Chapter 2

Review of Related Literature

This chapter is made up of three (3) parts, namely:

(1) Consequences of Teenage Pregnancy, (2) Coping Mechanisms

in Teenage Pregnancy, and (3) Synthesis.

Part one, Consequences of Teenage Pregnancy, includes

literature on the effects and consequences of teenage

pregnancy to students. It also includes the factors

associated with teenage pregnancy.

Part Two, Coping Mechanisms, describes the strategies

and ways students utilize in dealing with early pregnancy.

It tells about how students cope with the different effects

of early pregnancy.

Part Three, Synthesis, presents the summary of the

literature reviewed.

Consequences of Teenage Pregnancies

Adolescent pregnancy is a major social, health and

development issue for most governments in low- and middle-

income countries. It is estimated that 16 million girls

between 15-19 years and 2 million girls under 15 years get

pregnant every year with a ratio of 1 in 5 girls giving

birth by age 18 globally (UNFPA, 2015).

 23

Adolescent pregnancy according to the WHO (2014)

describes pregnancy among young women aged 10-19 years. The

prevalence of adolescent pregnancy vary across different

regions of the world yet the highest prevalence is found in

low- and middle-income countries. Several studies have

associated adolescent pregnancy with a high rate of infant

and maternal mortality and the risk of exposure to sexually

transmitted infections (STI) including HIV among adolescents

as well as its negative effects on the social and economic

development of low- and middle-income countries. School

dropout, lack of employment opportunities and lack of access

to reproductive health services among adolescents are some

of the social challenges associated with adolescent

pregnancy (Wodon et al., 2017).

Consequences or impacts of teenage pregnancy is very

huge. It includes the risk factors associated with

adolescent pregnancy which are shaped by the socioeconomic,

political and cultural characteristics of different regions

and countries which includes mental problems, social and

financial problems and health concerns. Unplanned pregnancy

among adolescents is mostly associated with alcohol and drug

use and among marginalized groups with low socioeconomic

status (Cook and Cameron, 2015).

 24

Teenage pregnancy is considered a social problem in

which adult practices and functions are displayed by a

person who, owing to her age and developmental status, is

not-yet-adult which have various effects on one’s

educational progress and negative implications for one’s

future adjustment into life in general (Macleod, 2014).

The cases of teenage pregnancy are rampant and alarming

in many nations of the world, including the Philippines.

This societal problem remains personally destructive in the

moral, economic and social lives of adolescents. According

to the National Demographic and Health Survey (2013),

14% of Filipino girls aged 15-19 are either pregnant

for the first time or are already mothers more than

twice the rate recorded (YAFS, 2014). Thus, because of the

increase in teenage pregnancy, public agencies such as the

Department of Education (DepEd), Department of Health

(DOH), Department of Social Works and Development

(DSWD), Population Commission (PopCom) and other agencies

find ways to reduce this problem.

In the Philippines, teenage pregnancy cases rose by 70

percent in the past 10 years. This was revealed by Percival

Cendaña, Commissioner of the National Youth Commission (NYC)

and he based it from the study conducted by the United

Nations Population Fund (UNFPA) that ranked the country

 25

first in terms of teenage pregnancy in Southeast Asia. He

also cited the NYC’s National Youth Assessment Study that

revealed that unplanned pregnancy was one of the main

reasons young people do not complete their education

(Inquirer.net, 2014).

The Philippines has one of the highest teenage

pregnancy rates among the ASEAN member states despite the

decrease of total live births of teenage mothers (aged 10-

19) in 2016 (203,085) to 183,000 in 2019. According to the

Commission on Population and Development (PopCom), the

Philippines has recorded a 7% increase in births among girls

aged 15 and below in 2019. Filipino minors who gave birth in

2019 increased to 62,510 from 62,341 in 2018. In 2019, 2,411

very young adolescents aged 10 to 14 gave birth, or almost

seven every day. Early childbearing may result in poor

health outcomes and may be a threat to the country’s

economic growth. Pregnant adolescents are less likely to

complete higher education and have lesser ability to earn

more income over the course of a lifetime, causing economic

losses to the country.

Young moms face a variety of financial and social

disadvantages as a result of being parents while still in

high school. They have a lower likelihood of graduating from

middle school and enrolling in a postsecondary college. They

 26

would have a harder time finding suitable jobs because of

their lack of educational accomplishment. They live on a

smaller income and are more likely to depend on government

assistance. Their relationships are more likely to be

dysfunctional, and they often have more children than they

first planned. Similarly, children born to teen mothers face

challenges. They have lower cognitive functioning, as well

as a greater number of behavioral and mental issues.

Children, on the other hand, tend to be more afflicted than

females. Teenage mothers' daughters do worse in school and

are more likely to get pregnant themselves. Teen mothers may

also have less experience in child rearing than older

mothers, resulting in less chances for excitement for their

children (Furstenberg and Brooks, 2012).

The impact of teenage pregnancy is not just on the teen

mother; it can also be traumatic for her child. According to

Hoffort et al (2012), the majority of young mothers are

unable to continue their schooling. According to Mailborn

(2015) if teenage mothers ultimately marry, she will become

the primary caretaker and her chances of furthering her

education will be drastically reduced.

Teenage pregnancy increases the risk of maternal

mortality, delivery complications, obstructed labor,

 27

systemic infections, stillbirth, premature birth, and severe

neonatal complications. Teenage pregnancy puts adolescents

at a more significant disadvantage, including limited

employment options, low educational attainment, and health

drawbacks. As a result, they are more likely to drop out of

school than those who are not pregnant, and only a few

return to school. Most unmarried pregnant adolescents face

immediate financial difficulty, leading to poverty. These

considerable risks can cause physical impairment, sterility,

mental trauma, and even death, as well as lifelong

consequences such as a decrease in women’s productivity and

earning capacity, which contributes to their own and their

children’s poverty (Ganchimeg et al., 2014).

According to Marnach et al (2015) maternal and prenatal

health is of particular concern among teens that are

pregnant or parenting. The worldwide incidence of premature

birth and low birth weight is higher among teenage mothers.

Teenage mothers also face difficulties that extend past

birth and are at a greater risk of developing academic,

linguistic, and socio-emotional delays.

According to Kosha (2012), teenage pregnancy could lead

to incomplete education, unemployment and other numerous

traumas. Early motherhood had been linked to affect the

psychological development of the child adversely. Teenage

 28

girl’s body is not as developed as adult women in term of

childbearing. Thus, they are often to face certain

complications during pregnancy.

The risk factors associated with adolescent pregnancy

include cultural and social norms, the level of economic

development and the general level of education within the

society, family background, low use of contraception and a

general lack of communication and sex education (Yakubu and

Salisu, 2018).

There have been extensive research on the health,

social and economic consequences associated with adolescent

pregnancy. In most cases, complications from pregnancy and

childbirth are a leading cause of death among adolescent

girls. The health consequences associated with adolescent

pregnancy is very high. This includes mental health

problems, high risk of low birth weight, preterm birth,

eclampsia, maternal and perinatal mortality and anaemia

(Grønvik and Sandøy, 2018).

A study by Corcoran (2016) revealed severe mental

health risk amongst adolescent mothers. The study found that

mental disorders could be a result of the social risk

factors that contribute to adolescent pregnancy such as drug

and alcohol use or it could be a result of stress of meeting

the demands of nurturing a child. Depression among teen

 29

mothers could also act as a risk factor for rapid repeated

childbearing.

Hodgkinson et al (2015) identified depression as a

pervasive mental health disorder among teenage mothers. They

identified social isolation, childhood adversity and

negative family history as some of the leading causes of

depression among teen mothers which may cause them to have

suicidal tendencies.

Ganchimeg et al. (2014), using a multi country dataset

collected in 29 countries found high risk of eclampsia,

puerperal endometriosis, systemic infections and adverse

perinatal outcomes among adolescent mothers. They also found

adolescent pregnancy to be independently associated with

increased risk of low birth weight, preterm delivery and

severe neonatal death.

MomboNgoma et al. (2016), using randomized control

trial (RCT) in assessing alternative drugs for intermittent

preventive treatment of malaria in pregnancy found that

younger mothers were more likely to deliver prematurely or

deliver a low birth weight infant compared to older mothers.

Their other finding shows that young maternal age had a

stronger association with adverse pregnancy outcomes than

other risk factors such as malaria and infections.

 30

Kawakita et al. (2016) study on the adverse effects of

adolescent pregnancy, found that pregnant adolescents

suffered very high consequences. Pregnant adolescents were

mostly at risk of “maternal anaemia, preterm delivery at

less than 37 weeks of gestation, postpartum hemorrhage and

preeclampsia.

Research shows that adolescent mothers are more likely

to have low educational attainment due to early school

dropout, repeated child birth, work in low-income

employment, are more likely to be single parents and their

female children are more likely to become teen mothers

themselves (Cook and Cameron, 2015).

Research findings by Simkins (2014), indicate that

adolescent pregnancy mostly disrupt both formal and

vocational education of teenagers which makes them less

skilled, eventually leading them to low-income jobs.

Lloyd and Mensch (2018) found that there is a high risk

of adolescents leaving school as a result of childbirth.

Studies by Gigante et al. (2019) also found that adolescent

mothers had less education and lower income compared to

mothers who had their first child at an older age. These

social and economic consequences of teen motherhood is seen

to be strongly associated with the family background of teen

parents as pregnant teenage girls from poor economic

 31

backgrounds often lack financial and social support during

and after pregnancy.

De Villiers and Kekesi (2014) report that teenage

pregnancy has a negative impact on the social, educational,

cultural and economic development of teenage mothers.

Several studies have found that the dual role of parenting

and being a learner has consequences on the academic

performance of a learner when learners’ performance before

and after pregnancy was compared. In a study by Chigona and

Chetty (2017), it is reported that teenage mothers were

constantly absent from school which subsequently affected

their academic performance.

Motjelebe (2015) reports that parenting creates new

social roles, demands and responsibilities on the mother,

father and grandparents. Moreover, the acquired

responsibilities of motherhood can have a significant

impairment on an individual’s level of functioning thus

affecting a teenage mothers’ relationship and interaction

patterns with her new baby.

A qualitative study by Agunbiade (2014) on pregnant

adolescents suggests that pregnant adolescents are

stigmatized by their peers, fellow community members and

even so, by people close to them which caused them to

attempt abortions prior to delivery. To expand on this,

 32

Ellis-Sloan (2014) states that even after giving birth,

teenage mothers continue to be stigmatized by members of the

public, medical professionals and their families. Under

those circumstances, teenage mothers are likely to

experience feelings of shame, regret and guilt.

According to Micah et al (2013) stigma has emotionally

devastating consequences on adolescent mothers. In addition,

Kaye (2014) avers that teenage motherhood is experienced as

stressful and this, coupled with stigma stemming from early

childhood conception, burdens teenage mothers, as a result,

they feel regretful and overwhelmed.

The United Nations International Children's Emergency

Fund (UNICEF) reported that teenage pregnancy and motherhood

gives rise to socioeconomic and psychological consequences

for the mother, child and the young siblings. Motjelebe

(2014) concurs that motherhood impairs the daily functioning

of teenagers because they experience various challenges

relating to finances, attaining basic needs for their

babies, seeking employment and balancing school and

parenting.

Nekongo-Nielsen and Mbukusa (2013) suggest that teenage

pregnancy poses major challenges to learners in schools,

challenges which tend to escalate even more as these

adolescents become mothers. It is reported that orphans and

 33

learners whose parents live far from schools, experience

difficulties in finding caretakers for their babies while

attending school. On the other hand, others cannot afford

babysitters. Moreover, teenage mothers reported that there

is little or no time at all to focus on studies because the

majority of their mothers had full time paid employment in

farms which required them to work the whole day, as a result

they were responsible their babies after school.

Chauke (2013) discusses some other challenges

experienced by teenage mothers such as undesirable attitudes

from peers and educators towards teenage mothers, lack of

supportive structures such as counselling services, extra

curriculum programs and educative programs for teenage

mothers. In consequence, a lack of supportive structures and

figures to assist teenage mothers with the role of

motherhood can contribute to a high absenteeism rate, poor

school performance and school dropout.

Nekongo-Nielsen and Mbukusa (2013) concur that school

dropout is highly influenced by psychological factors, such

as a learner’s inability to cope with the new role of

motherhood, school work and a lack of support from family

members.

Sibeko (2012) states that learners are faced with a

major challenge of trying to cope with the demands of

 34

motherhood and schooling simultaneously. For this reason,

many opt to drop out of school and continue the poverty

cycle in which they become trapped for the rest of their

lives.

An ethnographic qualitative study by Leese (2016)

reported that teenage mothers’ transition into motherhood

significantly differs from that of older mothers as it is

likely to be more stressful. Moreover, that teenage mothers

are reluctant to engage with support services, therefore in

planning, support services should be appropriately tailored

to help facilitate the challenges that they face.

Teenage motherhood may be experienced as overwhelming

because many teenagers are unemployed and for that reason,

they may experience financial difficulties especially those

that come from low socioeconomic households. Agunbiade

(2012) in his qualitative study reported that adolescent

mothers receive little informal support especially from

their mothers, as a result, in order to survive, most of

them serve as apprentices, restaurant attendants and engage

in profitable economic activities such as tailoring and

hairdressing. This clearly demonstrates some of financial

difficulties experienced by adolescents who are economically

disadvantaged. The financial pressures and difficulties

experienced by teenage mothers are likely influenced by

 35

factors such as; high unemployment rate, single parent

headed families and a whole family relying on monthly

government grant obtained by orphans and the old age.

The study conducted by Plaza and Madelo (2021) revealed

that based on the effect of teenage pregnancy as to

self-esteem, it was revealed that most of the key

informants felt ashamed on their pregnancy, this was due to

their experiences from criticisms within their friends,

family and also people in the community. As to the

effects on their relationship with their parents. The

teenage mothers and fathers got terribly upset on the

matter. In some cases, the head of the family tend to chase

their daughter out of their home. As to the effect on

their relationship with their siblings, they have

experienced rejections which also caused mental

pressures. As to their peers, most of the teenage

mothers chose to hide or avoid them. Then, they felt

ashamed of what happened. However, some also asserted that

their friends were supportive to them. As to social

stigma, most of the participants revealed that they felt

humiliated due to gossiping and speculations in their

barrios or community. Based on the effects as to their

schooling, the key informants resorted into dropping out of

 36

school, while others felt demotivated due to risk of

pregnancy.

Coping Mechanisms in Teenage Pregnancies

Coping mechanisms are necessary conditions for

preventing the harmful effects of a challenging and

problematic situation. Coping mechanisms refer to the

specific efforts that people use to master, reduce or

minimize stressful event. Coping is multi-dimensional and

involves various strategies of which some are functional

than others (William et al., 2014).

Alharbi and Smith (2018) opined that coping mechanisms

could be seen as ways individuals handle stressful issues

within the internal and external environment while Mason

(2017) regarded coping as a cognitive and behavioral

mechanism to handle over-powering situations beyond personal

capacity. The coping strategies are necessary for defending

the mental and physical effects of the situation. There are

different coping mechanisms depending on the stressor/s and

geographical location of an individual. Among the coping

mechanisms is self-understanding, building a support system,

having mentors or advisors and seeking help.

Based on Rogers and Yassin (2013), it is important for

students to develop different coping mechanisms in order to

 37

counter and manage stressful conditions. Coping mechanism

refers to ways to handle stressful and troublesome

circumstances. Coping is the sum of cognitive and behavioral

effort, which are constantly changing, that aim to handle

particular demands, whether internal or external, that are

viewed as demanding. Students need to develop different

coping mechanisms for them to manage stressful condition

every day. If students were not able to manage his/her

stress, the stressors coming from financial problems, sleep

deprivation, societal activities and many more can affect

the ability of students to perform.

Teenage pregnancy and childbearing is a phenomenon that

has significant ramifications at personal, societal, as well

as global levels. From the perspective of communities and

governments, teenage pregnancy and childbearing have a

strong and unwelcome association with low levels of

educational achievement for young women, which in turn may

have a negative impact on their position and potential

contribution to society (United Nations, 2015).

Being a teenage parent is one of the most difficult

jobs in the world. Most teens are not even capable of caring

for themselves. Teenage mothers are often affected by

interpersonal conflicts, and feelings of loneliness and

depression, particularly in the months following the baby’s

 38

birth. However, Rickel (2014) suggested that, increased

knowledge coupled with adequate emotional resources may

promote adaptive interaction patterns and enabled teen

mothers to be more effective parents.

Most teenagers have very inaccurate or no ideas of

child development, and they have an overall tendency to

expect children’s ability to develop much earlier than is

actually the case. Thus given advices and support in child

development can help them be good mothers. Grandmothers

(mothers of the teen mothers) can do this effectively. A

number of recent studies have carefully considered the roles

the grandmothers’ play in co-parenting, housing and

supporting young mothers and children. Coley & Chase-

Lansdale (2016) determined a pattern of shared rearing in

which grandmothers aided their daughters and modelled

appropriate parenting behaviors as the most appropriate for

providing young mothers with both the support and the

autonomy they need to effectively assume health, one of the

primary parental responsibilities.

The number of people (be it family members or peers)

offering social support to the teenage mothers appears to be

a major factor in the presence of nurturing behavior. Rickel

(2014) viewed social support as a factor to buffer the

effects of stress and to ameliorate depression. Rickel

 39

further suggested that interventions targeted toward helping

teenage mothers establish and maintain social support

contacts may be beneficial in terms of improving the

mothers’ ability to care for their children. Rickel, (ibid)

thus observed that, the teenage mother’s primary source of

social support usually is her family. In most cases the girl

and her baby live with her parents and are at least

partially supported by them even financially until she

become financially able to move out. In some instances a

young mother may live alone or with the child’s father, but

the maternal grandmother remains an important source of

material aid, advice, information, support, and sometimes

free child day care. Social support can be defined through

four categories of support namely the emotional,

instrumental, informational, and appraisal.

According to Cronenwett (2013), emotional support is

characterized as those acts that provide empathy, caring,

love, trust, and concern, whereas instrumental support

referred to access to behaviors that directly help the

person in need such as aid in kind, money, labor, and time.

Cronenwett finds the provision of information, advice and

directives that can be used in coping with personal and

environmental problems as the informational support, and

appraisal support as the transmission of information

 40

relevant to self-evaluation such as can be derived from

affirmation, feedback, and social comparison opportunities.

In the study conducted by Plaza and Madelo (2021) as

to the teenage mothers’ coping mechanism, it was

revealed that they exerted very high amount of coping

strategies to overcome depressing situations by thinking

of their children’s needs. The young mothers had taken the

courage to accept the responsibility as a new parent.

Besides, they were willing to do everything for their

children’s sake.

Yahya (2016) found that most of the pregnancies in

teenagers were unplanned. Regardless of whether the

pregnancies were desired or not most of the teenage mothers

had less preparation to cope and adapt to the roles of

parent. Their ability to cope with the stresses of teen

parenthood and their limited knowledge of appropriate child

rearing skills affected their psychological wellbeing. This

is because stress is assumed to place individuals at

increased risk for depression, anxiety, and other emotional

problem.

Kaye (2018) found that overall, young adolescents

reported more anxiety, loss of self-esteem (when they

conceived), difficulty in accessing financial, moral and

material support from parents or partners and stigmatization

 41

by health workers when they sought care from health

facilities. Three strategies by which adolescent mothers

cope with parenting and pregnancy stress that were described

as utilizing opportunities (thriving), accommodating the

challenges (bargaining and surviving), or failure

(despairing), and varied in the extent to which they enabled

adolescents to cope with the stress.

Wainaina (2021) reported that teenage mothers

demonstrated very high coping mechanisms to overcome the

helpless state that the girls felt. Resilience powered their

determination to survive and take care of their children,

the feeling of making it as a mother, and having a healthy

child was a motivator and a positive coping mechanism.

Taking up new habits, making new friends in similar

situations replaced the feelings of stigmatization and

neglect and build self-confidence and reduce the impact of

the stress the girls were facing.

Adolescent mothers used positive reappraisal of life

circumstances to create a positive self-image and resist the

stress of stigma and parenting. Overcoming stereotypes and

success in parenting were reappraised as “strength,” which

allowed the young women to feel empowered in their

caregiving role (Neale et al., 2016).

 42

Dhaka and Musese (2019) found that teenage mothers

experience difficulties in managing the dual role of

motherhood and learning. Despite the challenges experienced,

the teenage mothers remained hopeful and determined to

succeed in life and have goals to complete their secondary

education and continue with tertiary schooling, thus

demonstrating resilience at face value.

Codega et al (2013) found two themes emerging

regarding the most frequently used coping behaviors of

teenage mothers: a tendency for these adolescents to use

avoidant or passive types of behaviors, and the importance

of close friends as support. Significant differences were

found on only 7 of the 49 coping behaviors, suggesting more

similarity than differences between the two groups.

Abotsi (2020) that there is a significant relationship

between consequences of teenage pregnancy and coping

mechanisms of students. Students who were reported to have

experienced severe or very high negative consequences were

found to exert higher levels of coping mechanisms so as to

counter the stressful and challenging situation they are in.

Plaza and Madelo (2021) revealed that there is a

positive correlation between consequences of teenage

pregnancy and the coping mechanisms employed by pregnant

adolescents. The study revealed that students utilize

 43

different coping mechanisms depending on the severity or

seriousness of consequences brought by teenage pregnancy.

Synthesis

Teenage pregnancy is a major concern to world

communities. Teenage pregnancy is an unwelcomed occurrence

among females who are both educationally and economically

disadvantaged. Pregnancy among teenagers is one of the most

pressing issues confronting most countries today. Teenage

pregnancy is becoming a growing concern, and understanding

the various consequences of teenage pregnancy is critical.

Teenage pregnancy puts adolescents at a more significant

disadvantage, including limited employment options, low

educational attainment, and health drawbacks. As a result,

they are more likely to drop out of school than those who

are not pregnant, and only a few return to school. Most

unmarried pregnant adolescents face immediate financial

difficulty, leading to poverty. These considerable risks can

cause physical impairment, sterility, mental trauma, and

even death, as well as lifelong consequences.

It is important for students to develop positive coping

mechanisms in order to counter and manage the negative

consequences of teenage pregnancy. Coping mechanisms could

be seen as ways individuals handle stressful issues within

 44

the internal and external environment and to handle over-

powering situations beyond personal capacity. The coping

strategies are necessary for defending the mental and

physical effects of the situation. It was reported that

teenage mothers derived the coping strategies from their

experiences and depended largely on the support they

received from family, friends and people surrounding them.

Unplanned, unintended pregnancies for such age needed

different coping mechanisms to overcome the helpless state

that the girls felt.

Determining the consequences of teenage pregnancy in

relation to the coping mechanisms of students will help shed

light on what to do to better support them to safeguard

their general well-being from detrimental effects of teenage

pregnancy.