Psychosocial Aspects of Unwed Adolescent Pregnancy in Lusaka, Zambia

Adolescent pregnancy in Zambia contributed to 22.5% of the pregnancies seen at the University Teaching Hospital in Lusaka in 1979/80. Some of the psychosocial factors in teenage pregnancy are examined among 80 teenage unmarried adolescents appearing at the prenatal clinic of the University Teaching Hospital (40) and at a low-income prenatal clinic in Lusaka (40). Participants were matched with controls on the basis of age, education, and socioeconomic status. In-depth interviews were conducted in 1987, when the girls were in their second to fifth month of pregnancy. Analysis was conducted on sex socialization, knowledge of and attitudes toward contraception, socioeconomic factors, and family coherence as preventive aspects of teenage pregnancy. The reaction to the pregnancy and management of the pregnancy were also determined. The mean age of menarche was 13.2 and 13.5 years for the participants and controls, respectively, which is somewhat lower than reports among other African populations. A formal initiation ceremony was conducted for 3% of participants and 8% of controls. Participants had 2.4 sex partners, and controls had 0.5 sex partners. Motives for getting pregnant were: economic support (85%); being in love and hoping for marriage (67%); peer pressure (54%);l and three other reasons. Both groups were similar in their knowledge of, attitudes toward, and use of contraception. 28% of the pregnant girls reported knowing about "counting days," but only 1% knew how to do this. Only 6% had knowledge of contraception. About 75% came from low-income families. The average age of formal education was 6.2 years for participants and 6.8 years for controls. 68% were in school at the time of the pregnancy; 29% dropped out of school before the end of the pregnancy. 52% of the male partners were of low socioeconomic status. 61% of pregnant girls lived with both real parents. 6% reported wanting to become pregnant. 67% of male partners had a negative reaction to the pregnancy; 16% rejected the pregnancy. 63% of mothers agreed to care for the baby while their daughters returned to school. The control group appears to have had stronger responses to avoid sexual encounters. Traditional social control has been replaced by "ignorance and secrecy." There has been a breakdown in the means of acquiring information about healthy reproduction and about birth control.