost 60% respondents felt themselves unfit or unhealthy. It was found during FGD that

respondents generally face physical problems i.e. fatigue, weakness, body pain, unrest,

gynecological problems and frustration. Almost 10 percent respondents ‘used to have medicines

regularly’; they often used ‘hare pate ki Goli’ (tablet in green packing, which is pain killer

actually). Respondents are very much puzzled about home and outside responsibilities; 64.37%

respondents said they are unable to ‘have sound sleep’. It was not surprising that 82 percent

respondents believe they ‘look older than their age’ reason being burden of household chores and

responsibilities of more number of children along with never ending demands and dissatisfaction

of family members. Almost 40 percent respondents ‘felt mental pressure while working’ and main

reason asserted was fear of husband and in-laws. Only 10% respondents had suffered from

‘chronic diseases’ in past and still had its affect on their body and spent ‘maximum time on bed’.

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Mrs. D, the youngest of six sisters, was married in a joint marriage ceremony when she

was only four. Her husband was 12. Phuli's father is farmer and owns two acre of land. He says

his troubles were compounded when his wife, gave birth to seven daughters but no sons. She

recalls the day of her marriage. She says “the brides spend the night of their weddings in their

home, and then join their husband's families the next day for a journey to their in-laws' village. I

traveled half a day by oxcart to a village 15 kilometers away. After a few days there, as per

tradition required, I returned to my family and awaited for the onset of puberty”. After puberty,

another ceremony Gauna is performed to join husband's family. Her Gauna was done at the age of

14 years. She says “I enjoyed sexual relation but was unaware of its result. I conceived, soon after

Gauna.” After a year, her troubles started as she underwent still birth. Year by year, she gave five

still births. Due to these abortions, she became physically weak and now she is unable to conceive.

The results of one way ANOVA for B-Age and fertility & health status of the respondents

revealed that fertility and health status is highly affected by age at birth of first child of the

respondents i.e. number of pregnancies (F=18.99), Alive children (F=11.77), Abortion (F=12.87),

Still birth (F=18.99) and health status (F=2.20).

2. Denial of Education

The analysis of educational status of the respondents showed the higher incidence of illiteracy

(70%) among selected respondents and rest of them i.e. 24%, 4% and 2% were literate up to

primary level education, up to 8th standard and secondary or senior secondary level respectively.

Almost 90 percent respondents agreed with the statement that ‘early pregnancy denies girls’

education and 65 percent respondents wanted to study just after marriage. Respondents believed

that education is basic ability to read and write, keep accounts and cope with situation. More than

half of the respondents were illiterate and facing ill- effects of it. During FGD it was reported that

education greatly influences their life pattern. An educated woman always tries to educate their

children and want to marry their daughters after age of 18 years against all odds. Respondents

(86%) believe that education empowers women to protect their rights and on the contrary illiteracy

or less education denies status in family and community (86.33%).

Mrs. E was married at the age of 10 years, (when she was in 4th standard) along with her two

elder sisters due to pressure of grandparents. According to her early marriage is prevalent in her

caste and her Gauna was performed at age of 13 years and after one year she delivered a child.

Now she is 21 years and mother of three girl children. She has been pressurized by her husband

and in-laws to bear a male child. She is neither able to oppose her family nor convince them that

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she does not want more children. She added she was unaware and had no knowledge of getting

pregnant at the first time. She told that “I was very keen to study but early marriage and Gauna

snatched this opportunity from me”.

In total 85.33 percent respondents believed that denial of education hinders their way to

success/progress in life. Most of the respondents wanted to educate their daughters as they

themselves had to confront many problems in life due to lack of education and they did not want to

repeat these in their daughter’s life. Lack of education limits their scope of employment, utilization

of any facilities and availing legal and constitutional rights.

3. Denial of Freedom

Nearly 3/4 respondents agreed with imposing restriction on girls in their natal as well as in-

laws family and they were not permitted to go out anywhere with anybody. They were also not

allowed to go outside alone (72%). More than 2/3 respondents were not allowed to talk to any

person outside house. 76.33 percent respondents were allowed to participate in social festivals.

During discussion with the respondents it was found that social interactions of married girls in

rural areas are limited to those with the family members and relatives living in the village.

Friendship with peers related to family is not permitted. A friend could visit only if there is work

and not just to socialize and gossip. Men usually perform outside tasks such as going to the market,

visiting the gram panchayat or the panchayat and attending meetings etc. Women have no role in

the decision making process. All the major decisions regarding significant issues are taken largely

by men. Only 27 percent respondents agreed that they were free to decide about choice of

contraceptive. Almost 80 percent respondents said that many a time they had to work against their

wish. Ninety six percent respondents believed that traditional costumes and apparels of married

women are burden in performing household chores and they should be allowed to get rid of it.

Mrs. F was married in childhood by custom of Aata-Sata. Her Gauna was done at the age of

17 years after completion of senior secondary education. She lived in urban area before Gauna

and her in-laws were rigid and conservative about family ethics and strictly followed traditions

and customs. After Guana, she was forced to follow their in-laws morals and values and these

bindings snatched all her freedom. She had to have veil on her face and not allowed to talk to any

outsider. Once she was abused and beaten by her in-laws because she talked with post-man. She

gave birth to daughter after a year of Gauna and was pressurized to bear son. She gave birth to

twin girls again which became cause of increased violence and target of expressing anger of all

her family members. They often threat to leave her for not bearing a son.

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4. Personal development & inadequate socialization

Early marriage and early pregnancy always hinders personal development and socialization.

Only 14 percent respondents interviewed were allowed to take any decision on their own while

more than 3/4 respondents (80%) had to obey family’s decision to make them happy. During

interaction with Mrs. G, it was found that she was in stress and anxiety. At age of 21, she became

mother of six children, and often she used to beat them without any cause just to let out her

frustrations. She did not have strength to say a word to her husband and in-laws and now target of

her distress and anger is her own children.

Almost 84 percent respondents did not have time for their family, children and friends due to

excess household work and had no choice to spend their leisure time as they wish (67%). Only

23.67 percent respondents were satisfied with the role they played in the family and society. Half

of the respondents did not enjoy sexual relation as they have fear of it. 72.67% respondents were

insecure in participating social events. Only 35% respondents had role in decision making in

family. More than ¾ respondents (77.67%) were not expressive & it is difficult for them to share

their problems & feelings with others.

Mrs. H’s pathetic life began 15 years back when she got married at a tender age of seven

years. She was abandoned by her first husband before consummation of marriage, just because of

her dark complexion. She has four younger sisters and two brothers. Her father was very poor and

looked after his family with great difficulty. So her marriage was fixed with another man, 8 years

elder to her, with handsome price in return (Mayas). Today she is 22 year old woman (who looks

much older for her age) forced to lead a life full of distress. But this time also she has dire fortune

and her second husband is drug addict and beats her and her children without reason. Not only

this, because of this violence she had two miscarriages. Today she has two daughters aged six and

three years. There is no body with whom she could confide and share her sorrows/worries. Neither

she is allowed to visit her natal village nor do her natal family members afford to visit her. She has

not seen her parents since her marriage. She lives under constant fear that her husband being old

and unwell would die leaving her all alone to face a life of misery as she totally depends on him.

She laments that there will be no one to support and look after her and her small children, if he

dies.

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Mrs. I was married at the tender age of 14 years with her seven brothers and four sisters. Just

after marriage, she started living with her in-laws. She gave birth to a daughter at the age of 16

years and son at 18 years. She has big joint family with seven brothers. Her husband is youngest of

them and share common family asset. This was the cause of tussle in family. Her husband was

alcoholic. She became centre of his frustration. Her husband died in road mishap. Her in-laws

family’s cruelty and atrocities to her and children increased day by day. She decided to leave them

and remarried. Her second husband is well to do. She has three more children from new husband.

Her children from first husband are with her but are bound to live miserable and dejected life of

“Gelad” as followed by society.

Table 1.3 shows the results of one way ANOVA for respondents’ age at birth of first child and

PSC components. Results of ANOVA reveled that PSC components are significantly affected by

age at birth of first child of the respondents i.e. Denial of education (F=1.92), Denial of freedom

(F=1.99), and Personal development and inadequate socialization (F=1.96).

Table 3

One Way ANOVA for PSC components on respondents’ age at birth of first child

PSC components Groups S.S. DF M.S. F

Denial of educationBetween Groups 0.30 7 4.30 1.92*

Within Groups 6.54 292 2.24  Total 6.84 299    

Denial of freedomBetween Groups 31.93 7 4.56 1.99*

Within Groups 669.74 292 2.29  Total 701.67 299    

Personal development and inadequate

socialization

Between Groups

31.22 7 4.46 1.96*Within Groups 665.57 292 2.28  

Total 696.79 299    * Significant at 0.05 level, ** significant at 0.01 level

DISCUSSION AND CONCLUSION

To conclude, it can be said that early marriage causes teenage pregnancy and has adverse

impact on psycho-social health of women. In spite of many efforts have been done to combat the

practice of child marriage and legal awareness, people marry their daughters at an early age. Study

found that the mean age at marriage for respondents was 10.45 years while mean age at effective

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marriage was 14.8 years and mean age at birth of first child was 16.33 years Data reveal that most

of the respondents are pressurized to get pregnant, soon after effective marriage.

Study further revealed that age at birth of first child is widely reflected by socio- cultural setup and

women access to contraception. Almost half of the respondents reported that they themselves were

unaware of getting pregnant at first time and had no felling to enjoy their pregnancy. In few cases

it was found that they came to know about their pregnancy after two-three months.

Teenage mothers suffer more due to restrictions on their life regarding eating, moving and

so on. Her stress becomes heavy when she has to undergo separation, divorce or re-marriage

(Nata), thus suffering in silence with much loss of status. It was also found that high anxiety levels

of women, especially those who have many children, are not working; often ensue their anger on

children.

It was found that early marriage does not allow girl to study or pursue a career and early

pregnancy becomes another break. Most of the respondents want to study soon after marriage and

still tries to get that opportunity. At most of the time, in-laws dislike that their daughter in-law

study anymore. Early marriage leads to early and repetitive pregnancy and mother has to face

many new responsibilities as looking after children and house hold chores as well as she becomes

physically weak with time. According the report of Save the Children (2004) a girl who leaves

school usually loses connections with peers and mentoring adults. So not only does her formal

education stop, but she may also be cut off from informal opportunities to gain useful knowledge

and life skills. She may be unaware of services available nearby for her and her children. And she

is less likely to have a say in important life decisions such as planning when to get pregnant and

ideal family size.

Suggestions and Recommendations

Since Child Marriage is the main cause of teenage pregnancies in rural parts of India,

effective implementation of the Law and Behaviour change communication programs are

required for communities, practicing child marriage.

Lack of awareness of contraception among teens, especially during first sexual intercourse,

increases the chances of unintended pregnancies. So there is strong need for contraceptive

counseling in order to prevent repeated pregnancies. Clinics, private medical offices, or

NGOs can play a major role in providing counseling.

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Limited education can be both a cause and an effect of child motherhood. Girls who are not

attending school are more likely to become mothers at a dangerously early age, and girls in

school who marry young or become pregnant usually leave school. So there is a need to

develop strategies to help more girls go to school and stay in school, and to encourage

families and communities to value the education of girls.

Life skill education and vocational training programs for girls to empower them.

Health services to the special needs of newly married girls and young first-time mothers.

need health services that are designed to meet

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