Chapter 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the related studies and important concepts gleamed for

literature that have had been found useful in the conceptualization of the present study.

These related studies and literature offered assessment and enrichment in the conduct of

this research work on teenage pregnancy.

Related Literature

The increase rise on teenage pregnancy have left many wondering what is

happening today in the world, but what they need to search for is what is causing the

increase rise on teenage pregnancy to become a serious problem. According to Dr.

Alvarez (2010), “our society has created a cultural that makes having sex OK, and

creating an environment where promiscuity is accepted.”

Many have believed that today’s social media and the internet is highly exposed

to everyone and can be one the reasons on the rise of teenage pregnancy, such as Alvarez

has concluded.

Others might disagree otherwise such as Alexander Wright; a college student

majoring in psychology who was interviewed to see what he thought about the cause of

rise of teenage pregnancy was due to the social media and the internet. Wright disagrees

on the idea that social media and the internet have to do with the cause of teen pregnancy.

He explained as followed:
 12

Today’s generation is different from the past generations, teens are going to have

sex no matter what, the internet or social media has no affect to cause teen pregnancy,

parents just need to be able to know how communicate better to their teens to have safe

sex and consequences that may come from their actions. (Alexander Wright, personal

communication, 2010)

Research by Cynthia Bowers (2010), conducted that the main cause can be that no

one is paying attention to girls who are living in poverty, whose birth rate has never

declined since the past decade but increased over 60%, and the fact that schools lack sex

education. However, it can be interpret that many factors such as poverty, the media,

internet, or even peer pressure can be leading factors on teen pregnancy. In fact, in teens

say their major influence to have sex was based on their morals, religion, and values. For

the past decade, the United States can also be the blame for not seeing the increase rise on

teenage pregnancy coming mostly from those who live in poverty but solutions such as

sex education or schools distributing condoms can also help.

From 2000 to 2010, the number of live births by teenage mothers in the

Philippines rose by more than 60 percent, latest data from the National Statistics Office

showed.

Another alarming fact is that the number of teenage mothers who gave birth to

their second or third child during their teenage year has increased in the last 10 years.

This is according to the data shown in the press conference in Quezon City by Carmelita

Ericta, administrator and civil registrar general of the National Statistics Office. (Ime

Morales, July 9, 2013) Teenage pregnancy is a global issue and a major contributor to
 13

school drop-out among girls. Permanent expulsion was one of the solutions made for

teenage pregnancy but this has been proven ineffective and unfair to the girls. Now there

is a return to school policy where a student is temporarily dismissed from school due to

teenage pregnancy to further pursue their education. (Okeyo, 2012)

Torivillas (2013) The Philippine Star noted that there is evidence supporting the

Reproductive health law that calls for sexuality education among young students. Not

that for teaching the kids to engage in “safe” sex, but rather, for telling them why they

should not engage in early sex, and yes, before marriage. With regulated sexuality

education, the young are informed about sex, pregnancy, unplanned and planned, instead

of through the internet or pornographic magazines that somehow manage to reach them.

Peep into their rooms and see copies of Playboy and Pent house and other sexy

publications tucked between the bed sheets, and for-adults-only videos in the internet.

The factors that triggers the Teenage pregnancy in the country are: Family

problems, broken family/complicated family, peer pressure/bad influence,

Media/Television/Movies Influential Trends (regarding sex), pornography, lack of

attention, love, caring, lack of moral values, failure to nurture with good principle,

curiosity, lack of information about Sex (sex education), use of illegal drugs, lack of

Guidance, prostitution (involve poverty), unintelligent decision etc. (Discover questions

in the Philippines, 2013).

As stated by Brown and Amankwaa (2007) “As more female college students are

involved in sexual relationships their risk of conception increases. However, when

pregnancy occurs it is only the woman who bears the burden and risk of the pregnancy
 14

and in most cases child care.” Often these types of pregnancy are unplanned or planned

caring for a child becomes a full time job. Having a child while being a student becomes

stressful because child rearing consumes time and energy, with a few exceptions the

women are the primary care giver of the child. ( Hofferth, Reid, & Mott, 2001 as cited by

Brown & Amankwaa, 2007). According to Kidwell (2004), rearing a child while being

full-time student may be daunting and difficult however, it will be easier if she has a

partner or a family member who can help her in taking care of the child.

With the increase of higher education students, 10% of this population are parents

or mothers who are hoping to give their children a better future and attending to their

needs through receiving a degree. These non-traditional students are often Student

Mothers and should be given special attention because aside from their role as student

they are also mothers and care givers at home. Many see or consider their families a

hindrance to their education which is wrong they should see it as a motivator because

primarily, Student mother go back to studying because they want to provide for their

child. (Wilsey, 2013)

When pregnant students and student mothers are expected to subordinate their

needs and desires to those of their children and families, they are forced to grapple with

the conflicting roles of motherhood and studentship (Berg & Mamhute, 2013). Brown &

Amankwaa, (2007) stated that parenting is a very stressful and some women cannot

handle all the tasks involved especially the first time mothers and need help or assistance

from the people around them. Although having someone help the mother is good but the

expectation of receiving support after giving birth to a baby often causes Stressors that

may lead to depression during postpartum period. Many student mothers have expressed
 15

feelings of guilt, worry and inadequacy in both as a student and as a mother (Thompson,

2004)

Though not always does being a student mother have negative effect, it also has

positive effects. Story (1999), as cited by Brown & Amankwaa (2007), has found out that

student mothers are more responsible than those of regular students. He has seen that

girls who were irresponsible before pregnancy has become more responsible after

pregnancy and is more or less likely to drop out of College than the regular students.

For women who juggle family and student responsibilities, the lack of time is one

of the major issues faced. (Liversidge, 2004) Many student mothers use different coping

strategies to adjust to their situation. As stated by Grohman (2009), student mothers

depend on time management to handle the many different tasks of a student mother.

Another coping cited by Grohman&Renelamn (2009) is managing tasks to handle the

things needed to be done as student and a mother as well as emotional and physical

support from both the partner and parents of the student mother.

Okey (2012) has said student-mothers go through a number of challenges

as they live double lives as mothers and students. Often challenges are faced like lack of

support due to other factors like lack of finances and time being limited.

A study by Boutan (2012) shows the feeling of student mother in regards to

lifestyle she said that Gale (her participant) said she juggles multiple lifestyles as a full-

time student and a full-time mom. This does make her feel disconnected from campus

life.
 16

Due to student mothers’ situation being difficult they have adapted coping

mechanism. According to Okeyo (2012), their coping mechanisms included: problem-

focused, avoidance and emotion-focused strategies and the support they received upon

resuming studies were spiritual and social support.

Parenting is very stressful and some women cannot deal with all of the tasks that

are involved. It is best if there are people around who are there to assist. Although it is

best to have family, friends and spousal support after giving birth to a baby this

expectation often causes Stressors that may lead to depression during the postpartum

period. (Brown & Amankwaa, 2007)

Related Studies

Local

In 2014, the Philippine Statistical Authority (PSA) reveal that every hour, 24

babies are delivered by teenage mothers. According to the 2014 Young Adult Fertility and

Sexuality (YAFS) study, around 14 percent of Filipino girls aged 15 to 19 are either

pregnant for the first time or are already mothers—more than twice the rate recorded in

2002. Among six major economies in the Association of Southeast Asian Nations, the

Philippines has the highest rate of teenage pregnancies and is the only country where the

rate is increasing, per the United Nations Population Fund.

Aquino (2014) point out in her article the findings of a study conducted by the UP

Population Institute in 2013, that new technology brings forth new sexual activities and

new ways meeting sexual partners, which could mean higher risks of pregnancy.
 17

In 2014, Josefina Natividad, (YAFS coordinator and director of the University of

the Philippines Population Institute) on her study stated that young Filipinos have limited

access to sex education and ASRH services, especially if they are underage and

unmarried. Seventy-eight percent are not using any form of contraception or protection

against sexually transmitted diseases and infections when they are having sex for the first

time. While government programs aim to delay the beginning of childbearing and hasten

fertility decline, teenage pregnancies continue to increase.

Arceo-Gomes, Campos-Vasquez and Raymundo (2014) conducted a study to

found out some of the effects of teenage pregnancy such as: decrease of 0.6-0.8 years of

schooling, lower attendance, fewer hours of work, and a higher marriage rate. This result

doesn't end here. In fact, it results to a 1-1.2 years loss in education and a lower

household income per capita. Subsequently, such outcomes seem to have been like prior

knowledge or forecast of the parents when their teens fall into dangerous sexual activity.

Hence, their opposition in engaging in teen sexual acts is very firm.

The National Statistics Office in 2010 recorded cases of young women having

four to five children before the age of 19. There are more than 3,000 young mothers who

already gave birth three times by age 19. There are also more than 300 who have four

babies at the same age. More alarming are the cases of girls having 2-3 children before

the age of 15. NSO recorded incidence of girls below 15 years old who gave birth two to

three times already. These figures can be bigger because registration rate in the country is

not 100%, especially for deliveries outside of medical facilities. 44% of the delivery by

the 15-19 age group is at home (FHS 2011).

 18

According to the National Youth Study (NYAS) of 2010 by the National Youth

Commission (NYC), the young are already exploring romantic relationships at an early

age; almost 75% of 15- to 17-year-olds are already looking for romantic partners. Even

their perception on early sexual encounter is evolving: 37% of the same age group

believe early sexual encounter is acceptable to society. These perceptions shape their

sexual attitudes and behavior, leading to higher incidence of early sexual encounters

among the youth and having their sexual debut at a younger age. This explains why 37%

of women already had their first sexual encounter by age 19, as reported by the 2008

National Demographic Health Survey.

Perci Cendana (2009), commissioner of the National Youth Commission (NYC), a

government agency that lobbies and advocates for youth-friendly policies says on her

study, “Teen pregnancy is not only a public health concern. It is a social development

concern”. “It’s like a floodgate has opened. Once a teen gets pregnant, she is likely to get

pregnant again and again,”

UN Population Fund (UNFPA), teenage pregnancy has a huge rate in the

Philippines, especially among the poor. 2/3 of Filipinos, who give birth before age 20,

belongs to the low class society. Data from the National Statistics Office showed that 8

percent among 1.7 million babies born in 2004 were born to mothers 15-19 years old.

Young mother gave birth to 818,000 babies in 2000 alone. This means, almost one of

every 10 babies is born to teenage mothers. The risk is, almost 10 percent of the born

babies from young mothers are malnourished. As years passed by, the statistics are

getting higher. According to the study done by the Population Institute of the University

of the Philippines, more than 46 percent of teenage pregnant woman resort to induced
 19

abortion which is against the law and the Church; 2 of every 5 teenage pregnancies are

unwanted ones. If the government won’t start acting on this, this problem will be worse

as years goes by.

In an article in Philippine Daily Inquirer by Singson, (2008) noted that statistics

in the Philippines show that each year, almost 1 million teenage women—10 percent of

all women aged 15-19 and 19 percent of those who have had sexual intercourse—become

pregnant and one-fourth of teenage mothers have a second child within two years of their

first.

Foreign

In 2015, Eric Hazen on his study stated adolescent patients present a unique set of

challenges to pediatricians. A polite, compliant child can appear to transform into a surly,

rebellious teen before a doctor's eyes. Adolescence can be a tumultuous time, even when

it is unfolding in a healthy manner. For this reason, and because there is so much

individual variation in adolescent development, it can be particularly challenging to

determine what is “normal” in adolescent development. Although previously believed to

be uniformly a time of turmoil, this view has not been substantiated by large-scale

studies.

According to the United Nations Population Fund (UNFPA), "Pregnancies among

girls less than 18 years of age have irreparable consequences. It violates the rights of

girls, with life-threatening consequences in terms of sexual and reproductive health, and

poses high development costs for communities, particularly in perpetuating the cycle of

poverty." Health consequences include not yet being physically ready for pregnancy and
 20

childbirth leading to complications and malnutrition as the majority of adolescents tend to

come from lower-income households. The risk of maternal death for girls under age 15 in

low and middle income countries is higher than for women in their twenties. Teenage

pregnancy also affects girls' education and income potential as many are forced to drop

out of school which ultimately threatens future opportunities and economic prospects.

Long-term studies by Duke University economist V. Joseph Hotz and colleagues,

published in 2015, found that by age 35, former teen mothers had earned more in income,

paid more in taxes, were substantially less likely to live in poverty and collected less in

public assistance than similarly poor women who waited until their 20s to have babies.

Women who became mothers in their teens — freed from child-raising duties by their late

20s and early 30s to pursue employment while poorer women who waited to become

mothers were still stuck at home watching their young children — wound up paying more

in taxes than they had collected in welfare. Eight years earlier, the federally

commissioned report "Kids Having Kids" also contained a similar finding, though it was

buried: "Adolescent child bearers fare slightly better than later-childbearing counterparts

in terms of their overall economic welfare.”

According to the National Campaign to Prevent Teen Pregnancy (2015), nearly 1

in 4 teen mothers will experience another pregnancy within two years of having their

first. Pregnancy and giving birth significantly increases the chance that these mothers will

become high school dropouts and as many as half have to go on welfare. Many teen

parents do not have the intellectual or emotional maturity that is needed to provide for

another life.[citation needed] Often, these pregnancies are hidden for months resulting in

a lack of adequate prenatal care and dangerous outcomes for the babies. Factors that
 21

determine which mothers are more likely to have a closely spaced repeat birth include

marriage and education: the likelihood decreases with the level of education of the young

woman – or her parents – and increases if she gets married.

World Health Organization (2014) described the adolescence stage as ‘a period of

development and growth which happens after childhood and before adulthood from ages

10 to 19’. Next to infancy, it is characterized by a demanding evolution in the genes

which is outlined by an immense process in growth and changes. With the dawn of

puberty marking the transition from childhood to adolescence, many biological stages

rise up from this growth and development. To better understand this emergent theme, four

theme clusters were drawn to help readers understand awakening as a theme.

The Second emergent theme is entitled "Pregnancy: The Child Bearing."

Pregnancy is the span of time in women's life from conception to giving birth. It goes

through several processes like the union of the sperm and the egg cells, its implantation in

the uterus, the long stage of fetal development, and until the delivery of the baby. Such

events are also accompanied by physiological and psychological changes in the pregnant

mother (Ricci, 20014).

East, Reyes and Horn (2013) concluded that there is more significant likeliness

for young women, who had either sister or sister and mother having experienced teenage

pregnancy, to yield into the same experience than those young women who had neither

sister nor mother experiencing the same.

Consequently, the worldview about teenage pregnancy encompasses its usual

medical and social implications as far as the health of the young mother and child is
 22

concerned (Mukhopadhyay, Chauduri & Paul, 2010). Unfavorable perinatal outcomes for

the mother and the baby remain a priority basis for action (WHO). It also accounts for

unsafe abortions among 15-19 years old mothers; maternal deaths among under-sixteens;

incidence of anemia, malaria, HIV and other sexually transmitted infections; postpartum

hemorrhage; and depression.

Mann, Cardona & Gomez (2015) also identify the feeling of shock upon finding

and confirming the pregnancy before attaining its acceptance. Messages from their own

parents, family members, and partners are seen as the directive towards the resolution of

it. Parents serve many essential roles toward their children leading to the second theme

cluster called ‘parents know best’. According to American College of Pediatricians

(2013), "parents provide the foundational role of support, nurturance, and guidance for

their children." Such role of the parents toward their children is seen as a fundamental

right of the children in the society. This right is directed towards their welfare, and so that

they might be protected from different abuses. In preventing teenage pregnancy, parents

should observe different measures in providing guidance and directions to their

adolescent children.

Marxshall and Jones (2012) declare that adolescent pregnancy is perilous and

fatal with grave enduring and extensive consequences from health complications for

young mother and the child to wider psychosocial concerns. Pregnant teens and their

unborn babies have unique medical risks. World Health Organization (2012) confirms

that girls under age 15 are five times more likely to die during pregnancy or childbirth as

those over age 20.

 23

Daniels (2011) declares that teenage pregnancy is becoming an epidemic resulting

to failure on the young population. Concern on the risk of complications escalates due to

the fact that these young individuals have bodies which are not yet fully developed and

are not ready for childbearing.

In 2010, research carried out by the United Nations Children’s Fund (UNICEF)

Malaysia revealed strong evidence that teenage pregnancy is associated with higher rates

of poverty, with teen mothers ending up either unemployed or in low paid jobs. This

finding is in line with results from a case-control study of 102 adolescent participants and

102 adult controls at Kuala Lumpur General Hospital and Universiti Kebangsaan

Malaysia Medical Centre

Salasiah et al. (2010) conducted a questionnaire-based study among pregnant

adolescents at two women’s shelter homes and found that almost half of respondents

agreed that communication with their parents was low when it came to discussing their

personal problems. Furthermore, most respondents’ parents are busy at work, resulting in

a lack of attention and supervision of their teenagers. A focus group study by Zakiyah et

al. also found the same family problem among six pregnant adolescents. The lack of love

and attention from parents or excessive freedom led this adolescent population to engage

in premarital sex and become pregnant.

Khairani et al. (2010) found that teenagers in their cohort who had given birth had

lower educational levels compared with adult controls. The majority of pregnant

teenagers attended up to secondary school, with a small percentage (22.5%) having only

completed primary education and 2.9% not having received any formal education.
 24

Another interesting finding of this study is that teenagers who do not involve themselves

in school activities have a significantly higher chance of becoming pregnant. Another

study by Kwa et al. in a Malaysian semi-rural clinic showed a similar finding, whereby

32.5% of pregnant teenagers had a low educational background. Dropping out of school

predisposes teenagers to possessing inadequate knowledge about reproductive health and

hence to engage in risky sexual activity.

Kirchengast (2009) declares that teenage pregnancies are considered problematic

because complications from pregnancy and childbirth are the leading causes of death in

teenage girls in developing countries.

Bruce and Bongarts (2009) point out that the effect of teenage pregnancy also

disturbs the social and economic development of the countries. Moreover, offspring born

to teenage mother are more likely to have inferior educational, behavioural, and health

outcomes, paralleled with children born to older parents (Hoofman & Maynard, 2008).

According to Kim (2008) on the matter of teenage pregnancy in the family, the

same roles wasexpected and observed from the parents of the teenage mothers. Huge part

of the parental guidance for the adolescents were indicated on the prevention of

premarital/teen/unwanted pregnancy. Thus, this is viewed by parents as precursor to long

term negative outcome which affects the young women most especially.